Generic Name: Ertapenem Brand Name(s): Ertapenem.

Uses

What is Ertapenem used for?

Ertapenem is commonly used to prevent and treat a wide variety of bacterial infections. This medication is known as a carbapenem-type antibiotic. It works by stopping the growth of bacteria.

How should I take Ertapenem?

This medication is given by injection into a muscle or vein as directed by your doctor, usually once or twice daily. If you are using this medication to prevent an infection, it is given by injection into a vein by a health care professional. It is given as directed by your doctor, usually 1 hour before your surgery.

If this medication is given by injection into a muscle, follow the manufacturer’s directions for mixing with lidocaine 1 percent solution. Do not use this solution for injection into a vein.

If you are using this medication at home, learn all preparation and usage instructions from your health care professional. Before using, check this product visually for particles or discoloration. If either is present, do not use the liquid. Learn how to store and discard medical supplies safely.

The dosage is based on your medical condition and response to treatment. In children, the dosage is also based on age and weight.

For the best effect, use this antibiotic at evenly spaced times. To help you remember, use this medication at the same time(s) every day.

Continue to use this medication until the full prescribed treatment period is finished, even if symptoms disappear after a few days. Stopping the medication too early may result in a return of the infection.

Tell your doctor if your condition lasts or gets worse.

How do I store Ertapenem?

Prior to reconstitution, store vials at ≤25°C (77°F). The reconstituted IM solution should be used within 1 hour after preparation. The reconstituted IV solution may be stored at room temperature (25°C [77°F]) and used within 6 hours, or stored for 24 hours under refrigeration (5°C [41°F]) and used within 4 hours after removal from refrigeration. Do not freeze.

If you need to store this medicine at home, talk with your doctor, nurse, or pharmacist about how to store it.

Precautions & warnings

What should I know before using Ertapenem?

Before using ertapenem, tell your doctor or pharmacist if you are allergic to it; or to penicillins or cephalosporins; or if you have any other allergies. Before getting ertapenem by injection into a muscle, also tell your doctor or pharmacist if you are allergic to any amide-type local anesthetics (such as lidocaine). This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.

Before using this medication, tell your doctor or pharmacist your medical history, especially of: brain disorders (such as seizures, head injury, tumor), kidney disease, stomach/intestinal diseases (such as colitis).

Ertapenem may cause live bacterial vaccines (such as typhoid vaccine) to not work as well. Do not have any immunizations/vaccinations while using this medication unless your doctor tells you to.

Before having surgery, tell your doctor or dentist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products).

Tell your doctor if you are pregnant before using this medication.

This medication passes into breast milk. Consult your doctor before breast-feeding.

Is it safe during pregnancy or breast-feeding?

There are no adequate studies in women for determining risk when using this Ertapenem during pregnancy or while breastfeeding. Please always consult with your doctor to weigh the potential benefits and risks before taking Ertapenem. Ertapenem is pregnancy risk category B according to the US Food and Drug Administration (FDA).

FDA pregnancy risk category reference below:

  • A=No risk,
  • B=No risk in some studies,
  • C=There may be some risk,
  • D=Positive evidence of risk,
  • X=Contraindicated,
  • N=Unknown

Side effects

What side effects can occur from Ertapenem?

Swelling, redness, pain, or soreness at the injection site may occur. Upset stomach, headache, nausea, vomiting, or diarrhea may also occur. If any of these effects last or get worse, tell your doctor or pharmacist promptly.

Remember that your doctor has prescribed this medication because he or she has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.

Get medical help right away if you have any very serious side effects, such as: seizures, unusual weakness.

This medication may rarely cause a severe intestinal condition (Clostridium difficile-associated diarrhea) due to a type of resistant bacteria. This condition may occur during treatment or weeks to months after treatment has stopped. Tell your doctor right away if you develop: diarrhea that doesn’t stop, abdominal or stomach pain/cramping, blood/mucus in your stool.

Do not use anti-diarrhea products or narcotic pain medications if you have any of these symptoms because these products may make them worse.

Use of this medication for prolonged or repeated periods may result in oral thrush or a new yeast infection. Contact your doctor if you notice white patches in your mouth, a change in vaginal discharge, or other new symptoms.

A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, such as: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.

Not everyone experiences these side effects. There may be some side effects not listed above. If you have any concerns about a side-effect, please consult your doctor or pharmacist.

Interactions

What drugs may interact with Ertapenem?

Some products that may interact with this drug include: valproic acid and related drugs (such as divalproex sodium, sodium valproate).

Although most antibiotics are unlikely to affect hormonal birth control such as pills, patch, or ring, a few antibiotics (such as rifampin, rifabutin) can decrease their effectiveness. This could result in pregnancy. If you use hormonal birth control, ask your doctor or pharmacist for more details.

Ertapenem may interact with other drugs that you are currently taking, which can change how your drug works or increase your risk for serious side effects. To avoid any potential drug interactions, you should keep a list of all the drugs you are using (including prescription drugs, nonprescription drugs and herbal products) and share it with your doctor and pharmacist. For your safety, do not start, stop, or change the dosage of any drugs without your doctor’s approval.

Does food or alcohol interact with Ertapenem?

Ertapenem may interact with food or alcohol by altering the way the drug works or increase the risk for serious side effects. Please discuss with your doctor or pharmacist any potential food or alcohol interactions before using this drug.

What health conditions may interact with Ertapenem?

Ertapenem may interact with your health condition. This interaction may worsen your health condition or alter the way the drug works. It is important to always let your doctor and pharmacist know all the health conditions you currently have.

Dosage

The information provided is not a substitute for any medical advice. You should ALWAYS consult with your doctor or pharmacist before using this Ertapenem.

What is the dose of Ertapenem for an adult?

Usual Adult Dose for Intraabdominal Infection

Complicated: 1 gram IV or IM once daily for 5 to 14 days

Usual Adult Dose for Pelvic Infections

1 gram IV or IM once daily for 3 to 10 days

Usual Adult Dose for Pneumonia

Community-acquired: 1 gram IV or IM once daily

The recommended total duration of antibiotic treatment is 10 to 14 days, which includes a possible conversion to oral therapy after at least 3 days of parenteral therapy and once clinical improvement occurs.

Usual Adult Dose for Pyelonephritis

1 gram IV or IM once daily

The recommended total duration of antibiotic treatment is 10 to 14 days, which includes a possible conversion to oral therapy after at least 3 days of parenteral therapy and once clinical improvement occurs.

Usual Adult Dose for Skin or Soft Tissue Infection

Complicated: 1 gram IV or IM once daily for 7 to 14 days

The recommended total duration of antibiotic treatment for diabetic foot infections without osteomyelitis is up to 28 days, which includes a possible conversion to oral therapy.

Usual Adult Dose for Urinary Tract Infection

Complicated: 1 gram IV or IM once daily

The recommended total duration of antibiotic treatment is 10 to 14 days, which includes a possible conversion to oral therapy after at least 3 days of parenteral therapy and once clinical improvement occurs.

Usual Adult Dose for Infection Prophylaxis

Prophylaxis of surgical site infection following elective colorectal surgery: 1 gram IV one time, one hour prior to surgical incision

Renal Dose Adjustments

CrCl 30 mL/min or less:

Adult: 500 mg IV once daily

Pediatric: Data not available

Renal function should be monitored, especially in elderly patients.

Liver Dose Adjustments

No adjustment recommended

Precautions

Intramuscular administration is contraindicated in patients with amide anesthetic hypersensitivity.

Serious and occasionally fatal hypersensitivity reactions have been reported with antibiotics. The drug should be discontinued immediately at the first appearance of a skin rash or other signs of hypersensitivity. Severe, acute hypersensitivity reactions may require treatment with epinephrine and other resuscitative measures including oxygen, intravenous fluids, antihistamines, corticosteroids, cardiovascular support and airway management as clinically indicated.

Clostridium difficile associated diarrhea (CDAD) has been reported with almost all antibiotics and may potentially be life-threatening. Therefore, it is important to consider this diagnosis in patients who present with diarrhea following ertapenem therapy. Mild cases generally improve with discontinuation of the drug, while severe cases may require supportive therapy and treatment with an antimicrobial agent effective against C difficile. Hypertoxin producing strains of C difficile cause increased morbidity and mortality; these infections can be resistant to antimicrobial treatment and may necessitate colectomy.

Ertapenem has been associated with seizures and other CNS side effects such as confusion, most commonly in patients with CNS disorders such as brain lesions, history of seizures, bacterial meningitis, or renal impairment. Recommended dosages should not be exceeded, especially in patients with risk factors. Neurologic evaluation, anticonvulsant therapy, and ertapenem dosage adjustment or discontinuation are recommended for patients who experience tremors, myoclonus or seizures.

Periodic renal, hepatic and hematopoietic monitoring is recommend during prolonged therapy.

Efficacy and safety have not been established in patients less than 3 months of age. Ertapenem is not recommended in the treatment of meningitis in pediatric patients due to insufficient CSF penetration.

Dialysis

For hemodialysis patients, the recommended dose is 500 mg IV once daily, given at least 6 hours before hemodialysis. If administered within 6 hours before hemodialysis, a supplementary dose of 150 mg is recommended after the hemodialysis session.

There are no data regarding peritoneal dialysis or hemofiltration.

Other Comments

Intravenous ertapenem doses should be infused over 30 minutes.

Alternatively, ertapenem may be given by intramuscular injection for up to 7 days, where appropriate. The intravenous route is preferred for severe or life-threatening infections and for patients with reduced resistance (i.e., malnutrition, trauma, surgery, heart failure, malignancy, or shock).

What is the dose of Ertapenem for a child?

Usual Pediatric Dose for Intraabdominal Infection

Complicated infection:

3 months to 12 years: 15 mg/kg IV or IM every 12 hours

Maximum dose: 1 g/day

13 years or older: 1 gram IV or IM once daily

Duration: 5 to 14 days

Usual Pediatric Dose for Pelvic Infections

3 months to 12 years: 15 mg/kg IV or IM every 12 hours

Maximum dose: 1 g/day

13 years or older: 1 gram IV or IM once daily

Duration: 3 to 10 days

Usual Pediatric Dose for Pneumonia

Community-acquired:

3 months to 12 years: 15 mg/kg IV or IM every 12 hours

Maximum dose: 1 g/day

13 years or older: 1 gram IV or IM once daily

Duration: 10 to 14 days

Usual Pediatric Dose for Pyelonephritis

3 months to 12 years: 15 mg/kg IV or IM every 12 hours

Maximum dose: 1 g/day

13 years or more: 1 gram IV or IM once daily

Duration: 10 to 14 days

Usual Pediatric Dose for Skin or Soft Tissue Infection

Complicated:

3 months to 12 years: 15 mg/kg IV or IM every 12 hours

Maximum dose: 1 g/day

13 years or older: 1 gram IV or IM once daily

Duration: 7 to 14 days

Usual Pediatric Dose for Urinary Tract Infection

Complicated:

3 months to 12 years: 15 mg/kg IV or IM every 12 hours

Maximum dose: 1 g/day

13 years or more: 1 gram IV or IM once daily

Duration: 10 to 14 days

How is Ertapenem available?

Ertapenem is available in the following dosage forms and strengths:

  • Injectable powder for injection

What should I do in case of an emergency or overdose?

In case of an emergency or an overdose, call your local emergency services or go to your nearest emergency room.

What should I do if I miss a dose?

If you miss a dose of Ertapenem, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and take your regular dose as scheduled. Do not take a double dose.

Hello Health Group does not provide medical advice, diagnosis or treatment.

Sources

Review Date: January 29, 2018 | Last Modified: January 29, 2018

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