Primaxin IV Side Effects
Generic name: cilastatin / imipenem
Medically reviewed by Drugs.com. Last updated on Aug 31, 2024.
Note: This document provides detailed information about Primaxin IV Side Effects associated with cilastatin / imipenem. Some dosage forms listed on this page may not apply specifically to the brand name Primaxin IV.
Applies to cilastatin / imipenem: powder for solution.
Serious side effects of Primaxin IV
Along with its needed effects, cilastatin / imipenem may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor immediately if any of the following side effects occur while taking cilastatin / imipenem:
More common side effects
- confusion
- convulsions (seizures)
- dizziness
- pain at place of injection
- skin rash, hives, itching, fever, or wheezing
- tremors
Less common side effects
- dizziness
- increased sweating
- nausea or vomiting
- unusual tiredness or weakness
Rare side effects
- fever
- severe abdominal or stomach cramps and pain
- watery and severe diarrhea, which may also be bloody (these side effects may also occur up to several weeks after you stop receiving this medicine)
Other side effects of Primaxin IV
Some side effects of cilastatin / imipenem may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects.
Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:
More common side effects
- diarrhea
- nausea and vomiting
For healthcare professionals
Applies to cilastatin / imipenem: injectable powder for injection, intramuscular powder for injection, intravenous powder for injection.
Local adverse events
- Common (1% to 10%): Phlebitis/thrombophlebitis at the injection site
- Uncommon (0.1% to 1%): Pain at the injection site, erythema at the injection site, vein induration, local pain and induration at the injection site
- Frequency not reported: Infused vein infection, injection site irritation, injection site reaction[Ref]
Gastrointestinal
- Common (1% to 10%): Nausea, vomiting, diarrhea
- Rare (0.01% to 0.1%): Pseudomembranous colitis
- Very rare (less than 0.01%): Hemorrhagic colitis, gastroenteritis, abdominal pain, glossitis, tongue papillar hypertrophy, heartburn, increased salivation
- Frequency not reported: Clostridium difficile-associated diarrhea, oral candidiasis, constipation
- Postmarketing reports: Staining of the teeth and/or tongue[Ref]
Drug-related nausea and/or vomiting appeared to occur more often in granulocytopenic patients than in nongranulocytopenic patients.[Ref]
Dermatologic
- Common (1% to 10%): Rash (e.g., exanthematous)
- Uncommon (0.1% to 1%): Pruritus, urticaria
- Rare (0.01% to 0.1%): Erythema multiforme, angioedema/angioneurotic edema, exfoliative dermatitis
- Very rare (less than 0.01%): Hyperhidrosis, skin texture changes, candidiasis
- Postmarketing reports: Stevens-Johnson syndrome, toxic epidermal necrolysis
Beta-lactams:
- Frequency not reported: Severe cutaneous adverse reactions (including Stevens-Johnson syndrome, toxic epidermal necrolysis, drug reaction with eosinophilia and systemic symptoms [DRESS], acute generalized exanthematous pustulosis)[Ref]
Hematologic
- Common (1% to 10%): Eosinophilia
- Uncommon (0.1% to 1%): Thrombocytosis, positive Coombs test, prolonged prothrombin time, decreased hemoglobin
- Frequency not reported: Increased eosinophils, increased WBC, increased platelets, decreased hemoglobin and hematocrit, increased monocytes, abnormal prothrombin time, increased lymphocytes, increased basophils, decreased neutrophils, increased/decreased platelet count, increased/decreased hematocrit, anemia
- Postmarketing reports: Pancytopenia, bone marrow depression, neutropenia, thrombocytopenia, leukopenia, hemolytic anemia, agranulocytosis[Ref]
Hepatic
- Common (1% to 10%): Increased serum transaminases
- Uncommon (0.1% to 1%): Increased bilirubin
- Frequency not reported: Elevated ALT, elevated AST, increased/decreased bilirubin
- Postmarketing reports: Hepatitis (including fulminant hepatitis), jaundice, hepatic failure[Ref]
Other
- Common (1% to 10%): Increased alkaline phosphatase
- Uncommon (0.1% to 1%): Fever
- Very rare (less than 0.01%): Flushing, asthenia/weakness
- Frequency not reported: Increased LDH, decreased serum sodium, increased potassium, increased chloride, facial edema, pain, superinfection
- Postmarketing reports: Drug fever[Ref]
Nervous system
- Uncommon (0.1% to 1%): Seizures, myoclonic activity, dizziness, somnolence
- Rare (0.01% to 0.1%): Encephalopathy, paresthesia, focal tremor, hearing loss
- Very rare (less than 0.01%): Exacerbation of myasthenia gravis, headache, vertigo, tinnitus
- Frequency not reported: Myoclonus
- Postmarketing reports: Tremor, dyskinesia, taste perversion[Ref]
Cardiovascular
- Uncommon (0.1% to 1%): Hypotension
- Very rare (less than 0.01%): Palpitations, tachycardia, cyanosis[Ref]
Psychiatric
- Uncommon (0.1% to 1%): Confusion
- Postmarketing reports: Psychic disturbances (including hallucinations), agitation
Renal
- Uncommon (0.1% to 1%): Increased BUN, increased creatinine
- Rare (0.01% to 0.1%): Oliguria/anuria
- Postmarketing reports: Acute renal failure[Ref]
Genitourinary
- Rare (0.01% to 0.1%): Polyuria
- Very rare (less than 0.01%): Pruritus vulvae
- Frequency not reported: Presence of urine protein, presence of urine red blood cells, presence of urine white blood cells, presence of urine casts, presence of urine bilirubin, presence of urine urobilinogen, increased urine protein, presence of urine bacteria
- Postmarketing reports: Urine discoloration[Ref]
Hypersensitivity
- Rare (0.01% to 0.1%): Anaphylactic reactions
Beta-lactams:
- Frequency not reported: Hypersensitivity (anaphylactic) reactions[Ref]
Respiratory
- Very rare (less than 0.01%): Chest discomfort, dyspnea, hyperventilation, pharyngeal pain[Ref]
Musculoskeletal
- Very rare (less than 0.01%): Polyarthralgia, thoracic spine pain[Ref]
References
1. (2002) "Product Information. Primaxin (imipenem)." Merck & Co., Inc
2. Embil JM, Soto NE, Melnick DA (2006) "A post hoc subgroup analysis of meropenem versus imipenem/cilastatin in a multicenter, double-blind, randomized study of complicated skin and skin-structure infections in patients with diabetes mellitus." Clin Ther, 28, p. 1164-74
3. Zhanel GG, Wiebe R, Dilay L, et al. (2007) "Comparative Review of the Carbapenems." Drugs, 67, p. 1027-1052
4. Calandra GB, Hesney M, Grad C (1984) "A multiclinic randomized study of the comparative efficacy, safety and tolerance of imipenem/cilastatin and moxalactam." Eur J Clin Microbiol, 3, p. 478-87
5. Wang C, Calandra GB, Aziz MA, Brown KR (1985) "Efficacy and safety of imipenem/cilastatin: a review of worldwide clinical experience." Rev Infect Dis, 7, s528-36
6. Lyon JA (1985) "Imipenem/cilastatin: the first carbapenem antibiotic." Drug Intell Clin Pharm, 19, p. 894-8
7. Calandra GB, Brown KR, Grad LC, et al. (1985) "Review of adverse experiences and tolerability in the first 2,516 patients treated with imipenem/cilastatin." Am J Med, 78, p. 73-8
8. Young K (1986) "Imipenem/cilastatin." Pharm Ther Forum, 34, p. 1-3
9. Clissold SP, Todd PA, Campoli-Richards DM (1987) "Imipenem/cilastatin: a review of its antibacterial activity, pharmacokinetic properties and therapeutic efficacy." Drugs, 33, p. 185-241
10. Patel SA, Braun HL, Fine MS, et al. (1989) "Imipenem-associated elevation of amylase and lipase." Am J Gastroenterol, 84, p. 80-1
11. Schmitt DV, Leitner E, Welte T, Lode H (2006) "Piperacillin/Tazobactam vs Imipenem/Cilastatin in the Treatment of Nosocomial Pneumonia-a Double Blind Prospective Multicentre Study." Infection, 34, p. 127-34
12. Rivera M, Crespo M, Teruel JL, Marcen R, Ortuno J (1999) "Neurotoxicity due to imipenem/cilastatin in patients on continuous ambulatory peritoneal dialysis." Nephrol Dial Transplant, 14, p. 258-9
13. Chastre J, Wunderink R, Prokocimer P, Lee M, Kaniga K, Friedland I (2008) "Efficacy and safety of intravenous infusion of doripenem versus imipenem in ventilator-associated pneumonia: a multicenter, randomized study." Crit Care Med, 36, p. 1089-96
14. Larsen JW, Gabel-Hughes K, Kreter B (1992) "Efficacy and tolerability of imipenem-cilastatin versus clindamycin + gentamicin for serious pelvic infections." Clin Ther, 14, p. 90-6
15. Semel JD, Allen N (1991) "Seizures in patients simultaneously receiving theophylline and imipenem or ciprofloxacin or metronidazole." South Med J, 84, p. 465-8
16. Zazgornik J, Schein W, Heimberger K, et al. (1986) "Potentiation of neurotoxic side effects by coadministration of imipenem to cyclosporine therapy in a kidney transplant recipient: synergism of side effects or drug." Clin Nephrol, 26, p. 265-6
17. Eng RH, Munsif AN, Yangco BG, et al. (1989) "Seizure propensity with imipenem." Arch Intern Med, 149, p. 1881-3
18. Job ML, Dretler RH (1990) "Seizure activity with imipenem therapy: incidence and risk factors." DICP, 24, p. 467-9
19. Duque A, Altimiras J, Garcia-Cases C, Vidal P (1991) "Vertigo caused by intravenous imipenem/cilastatin." DICP, 25, p. 1009
20. Leo RJ, Ballow CH (1991) "Seizure activity associated with imipenem use: clinical case reports and review of the literature." DICP, 25, p. 351-4
21. Oriordan J, Javed M, Doherty C, Hutchinson M (1994) "Worsening of myasthenia gravis on treatment with imipenem/cilastatin." J Neurol Neurosurg Psychiatry, 57, p. 383
22. Lane M, Kania D, Rapp RP (1996) "Seizures related to use of imipenem-cilastatin." Am J Health Syst Pharm, 53, p. 1605-6
23. Guglielmo BJ, Jacobs RA (1996) "Impact of dosage-monitoring system on frequency of seizures associated with imipenem-cilastatin." Am J Health Syst Pharm, 53, p. 2097-8
24. Guglielmo BJ, Jacobs RA (1996) "Impact of dosage-monitoring system on frequency of seizures associated with imipenem-cilastatin." Am J Health Syst Pharm, 53, p. 1097-8
25. Frucht S, Eidelberg D (1997) "Imipenem-induced myoclonus." Mov Disord, 12, p. 621-2
26. Campise M (1998) "Neurological complication during imipenem/cilastatin therapy in uraemic patients." Nephrol Dialysis Transplant, 13, p. 1895-6
27. Roberts JA, Lipman J (2006) "Antibacterial Dosing in Intensive Care : Pharmacokinetics, Degree of Disease and Pharmacodynamics of Sepsis." Clin Pharmacokinet, 45, p. 755-773
28. Hantson P, de Coninck B, Horn JL, Mahieu P (1991) "Immediate hypersensitivity to aztreonam and imipenem." Br Med J, 302, p. 294-5
29. Pleasants RA, Walker TR, Samuelson WM (1994) "Allergic reactions to parenteral beta-lactam antibiotics in patients with cystic fibrosis." Chest, 106, p. 1124-8
30. Romano A, Viola M, Gueant-Rodriguez RM, Gaeta F, Pettinato R, Gueant JL (2006) "Imipenem in patients with immediate hypersensitivity to penicillins." N Engl J Med, 354, p. 2835-7
More about Primaxin IV (cilastatin / imipenem)
- Check interactions
- Compare alternatives
- Pricing & coupons
- Dosage information
- During pregnancy
- Drug class: carbapenems
- En español
Patient resources
Other brands
Professional resources
Related treatment guides
Further information
Primaxin IV side effects can vary depending on the individual. Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.
Note: Medication side effects may be underreported. If you are experiencing side effects that are not listed, submit a report to the FDA by following this guide.