Cilastat Injection: A Comprehensive Guide to Uses, Side Effects, and Safety
Clinical Reference Standards: CDSCO (Central Drugs Standard Control Organisation), Indian Pharmacopoeia (IP) & WHO | Last Updated: September 2026
When to Call Your Doctor IMMEDIATELY
- Difficulty breathing or swelling of the face, lips, or throat
- Severe rash with blistering or peeling skin
- Seizures or convulsions
- Severe, persistent diarrhea that may contain blood or mucus
- Decreased urine output or swelling in the legs
- Yellowing of the skin or eyes
- Unusual bleeding or bruising
- High fever with chills that does not improve
If experiencing severe symptoms, call emergency services immediately.
What is cilasimune injection used for?
This medicine is a combination antibiotic containing imipenem and cilastatin, given intravenously to treat serious bacterial infections. It works by killing bacteria and protecting the antibiotic from being broken down in the kidneys.
- Generic Name: Imipenem + Cilastatin
- Manufacturer: Kinedex Healthcare Pvt Ltd
- Form: Allopathy
- Pregnancy Category: Consult doctor
- Prescription Required: Yes
🇮🇳 cilasimune injection के बारे में (Hindi Summary)
उपयोग: यह दवा एक शक्तिशाली एंटीबायोटिक है जिसे इमिपेनम और सिलास्टेटिन के संयोजन से बनाया गया है। यह गंभीर बैक्टीरियल संक्रमणों के इलाज के लिए नस के माध्यम से दी जाती है। इसका उपयोग पेट के अंदर के गंभीर संक्रमण, निमोनिया, मूत्र मार्ग के संक्रमण, त्वचा के संक्रमण और रक्त के संक्रमण के लिए किया जाता है। यह दवा अस्पताल में डॉक्टर की देखरेख में ही दी जाती है।
साइड इफेक्ट्स: इस दवा के सामान्य दुष्प्रभावों में मतली, उल्टी, दस्त, चकत्ते और इंजेक्शन की जगह पर दर्द शामिल हैं। गंभीर दुष्प्रभावों में एलर्जी, दौरे, गुर्दे की समस्या और लीवर की समस्या हो सकती है। यदि आपको सांस लेने में कठिनाई, चेहरे या गले में सूजन, या गंभीर दस्त हो तो तुरंत डॉक्टर से संपर्क करें।
सुरक्षा सलाह: यह दवा केवल अस्पताल में डॉक्टर या नर्स द्वारा ही दी जानी चाहिए। इसे स्वयं न लें। इस दवा को लेने से पहले अपने डॉक्टर को अपनी सभी चिकित्सीय स्थितियों और दवाओं के बारे में बताएं। गुर्दे की कार्यप्रणाली की निगरानी की जाएगी। यदि आपको एलर्जी के लक्षण दिखें तो तुरंत मदद लें। इलाज के दौरान शराब न पिएं। गर्भवती या स्तनपान कराने वाली महिलाएं डॉक्टर से सलाह लें।
💊 cilasimune injection Uses & Benefits
[{"condition":"Complicated intra-abdominal infections","description":"Used to treat severe infections within the abdominal cavity, such as peritonitis, abscesses, and appendicitis with rupture, often caused by mixed aerobic and anaerobic bacteria.","evidence":"Well-established"},{"condition":"Severe pneumonia","description":"Effective against hospital-acquired and ventilator-associated pneumonia caused by susceptible gram-negative and gram-positive bacteria.","evidence":"Well-established"},{"condition":"Complicated urinary tract infections","description":"Treats serious kidney and urinary tract infections, including pyelonephritis, especially those caused by multidrug-resistant organisms.","evidence":"Well-established"},{"condition":"Skin and soft tissue infections","description":"Used for severe skin infections such as necrotizing fasciitis, complicated cellulitis, and diabetic foot infections.","evidence":"Well-established"},{"condition":"Bloodstream infections","description":"Treats bacteremia and sepsis caused by susceptible organisms, including those resistant to other antibiotics.","evidence":"Well-established"},{"condition":"Surgical prophylaxis","description":"May be used to prevent infections in certain high-risk surgical procedures, particularly colorectal surgery.","evidence":"Established"}]
Off-label uses: [{"condition":"Febrile neutropenia","description":"Sometimes used as empiric therapy in cancer patients with low white blood cell counts and fever, though other agents are often preferred.","evidence":"Limited"},{"condition":"Melioidosis","description":"May be used in the treatment of melioidosis, a bacterial infection caused by Burkholderia pseudomallei, in certain clinical scenarios.","evidence":"Limited"}]
Primary treatment for: Serious bacterial infections
Also treats: Complicated intra-abdominal infections, Severe pneumonia, Complicated urinary tract infections, Skin and soft tissue infections, Bloodstream infections
📋 Drug Information
| Generic Name(s) | Imipenem + Cilastatin |
| Brand Name | Avim C 500mg/500mg Injection |
| Manufacturer | Kinedex Healthcare Pvt Ltd |
| Packaging / Form | Varies by brand (Allopathy) |
| Therapeutic Class | ANTI INFECTIVES |
| Action Class | Carbapenem antibiotic with renal dehydropeptidase inhibitor |
| Route of Administration | Intravenous (IV) infusion over 20-30 minutes |
| Storage | Store the unreconstituted vial at 20-25°C (68-77°F). After reconstitution, the solution should be used immediately or stored as per manufacturer's instructions. Do not freeze. |
| Shelf Life | Typically 24 months from the date of manufacture. Refer to the product label for exact expiry date. |
| WHO Guideline | Not established from the available information. |
| ICMR Guideline | Not established from the available information. |
👨⚕️ Doctor's Practical Tips
Evidence-based practical advice from experienced clinicians
🔍 Is This Medicine Right for Your Symptom?
Educational reference. Always consult a doctor for diagnosis.
🔬 How This Medicine Works (Pharmacology)
Pharmacokinetics
How It Works
This medicine combines two active substances: imipenem and cilastatin. Imipenem is a carbapenem antibiotic that exerts its bactericidal effect by inhibiting bacterial cell wall synthesis. It binds to penicillin-binding proteins (PBPs), particularly PBP-2 and PBP-1a/1b, which are enzymes involved in the cross-linking of peptidoglycan chains in the bacterial cell wall. This inhibition leads to weakened cell walls and ultimately bacterial lysis and death. Imipenem has a broad spectrum of activity against many gram-positive and gram-negative aerobic and anaerobic bacteria. Cilastatin is a renal dehydropeptidase inhibitor that blocks the enzyme dehydropeptidase-I in the kidneys, which normally metabolizes imipenem. By inhibiting this enzyme, cilastatin increases the urinary recovery of imipenem and reduces its potential nephrotoxicity, allowing imipenem to exert its full antibacterial effect without being rapidly degraded.
Mechanism Steps
💡 How to Take cilasimune injection
Strength: 500 mg vial for intravenous infusion.
Dosage Information
| Adult Dosage | The usual adult dose of this medicine is 500 mg intravenously every 6 to 8 hours, depending on the severity and type of infection. For severe infections, the dose may be increased to 1 gram every 6 to 8 hours. The maximum daily dose is 4 grams. Dose must be individualized by a qualified clinician based on indication, age, weight, renal and hepatic function. In patients with renal impairment, dose reduction is required. Treatment duration varies from 5 to 14 days or longer based on clinical response. |
| Pediatric Dosage | Pediatric dosing is not established from available information. Consult a pediatrician. For children over 3 months, doses are typically based on weight and severity of infection, but must be determined by a pediatrician. |
| Elderly Dosage | Elderly patients may have decreased renal function, which can increase the risk of toxicity. Dose should be adjusted based on creatinine clearance. Monitor renal function closely. |
| Renal Impairment | Dose adjustment is required in patients with renal impairment. For creatinine clearance (CrCl) 60-90 mL/min, usual dose; CrCl 30-59 mL/min, 500 mg every 8 hours; CrCl 15-29 mL/min, 500 mg every 12 hours; CrCl <15 mL/min, 500 mg every 24 hours (or as guided by levels). For patients on hemodialysis, dose after dialysis. Always consult a clinician for precise dosing. |
| Hepatic Impairment | No specific dose adjustment is recommended for hepatic impairment alone. However, monitor liver function tests during therapy. |
| Maximum Daily Dose | The maximum recommended daily dose is 4 grams (4000 mg) per day, administered in divided doses. |
Dosage Timeline
⏰ What to Do If You Miss a Dose
⚠️ Side Effects of cilasimune injection
✅ Common Side Effects
🚨 Serious Side Effects
⚠️ Rare Side Effects
Consult your doctor if you experience any unusual symptoms.
🔬 Drug Interactions
| Drug | Severity | Effect |
|---|---|---|
| Ganciclovir | Major | |
| Valproic acid | Major | |
| Probenecid | Major | |
| Cyclosporine | Moderate | |
| Aminoglycosides | Moderate | |
| Warfarin | Moderate | |
| Oral contraceptives | Minor | |
| Live vaccines | Minor |
🚨 Major Interactions
- Ganciclovir
- Valproic acid
- Probenecid
⚡ Moderate Interactions
- Cyclosporine
- Aminoglycosides
- Warfarin
🍷 Alcohol Interaction
Alcohol may increase the risk of certain side effects such as nausea, vomiting, and dizziness. It is advisable to avoid alcohol while receiving this medicine and until treatment is completed.
🔎 Check Your Other Medicines
Educational tool. Always confirm with your doctor or pharmacist.
🛡️ Safety & Warnings
🚫 Contraindications
["Known hypersensitivity to imipenem, cilastatin, or other carbapenem antibiotics.","Severe allergic reaction to penicillins or cephalosporins (cross-reactivity may occur).","Concurrent use with ganciclovir (increased risk of seizures).","Patients with a history of seizures or CNS disorders (use with caution)."]
⚠️ Warnings & Precautions
["Serious allergic reactions, including anaphylaxis, have been reported. Discontinue immediately if allergic reaction occurs.","Seizures have been reported, particularly in patients with renal impairment or CNS disorders. Adjust dose in renal impairment.","Clostridioides difficile-associated diarrhea may occur. Evaluate if diarrhea develops.","Prolonged use may lead to overgrowth of non-susceptible organisms, including fungi.","Use with caution in patients with renal impairment; dose adjustment required.","May cause false-positive results in certain urine glucose tests.","Safety and efficacy in children under 3 months not established.","Elderly patients may have reduced renal function; dose adjustment may be needed."]
🤱 Lactation Safety
Imipenem and cilastatin are excreted in human milk in low amounts. Because of the potential for serious adverse reactions in nursing infants, a decision should be made whether to discontinue nursing or to discontinue the drug, taking into account the importance of the drug to the mother.
💊 Overdose Management
Overdose with this medicine is unlikely due to its intravenous administration in a controlled setting. In case of overdose, discontinue infusion and provide supportive care. Imipenem and cilastatin can be removed by hemodialysis. Monitor vital signs and renal function. Contact a poison control center for guidance.
⏰ Missed Dose
Since this medicine is administered by a healthcare professional, missed doses are unlikely. If a dose is missed, it should be given as soon as possible. However, if it is almost time for the next dose, skip the missed dose and continue with the regular schedule. Do not double the dose to catch up.
Additional Safety Advice
This medicine must only be administered by a qualified healthcare professional in a hospital or clinic setting. Do not attempt to self-administer. Before receiving this medicine, inform your doctor about all your medical conditions, especially kidney disease, seizures, or allergies to antibiotics. Also, disclose all medications you are taking, including over-the-counter drugs and herbal supplements, as interactions can occur. Your kidney function will be monitored during treatment, and the dose may be adjusted accordingly. If you experience signs of a severe allergic reaction such as difficulty breathing, swelling of the face or throat, or a severe rash, seek emergency medical help immediately. Report any persistent diarrhea, as it could be a sign of a serious bowel infection. Avoid alcohol while receiving this medicine, as it may increase the risk of side effects. If you are pregnant or breastfeeding, discuss the risks and benefits with your doctor. Do not skip doses or stop treatment early, even if you feel better, as this can lead to antibiotic resistance and recurrence of infection.
👴 Special Considerations for Elderly
💡 For Patients Above 65
Elderly patients are more likely to have decreased renal function, which can increase the risk of seizures and other side effects. Dose adjustment based on creatinine clearance is essential. Monitor renal function closely and watch for signs of neurotoxicity.
🤰 Pregnancy Planning (TTC)
If you are planning to become pregnant, discuss with your doctor before starting this medicine. It is generally used during pregnancy only if clearly needed. Effective contraception is recommended during treatment if you are of childbearing potential.
🏥 Post-Surgery Considerations
This medicine may be used to prevent or treat infections after surgery. If you have recently had surgery, inform your surgeon and anesthesiologist about this medicine. It may interact with other medications used during surgery.
🦷 Dental Procedures
Inform your dentist if you are receiving this medicine. It may affect the choice of antibiotics for dental prophylaxis or treatment. No specific precautions are required for routine dental work, but maintain good oral hygiene.
💚 Lifestyle Tips for Better Results
🏋️ Exercise Considerations
While receiving this medicine, you may feel weak or dizzy. Avoid strenuous exercise until you have fully recovered. Light activity like walking is encouraged as tolerated, but consult your doctor before resuming intense workouts.
🥗 Diet Recommendations
💼 Impact on Daily Work & Life
This medicine is given in a hospital setting, so you will likely need to take time off work during treatment. You may experience fatigue, dizziness, or nausea, which can affect your ability to drive or operate machinery. It is advisable to rest and avoid driving until you feel fully recovered. Discuss with your employer about sick leave and return-to-work plans.
🛑 When to Stop This Medicine
Do not stop this medicine without consulting your doctor. Stopping early can lead to incomplete treatment, recurrence of infection, and antibiotic resistance. Your doctor will determine when to stop based on your clinical response and test results. If you experience severe side effects, contact your doctor immediately; they may adjust or change the treatment.
📅 Long-Term Use Effects
Long-term use of this medicine may lead to antibiotic resistance, superinfections (such as fungal infections), and alterations in gut flora. Prolonged therapy may also increase the risk of liver and kidney toxicity. Regular monitoring of renal and hepatic function is recommended during extended treatment. If used for more than 14 days, periodic blood counts and cultures may be advised.
🌿 Non-Medicine Approaches
These can complement medicine but do not replace prescribed treatment.
Depending on the infection and susceptibility, other antibiotics like meropenem, doripenem, or third-generation cephalosporins may be used.
Evidence: Well-establishedFor certain infections like abscesses, surgical drainage may be necessary in addition to antibiotics.
Evidence: Well-established💉 Vaccination Considerations
💉 If You're Getting Vaccinated
This medicine may reduce the immune response to live vaccines. Avoid receiving live vaccines during treatment and for a short period after. Inactivated vaccines are generally safe, but consult your doctor for timing.
📦 Storage Guide
✅ DO
Store at room temperature (20-25°C)
❌ DON'T
Do not freeze the vial
✅ DO
Keep in original container
❌ DON'T
Do not transfer to unmarked containers
✅ DO
Keep away from direct sunlight
❌ DON'T
Do not store in bathroom cabinet
✈️ Traveling with This Medicine
This medicine is administered in a hospital setting, so travel advice is limited. If you are prescribed this medicine as an outpatient, ensure you carry the original packaging and a copy of your prescription. Store the vials at room temperature, away from direct sunlight. If traveling by air, carry the medicine in your hand luggage with proper documentation. Check customs regulations for carrying prescription medications. It is important to adhere to the dosing schedule; plan your travel around your infusion times.
💰 Cost Analysis & Savings
👥 Real Patient Stories
Educational, anonymized scenarios. Individual results may vary.
💬 Questions Patients Often Ask
A: This medicine starts working immediately after infusion, but you may not feel better for 24-48 hours. Complete the full course as prescribed.
A: No, this medicine must be given intravenously by a healthcare professional in a hospital or clinic setting.
A: Report any side effects to your doctor immediately. Mild side effects like nausea may resolve, but serious effects require prompt medical attention.
🤔 Common Patient Concerns
🔄 Substitutes for cilasimune injection
View AllAlternative brands with exact same active ingredient:
-
cilastat injectionInd Swift Laboratories Ltd ₹1,040.63 14.7% CHEAPER
-
alimpenam c injectionAlembic Pharmaceuticals Ltd ₹1,247.62 2.3% COSTLIER
Medical Note: Always consult your doctor before switching medications.
🛑 Myths vs. Facts
- Myth: This medicine can cure any infection.
Fact: This medicine is effective only against susceptible bacteria and is reserved for serious infections. It is not effective against viral infections. - Myth: This medicine is safe for everyone.
Fact: It can cause serious allergic reactions and is not recommended for individuals with certain allergies or conditions. Always consult a doctor. - Myth: You can stop treatment once you feel better.
Fact: You must complete the full course as prescribed to prevent recurrence and antibiotic resistance.
🔄 Alternative Options
Generic Alternatives
- Imipenem and cilastatin injection (generic versions may be available)
Brand Alternatives
- Cilastat injection