Restricted
Hospital Formulary Status Yes (parenteral inj)
In-Hospital Cost will be updated
PharmaCare Formulary Status Yes (parenteral inj)
Special Authority None
PharmaCare Coverage 500mg powder for soln/inj - $40.0809/vial
Outpatient Cost 250mg powder for soln/inj - $12.68-13.95/vial 500mg powder for soln/inj - $47.39-52.13/vial
Restrictions Status: Yes (inj)
Restricted to:
1) Empiric therapy: Severe Gram-negative or polymicrobial infections in patients with risk factors for resistance, or when other antibiotics are contraindicated due to allergy or intolerance
OR
2) Empiric or directed therapy of Nocardia or non-tuberculous mycobacterial infections where indicated
OR
3) Directed therapy: Gram-negative or polymicrobial infections resistant to other antibiotics (e.g. ceftriaxone, fluoroquinolones, cotrimoxazole), or when other antibiotics are contraindicated due to allergy or intolerance.
Note: Pharmacists are NOT required to enforce compliance with new provincial ‘indication based’ restrictions at the time of order verification.
For additional assistance in optimizing this order, contact an Antimicrobial Stewardship pharmacist, medical microbiologist on call or an ID physician.
Acute liver injury (mainly with IV)
Neutropenia (mainly with IV)
Thrombocytopenia (mainly with IV)
Allergic interstitial nephritis (mainly with IV)
Pulmonary infiltrate with eosinophilia (PIE) syndrome (mainly with IV)
CNS toxicity (mainly with IV)
Allergic reaction (PO and IV)
Serum sickness (PO and IV)
Rash (PO and IV)
Note: EBV-related rash - not an allergy
May decrease serum concentrations of valproic acid.
May increase risk of seizures with ganciclovir, valganciclovir.
Cyclosporine may increase risk of seizures with imipenem.
Antimicrobial class: Carbapenem
Imipenem-cilastatin is the preferred carbapenem for polymicrobial infections where Enterococcus faecalis is prominent in culture.
Average serum half life: 1.0 hr
CSF penetration: yes, but meropenem preferred for CNS infections due to seizure risk with imipenem-cilastatin