Ertapenem
INVANZ
What it isCarbapenem inhibiting penicillin-binding proteins; intra-abdominal, urinary, and skin infections.
Why this oneOnce-daily administration makes it the carbapenem best suited to outpatient IV therapy.
What limits it⚑ It lacks Pseudomonas, Acinetobacter, and Enterococcus coverage; renal accumulation can provoke seizures.
FDA-approved for
- serious infections (2001)
FDA label
Read the full label on DailyMed ↗
| FDA dosing | Population | Start | Target | Max |
|---|---|---|---|---|
| Treatment of susceptible infections | Adults & peds >=13 y | 1 g QD IV/IM | 1 g QD IV/IM | 1 g QD |
| Treatment of susceptible infections | Peds 3 months-12 y | 15 mg/kg BID (max 1 g/day) IV/IM | 15 mg/kg BID | 1 g/day |
| Prophylaxis, elective colorectal surgery | Adults | 1 g single dose 1 h pre-op | 1 g single dose | 1 g single dose |
Renal Dose adjustment necessary if CrCl <=30 mL/min/1.73m2 and for hemodialysis
Hepatic Undefined
Do not mix or co-infuse with other medications; do not use dextrose-containing diluents
Instructions
- Infuse IV over 30 minutes
- IV up to 14 days; IM up to 7 days
- Reconstitute IM with lidocaine HCl diluent
Contraindications
- Anaphylactic reactions to beta-lactams; hypersensitivity to other drugs in the same class
- IM use: known hypersensitivity to amide-type local anesthetics (lidocaine diluent)
Cautions
- Serious hypersensitivity/anaphylactic reactions
- Seizures and CNS adverse effects (esp. renal impairment/CNS disorders)
- Reduces valproic acid levels — risk of breakthrough seizures
- C. difficile-associated diarrhea
- IM: avoid inadvertent intravascular injection
Adverse reactions
- Diarrhea
- Nausea
- Headache
- Infused vein complication
- Vaginitis
- Peds: vomiting, infusion site pain
Pregnancy Insufficient human data; no developmental malformations in animal studies
Lactation Present in human milk at low levels; weigh benefits and risks
NO BOXED WARNINGS
Principal riskNo pseudomonal or enterococcal cover
Cost, est. cash$20–$1,500/dose or month
Generic entry2018
Classes and tags
Clinical profile
Legacy pregnancy categoryB
Defining liabilityAllergy, gastrointestinal effects and agent-specific renal, hepatic, hematologic or interaction risks.
Mechanism of action: Ertapenem ballicule
