Vexpinem 500 Dosage/Direction for Use

For intravenous administration only.
The dosage of Imipenem/Cilastatin should be based on the type or severity of infection, consideration of degree of susceptibility of the pathogen(s), renal function and bodyweight. The total daily requirement should be given in equally divided doses.
For instructions on dilution of the medicinal product enclosed.
The dosage recommendations that follow specify the amounts of imipenem to be given. One vial of Imipenem/Cilastatin 500 mg/500 mg provides the equivalent of 500 mg imipenem and 500 mg cilastatin.
Adults: Doses cited are based on a bodyweight of ≥70 kg. The usual adult daily dosage is 1.5-2 g administered in 3-4 equally divided doses (see Table 1 as follows). In infections due to less sensitive organisms, the daily dose may be increased to a maximum dose of 50 mg/kg/day (not exceeding 4 g daily).
Usual adult intravenous dosage: Each dose of 250 mg or 500 mg should be given by intravenous infusion over 20-30 minutes. Each dose of 1000 mg should be infused over 40-60 minutes. In patients who develop nausea during infusion, the infusion rate may be slowed.
IV administration: See Table 1.

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Use in elderly patients: Age does not usually affect the tolerability and efficacy of imipenem/cilastatin.
In patients with renal insufficiency: As in patients with normal renal function, dosing is based on the severity of the infection. The dosage for patients with various degrees of renal functional impairment is shown in the following table. Doses cited are based on a bodyweight of 70 kg. Proportionate reduction in dose administered should be made for patients with lower bodyweight.
Maximum dosage in relation to renal function: See Table 2.

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Patients with a creatinine clearance of 5 mL/min should not receive imipenem/cilastatin unless haemodialysis is started within 48 hours. Imipenem/cilastatin is cleared by haemodialysis. The patient should receive imipenem/cilasatin immediately after haemodialysis and at 12-hourly intervals thereafter. Dialysis patients, especially those with background CNS disease, should be carefully monitored. Patients on haemodialysis should receive imipenem/cilastatin only when the benefit outweighs the potential risk of convulsions. There are currently inadequate data to recommend the use of imipenem/cilastatin for patients on peritoneal dialysis.
Paediatric dosage: See Table 3.

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The maximum daily dose should not exceed 2 g.
Children and adolescents over 40 kg bodyweight should be dosed as adults.
Clinical data are insufficient to recommend an optimal dose for children under 3 years of age or infants and children with impaired renal function (serum creatinine >177 µmol/l).
Imipenem/cilastatin is not recommended for treatment of meningitis. If meningitis is suspected an appropriate agent should be used.