部份中文亚胺培南/西司他丁钠处方资料（仅供参考） 商品名：TIENAM(抗生素) 英文名：Imipenem, Cilastatin 中文名：亚胺培南/西司他丁钠 治疗类别名称 碳青霉烯类抗生素配方 藥理類別：imipenem and enzyme inhibitor 孕婦用藥分級 C 級： 在對照的動物研究試驗中顯示該藥學物對胚胎有不良反應（致畸胎性或殺胚胎性或其他），但未進行人體懷孕婦女研究；或者尚無對照的人體懷孕婦女或動物研究試驗。只有在可能的利益大於潛在的危險，才可使用此藥物。 結構式 Imipenem：(5R,6S)-3-[2-(aminomethylideneamino)ethylsulfanyl]-6-(1-hydroxyethyl)-7-oxo-1-azabicyclo[3.2.0]hept-2-ene-2-carboxylic acid Cilastatin：(Z)-7-[(2S)-2-amino-3-hydroxy-3-oxopropyl]sulfanyl-2-{[(1S)-2,2-dimethylcyclopropanecarbonyl]amino}hept-2-enoic acid UpToDate UpToDate 連結 藥理作用 TIENAM為強效之細菌細胞壁合成抑制劑，可有效地殺死(bactericidal)大多數之病源菌-格蘭氏陽性菌，格蘭氏陰性菌，嗜氧菌及厭氧菌。 適應症 對IMIPENEM具有感受性革蘭氏陰性菌、陽性菌感染症。 用法用量 Tienam之建議劑量係以所需之Imipenem量表示，其中含有等量之Cilastatin。 Tienam之每日總劑量及給藥途徑，需視其感染之種類及嚴重程度而定；其給藥間隔則視其病原菌感受性、腎功能及體重而定。常用劑量： 1. 輕度感染:每8小時一次,每次250mg。 2. 中度感染:每8小時一次,每次500mg。 3. 嚴重度感染:每8小時一次,每次500～1000mg。 副作用 偶有噁心、胃部不適、食慾不振、口渴、胸悶症狀，或BUN(血中尿蛋白)或 S-GOT，S-GPT，ALP，上昇的可能。 交互作用 Cyclosporine CNS side effects (eg, myoclonia, seizures) may be increased. Ganciclovir Generalized seizures may occur; avoid use. Probenecid Minimal increases in imipenem levels and half-life; do not give probenecid concurrently. Incompatibility Do not physically mix imipenem-cilastatin with other antibiotics. 禁忌 Tienam禁用於對該品任何成份過敏的病人。 給付規定 10.5.1.Imipenem + cilastatin（如Tienam）：(87/11/1、93/2/1、93/5/1、99/5/1) 1.經細菌培養證實有意義之致病菌且對其他抗微生物製劑均具抗藥性，而對carbapenem具有 感受性 (sensitivity)。 2.經細菌培養，發現有意義之致病菌對carbapenem及其他抗微生物製劑具有感受性，但病患 對其他抗微生物製劑過敏無其他藥物可供選用時。 3.臨床上為嚴重之細菌感染，且經其他廣效性的非第一線抗微生物製劑治療仍無法控制病情 者。 4.經感染症專科醫師會診，確認有感染症需使用者 (申報費用時需檢附會診紀錄及相關之病 歷資料)。(93/5/1) 注意事項 1.對β-Lactam (如Penicillins、Cephalosporins或Carbapenems)有過敏病史的患者，應小心使用。 2.患有中樞神經系統感染之孩童使用本藥後會有發生癲癇的危險，因此這類病患禁止使用本製劑。 3.Tienam不可以含乳酸鹽(Lactate)之稀釋液來調配。 4.配製後之溶液可置於室溫4小時，在冰箱中可保存24小時。 5.Tienam不可與其他種抗生素混合。 6.小兒及腎功能不健全的患者其劑量，請參閱藥品內頁說明書。 藥品保存方式 藥品應置於攝氏15 ~ 25度乾燥處所；如發生變質或過期，不可再使用。 imipenem and cilastatin (Primaxin IM, Primaxin IV) Brand Names: Primaxin IM, Primaxin IV What is imipenem and cilastatin (Primaxin IM, Primaxin IV)? Imipenem is an antibiotic that fights serious infections caused by bacteria. Cilastatin helps imipenem work more effectively by preventing the breakdown of the antibiotic in the kidneys. Imipenem and cilastatin is used to treat severe infections of the lower respiratory tract, skin, stomach, female reproductive organs, and other body systems. Imipenem and cilastatin may also be used for other purposes not listed here. What are the possible side effects of imipenem and cilastatin (Primaxin IM, Primaxin IV)? Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat. Call your doctor at once if you have a serious side effect such as: •fast or pounding heartbeats; •diarrhea that is watery or bloody; •confusion, tremors, hallucinations, seizure (convulsions); •feeling light-headed, fainting; •fever, chills, body aches, flu symptoms; •nausea, stomach pain, low fever, loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes); or •fever, sore throat, and headache with a severe blistering, peeling, and red skin rash. Less serious side effects may include: •pain, swelling, or redness where the medicine was injected; •mild nausea, vomiting, heartburn, or stomach pain; •sore throat; •vaginal itching or discharge; •mild skin rash or itching; •dizziness or tired feeling; •numbness or tingling; or •ringing in your ears. This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088. What is the most important information I should know about imipenem and cilastatin (Primaxin IM, Primaxin IV)? Do not use imipenem and cilastatin if you are allergic to it, if you have heart block, or if you are allergic to lidocaine or other local anesthetics (numbing medicine). Before using imipenem and cilastatin, tell your doctor if you have kidney disease (or if you are on dialysis), or a seizure disorder. Also tell your doctor if you are either allergic to or are currently taking a penicillin or cephalosporin antibiotic such as Amoxil, Augmentin, Bactocill, Beepen-VK, Ceclor, Ceftin, Duricef, Dycill, Dynapen, Keflex, Ledercillin VK, Omnipen, Pen-V, Pfizerpen, Principen, Veetids, and others. Primaxin IM (for the muscle) and Primaxin IV (for the vein) are different forms of this medicine and should be used only for their specific type of injection. Do not inject Primaxin IM into a vein and do not inject Primaxin IV into a muscle. Call your doctor at once if you have serious side effects such as pounding heartbeats, confusion, hallucinations, seizure (convulsions), feeling light-headed, fainting, flu symptoms, nausea, stomach pain, loss of appetite, dark urine, jaundice (yellowing of the skin or eyes), or a severe blistering, peeling, and red skin rash. Antibiotic medicines can cause diarrhea, which may be a sign of a new infection. If you have diarrhea that is watery or has blood in it, call your doctor. Do not use anti-diarrhea medicine unless your doctor tells you to. What should I discuss with my healthcare provider before use imipenem and cilastatin (Primaxin IM, Primaxin IV)? Do not use imipenem and cilastatin if you are allergic to it, if you have heart block, or if you are allergic to lidocaine or other local anesthetics (numbing medicine). If you have any of these other conditions, you may need a dose adjustment or special tests: •kidney disease (or if you are on dialysis); •epilepsy or other seizure disorder; •a history of allergy to penicillin antibiotics such as Amoxil, Augmentin, Omnipen, Principen, Dycill, Dynapen, Bactocill, Beepen-VK, Ledercillin VK, Pen-V, Pfizerpen, Veetids, and others; or •a history of allergy to cephalosporin antibiotics such as Ceclor, Ceftin, Duricef, Keflex, and others. FDA pregnancy category C. It is not known whether imipenem and cilastatin will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant while using this medication.. It is not known whether imipenem and cilastatin passes into breast milk or if it could harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby. How should I use imipenem and cilastatin (Primaxin IM, Primaxin IV)? Imipenem and cilastatin is injected into a vein (IV) or into a muscle (IM). Imipenem and cilastatin is usually given in a clinic or hospital setting. The IV medicine must be given as a slow infusion and can take up to an hour to complete. Tell your caregiver if you feel nauseated during the infusion. You may need to receive the medicine at a slower rate. The IM form of imipenem and cilastatin is given as a rapid injection into a muscle. You may be shown how to use injections at home. Do not self-inject this medicine if you do not fully understand how to give the injection and properly dispose of used needles and syringes. Primaxin IM (for the muscle) and Primaxin IV (for the vein) are different forms of this medicine and should be used only for their specific type of injection. Do not inject Primaxin IM into a vein and do not inject Primaxin IV into a muscle. Imipenem and cilastatin is usually given as long as needed until your infection has cleared or you have been symptom-free for at least 48 hours. Use this medication for the full prescribed length of time. Your symptoms may improve before the infection is completely cleared. Imipenem and cilastatin will not treat a viral infection such as the common cold or flu. Do not give this medication to another person, even if they have the same symptoms you do. Imipenem and cilastatin is a powder that must be mixed with a liquid (diluent). Primaxin IM and Primaxin IV are each mixed with different types of diluent. Prepare your dose in a syringe only when you are ready to give yourself an injection. After mixing Primaxin IV, you may keep it in a refrigerator and use it within 24 hours. You may also store the mixed IV medicine at room temperature if you use it within 4 hours. Store unmixed imipenem and cilastatin powder at room temperature away from moisture and heat. What happens if I miss a dose (Primaxin IM, Primaxin IV)? If imipenem and cilastatin is given in a hospital setting, it is not likely that you will miss a dose. If you are using the medication at home and you miss a dose, give the injection as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not use extra medicine to make up the missed dose. What happens if I overdose (Primaxin IM, Primaxin IV)? Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. Overdose symptoms may include weakness, drooping eyelid, tremors, trouble breathing, or seizure (black-out or convulsions). What should I avoid while using imipenem and cilastatin (Primaxin IM, Primaxin IV)? Antibiotic medicines can cause diarrhea, which may be a sign of a new infection. If you have diarrhea that is watery or has blood in it, call your doctor. Do not use anti-diarrhea medicine unless your doctor tells you to. What other drugs will affect imipenem and cilastatin (Primaxin IM, Primaxin IV)? Tell your doctor about all other medications you use, especially: •valproic acid (Depakene, Stavzor); •ganciclovir (Cytovene); •probenecid (Benemid); •a penicillin antibiotic such as amoxicillin (Amoxil, Augmentin), ampicillin (Omnipen, Principen), dicloxacillin (Dycill, Dynapen), oxacillin (Bactocill), or penicillin (Beepen-VK, Ledercillin VK, Pen-V, Pen-Vee K, Pfizerpen, V-Cillin K, Veetids, and others); or •a cephalosporin antibiotic such as cefaclor (Ceclor), cefuroxime (Ceftin), cefadroxil (Duricef), cephalexin (Keflex), and others. ---------------------------------------------- 产地国家：美国 原产地英文商品名: PRIMAXIN VIAL 500MG 20ML 25 原产地英文药品名: IMIPENEM/CILASTATIN SODIUM 中文参考商品译名: PRIMAXIN VIAL 500毫克 20毫升/瓶 25瓶/盒 中文参考药品译名: 亚胺培南/西司他丁钠 生产厂家英文名: MERCK SHARP & DOHME ---------------------------------------------- 产地国家：美国 原产地英文商品名: PRIMAXIN VIAL 250MG 10ML 25 原产地英文药品名: IMIPENEM/CILASTATIN SODIUM 中文参考商品译名: PRIMAXIN VIAL 250毫克 10毫升/瓶 25瓶/盒 中文参考药品译名: 亚胺培南/西司他丁钠 生产厂家英文名: MERCK SHARP & DOHME ---------------------------------------------- 产地国家：美国 原产地英文商品名: PRIMAXIN AVV 500MG 15ML 25 原产地英文药品名: IMIPENEM/CILASTATIN SODIUM 中文参考商品译名: PRIMAXIN AVV 250毫克/瓶 25瓶/盒 中文参考药品译名: 亚胺培南/西司他丁钠 生产厂家英文名: MERCK SHARP & DOHME  ---------------------------------------------- 产地国家：美国 原产地英文商品名: PRIMAXIN AVV 250MG 15ML 25 原产地英文药品名: IMIPENEM/CILASTATIN SODIUM 中文参考商品译名: PRIMAXIN AVV 500毫克/15毫升/瓶 25瓶/盒 中文参考药品译名: 亚胺培南/西司他丁钠 生产厂家英文名: MERCK SHARP & DOHME ---------------------------------------------- 产地国家：美国 原产地英文商品名: PRIMAXIN 500MG SDV PWD 25/PAC 原产地英文药品名: IMIPENEM/CILASTATIN SODIUM 中文参考商品译名: PRIMAXIN 500毫克/瓶 25瓶/盒 中文参考药品译名: 亚胺培南/西司他丁钠 生产厂家英文名: MERCK SHARP & DOHME CORP