zicerot 250mg/250mg injection - Imipenem (250mg) + Cilastatin (250mg) medicine

Emilast Injection: Complete Medicine Guide

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🏭 Taj Pharma India Ltd 📦 Varies by brand 💊 Allopathy 📅 Updated: Sep 25, 2026
⚠️ Hepatotoxicity Risk ⚠️ Nephrotoxicity Risk 📋 Prescription Required 💊 Generic Available
Medically Reviewed
11 min read
Evidence: Well-established for approved indications.
Reviewed by
SaathiMed Expert Panel | Sep 25, 2026
🩺
Medically Fact-Checked & Clinically Verified by SaathiMed Clinical Review Board
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 face, lips, or throat
  • Seizures or convulsions
  • Severe diarrhea with blood or mucus
  • Yellowing of skin or eyes
  • Decreased urine output
  • Severe abdominal pain
  • Unusual bleeding or bruising

If experiencing severe symptoms, call emergency services immediately.

What is zicerot 250mg/250mg injection used for?

This medicine is a combination antibiotic containing imipenem and cilastatin, used to treat serious bacterial infections. It works by killing bacteria and is administered by injection in a hospital setting.

  • Generic Name: Imipenem (250mg) + Cilastatin (250mg)
  • Manufacturer: Taj Pharma India Ltd
  • Form: Allopathy
  • Pregnancy Category: Consult doctor
  • Prescription Required: Yes

🇮🇳 zicerot 250mg/250mg injection के बारे में (Hindi Summary)

उपयोग: यह दवा इमिपेनम और सिलास्टेटिन का संयोजन है, जिसका उपयोग गंभीर जीवाणु संक्रमणों के इलाज के लिए किया जाता है। यह अस्पताल में इंजेक्शन के रूप में दी जाती है और डॉक्टर की देखरेख में ही ली जानी चाहिए।

साइड इफेक्ट्स: आम दुष्प्रभावों में मतली, उल्टी, दस्त, चकत्ते और इंजेक्शन स्थल पर दर्द शामिल हैं। गंभीर दुष्प्रभावों में एलर्जी, दौरे और आंतों का संक्रमण हो सकता है। किसी भी असामान्य लक्षण पर तुरंत डॉक्टर से संपर्क करें।

सुरक्षा सलाह: यह दवा केवल अस्पताल में डॉक्टर या नर्स द्वारा दी जाती है। इसे स्वयं न लें। अपनी सभी एलर्जी और स्वास्थ्य समस्याओं के बारे में डॉक्टर को बताएं। शराब का सेवन न करें। उपचार का पूरा कोर्स करें।

💡 Did You Know? Over 80% of the antiretroviral drugs used globally to combat AIDS are supplied by Indian pharmaceutical companies.

💊 zicerot 250mg/250mg injection Uses & Benefits

[{"condition":"Complicated intra-abdominal infections","description":"Used to treat serious infections within the abdomen, such as peritonitis and abscesses, often caused by mixed bacteria.","evidence":"Well-established"},{"condition":"Hospital-acquired pneumonia","description":"Effective against severe lung infections acquired during hospital stays, including ventilator-associated pneumonia.","evidence":"Well-established"},{"condition":"Complicated urinary tract infections","description":"Treats severe kidney and urinary tract infections that may be resistant to other antibiotics.","evidence":"Well-established"},{"condition":"Skin and soft tissue infections","description":"Used for serious skin infections, including those caused by multidrug-resistant bacteria.","evidence":"Well-established"},{"condition":"Febrile neutropenia","description":"Prescribed as empirical therapy for fever in patients with low white blood cell counts, often due to cancer treatment.","evidence":"Well-established"},{"condition":"Bone and joint infections","description":"May be used for osteomyelitis and septic arthritis caused by susceptible organisms.","evidence":"Moderate"},{"condition":"Endocarditis","description":"Sometimes used for serious heart valve infections, often in combination with other antibiotics.","evidence":"Moderate"}]

Off-label uses: [{"condition":"Melioidosis","description":"May be used off-label for this rare bacterial infection in some regions.","evidence":"Limited"},{"condition":"Nocardiosis","description":"Occasionally used off-label for infections caused by Nocardia species.","evidence":"Limited"}]

Primary treatment for: Serious bacterial infections

Also treats: Complicated intra-abdominal infections, Hospital-acquired pneumonia, Complicated urinary tract infections, Skin and soft tissue infections, Febrile neutropenia

📋 Drug Information

Generic Name(s)Imipenem (250mg) + Cilastatin (250mg)
Brand Namezicerot 250mg/250mg injection
ManufacturerTaj Pharma India Ltd
Packaging / FormVaries by brand (Allopathy)
Therapeutic ClassANTI INFECTIVES
Action Class
Route of AdministrationParenteral (intravenous infusion or intramuscular injection)
StorageStore vials at controlled room temperature 20°C to 25°C (68°F to 77°F). Protect from light. Reconstituted solutions should be used immediately or stored as directed by the manufacturer.
Shelf LifeTypically 24 months from the date of manufacture. Refer to the product label for exact expiry date.
WHO GuidelineNot established from the available information.
ICMR GuidelineNot established from the available information.

👨‍⚕️ Doctor's Practical Tips

Evidence-based practical advice from experienced clinicians

1
Administer this medicine only in a hospital setting with appropriate monitoring.
2
Adjust dose based on renal function to prevent seizures and toxicity.
3
Monitor for signs of anaphylaxis during the first dose.
4
Watch for Clostridium difficile-associated diarrhea if diarrhea develops.
5
Ensure the full course is completed to prevent resistance.
6
Avoid concomitant use with ganciclovir due to seizure risk.

🔍 Is This Medicine Right for Your Symptom?

Educational reference. Always consult a doctor for diagnosis.

✅
Fever with severe abdominal pain
May indicate intra-abdominal infection.
Likely Use
✅
Cough with fever and difficulty breathing
May indicate pneumonia.
Likely Use
✅
Burning urination with fever
May indicate urinary tract infection.
Likely Use
❌
Mild headache
Not a primary use.
Not Primary

🔬 How This Medicine Works (Pharmacology)

Pharmacokinetics

AbsorptionThis medicine is administered intravenously or intramuscularly, so absorption is not applicable. It achieves rapid systemic availability after infusion.
DistributionImipenem distributes widely into body tissues and fluids, including lung, peritoneal fluid, and urine. It crosses the placenta and is found in breast milk in small amounts.
Protein BindingImipenem is approximately 20% bound to plasma proteins; cilastatin is about 40% bound.
MetabolismImipenem is metabolized in the kidneys by dehydropeptidase I, but cilastatin inhibits this enzyme, reducing imipenem's metabolism and increasing its urinary recovery.
Half-LifeThe elimination half-life of imipenem is approximately 1 hour in patients with normal renal function. Cilastatin has a similar half-life.
ExcretionBoth imipenem and cilastatin are primarily excreted unchanged in the urine. Approximately 70% of imipenem and 70-80% of cilastatin are recovered in urine within 10 hours.
BioavailabilityBioavailability is 100% when administered intravenously. Intramuscular administration provides high bioavailability but is less commonly used.
Onset of ActionRapid onset; peak plasma concentrations are achieved at the end of infusion.
Peak Plasma TimePeak plasma concentrations occur immediately after the end of a 20-30 minute intravenous infusion.
Duration of ActionThe duration of action depends on the dosing interval, typically 6-8 hours, but antibacterial effects persist as long as concentrations remain above the minimum inhibitory concentration (MIC) for the pathogen.

How It Works

Imipenem, the active antibacterial component, inhibits bacterial cell wall synthesis by binding to penicillin-binding proteins (PBPs), particularly PBP-2 and PBP-1a/1b. This binding prevents the cross-linking of peptidoglycan chains, leading to weakened cell walls and bacterial lysis. Cilastatin is a renal dehydropeptidase inhibitor that blocks the enzyme responsible for metabolizing imipenem in the kidneys, thereby increasing imipenem's urinary concentration and reducing potential nephrotoxicity. This combination broadens the spectrum of activity against many Gram-positive, Gram-negative, and anaerobic bacteria.

Mechanism Steps

1
Binding to penicillin-binding proteins: Imipenem binds to specific PBPs on the bacterial cell membrane, inhibiting cell wall synthesis.
2
Inhibition of peptidoglycan cross-linking: This binding prevents the cross-linking of peptidoglycan chains, weakening the bacterial cell wall.
3
Bacterial cell lysis: The weakened cell wall leads to osmotic instability and bacterial cell death.
4
Cilastatin protection: Cilastatin inhibits renal dehydropeptidase, preventing imipenem breakdown in the kidneys and increasing its urinary concentration.

💡 How to Take zicerot 250mg/250mg injection

Strength: Injection: Imipenem 250 mg + Cilastatin 250 mg per vial.

1This medicine is administered by a healthcare professional in a hospital or clinic setting.
2It is given as an intravenous infusion over 20-30 minutes or as an intramuscular injection.
3Do not self-administer; follow your doctor's instructions exactly.
4Report any side effects to your healthcare provider immediately.

Dosage Information

Adult DosageThe usual adult dose ranges from 250 mg to 1000 mg of imipenem/cilastatin every 6 to 8 hours, depending on the severity and type of infection. For moderate infections, 500 mg every 6 to 8 hours may be used; for severe infections, 1000 mg every 6 to 8 hours may be required. Dose must be individualized by a qualified clinician based on indication, age, weight, renal and hepatic function.
Pediatric DosagePediatric dosing is not established from available information. Consult a pediatrician.
Elderly DosageElderly patients may have reduced renal function; dose should be adjusted based on creatinine clearance. Use with caution and monitor renal function.
Renal ImpairmentDose adjustment is required in patients with renal impairment. For creatinine clearance 20-40 mL/min, reduce dose; for less than 20 mL/min, further reduce or avoid unless dialysis is available. Consult a clinician for specific dosing.
Hepatic ImpairmentNo specific dose adjustment is established for hepatic impairment, but monitor liver function closely.
Maximum Daily DoseThe maximum daily dose is typically 4000 mg (4 grams) of imipenem/cilastatin, but this must be individualized by a clinician.

Dosage Timeline

🌅 Morning ❌ ☀️ Afternoon ❌ 🌆 Evening ❌ 🌙 Night ❌

🍽️ Food Timing Guide

No specific food interactions
No restrictions
Administered intravenously, food does not affect absorption.

⏰ What to Do If You Miss a Dose

📌 Missed dose in hospital
→ Inform nursing staff immediately.
💡 They will reschedule the dose as per protocol.
📌 Missed dose at home (if prescribed for self-administration, though unlikely)
→ Contact your healthcare provider for guidance.
💡 Do not attempt to double the dose.

⚠️ Side Effects of zicerot 250mg/250mg injection

✅ Common Side Effects

Nausea (Common (1-10%))
Usually resolves; if persistent, consult your doctor.
Vomiting (Common (1-10%))
Report to your doctor if severe or persistent.
Diarrhea (Common (1-10%))
Stay hydrated; if bloody or severe, seek medical attention.
Rash (Common (1-10%))
Monitor; if spreading or accompanied by other symptoms, seek medical advice.
Injection site pain (Common (1-10%))
Apply cold compress; report if severe.

🚨 Serious Side Effects

Anaphylaxis (Rare (<0.1%))
Seek emergency medical help immediately if you experience swelling of face, lips, throat, difficulty breathing, or severe rash.
Seizures (Uncommon (0.1-1%))
Report to doctor immediately; may require dose adjustment or discontinuation.
Clostridium difficile-associated diarrhea (Uncommon (0.1-1%))
Seek medical attention if you develop severe, persistent diarrhea, abdominal pain, or fever.
Hepatotoxicity (Uncommon (0.1-1%))
Report yellowing of skin or eyes, dark urine, or abdominal pain.
Nephrotoxicity (Uncommon (0.1-1%))
Monitor kidney function; report decreased urine output or swelling.

⚠️ Rare Side Effects

Agranulocytosis
Report fever, sore throat, or unusual fatigue.
Thrombocytopenia
Report unusual bleeding or bruising.
Stevens-Johnson syndrome
Seek immediate medical attention for severe rash, blisters, or mucosal lesions.

Consult your doctor if you experience any unusual symptoms.

🔬 Drug Interactions

Drug Severity Effect
Ganciclovir Major
Valproic acid Major
Probenecid Moderate
Cyclosporine Moderate
Aminoglycosides Moderate
Warfarin Moderate
Oral contraceptives Minor

🚨 Major Interactions

  • Ganciclovir
  • Valproic acid
  • Probenecid

⚡ Moderate Interactions

  • Cyclosporine
  • Aminoglycosides
  • Warfarin

🍷 Alcohol Interaction

Avoid alcohol consumption while receiving this medicine, as it may increase the risk of seizures and gastrointestinal side effects.

🔎 Check Your Other Medicines

Educational tool. Always confirm with your doctor or pharmacist.

🛡️ Safety & Warnings

🚫 Contraindications

["Known hypersensitivity to imipenem, cilastatin, or other carbapenems","Severe allergic reaction to penicillins or cephalosporins","History of seizures (relative contraindication)","Severe renal impairment (dose adjustment required)"]

⚠️ Warnings & Precautions

["Serious allergic reactions, including anaphylaxis, have been reported.","Seizures may occur, especially in patients with renal impairment or CNS disorders.","Clostridium difficile-associated diarrhea may occur; monitor for severe diarrhea.","Prolonged use may lead to superinfection with resistant organisms.","Use with caution in patients with renal impairment; dose adjustment may be needed.","May interact with valproic acid, reducing its efficacy."]

🤱 Lactation Safety

Imipenem and cilastatin are excreted in breast milk in small amounts. Consult your doctor before breastfeeding while on this medicine.

💊 Overdose Management

Overdose may cause nausea, vomiting, seizures, and electrolyte imbalances. Treatment is symptomatic and supportive. Hemodialysis may be considered to remove imipenem and cilastatin from the blood in severe cases.

⏰ Missed Dose

Since this medicine is administered by healthcare professionals, missed doses are unlikely. If a dose is missed, contact your healthcare provider for guidance. Do not attempt to self-administer.

Additional Safety Advice

General Safety

This medicine should only be administered by a healthcare professional in a hospital or clinic setting. Inform your doctor about any allergies, especially to penicillins or cephalosporins, and about any kidney or liver problems, seizures, or gastrointestinal issues. Do not self-administer. Use exactly as prescribed and complete the full course. Avoid alcohol during treatment. Report any signs of allergic reaction, severe diarrhea, or seizures immediately.

👴 Special Considerations for Elderly

💡 For Patients Above 65

Elderly patients are at higher risk of seizures and renal impairment. Dose adjustment based on renal function is essential.

🤰 Pregnancy Planning (TTC)

Consult your doctor if you are planning pregnancy. This medicine is Category C and should be used only if clearly needed.

🏥 Post-Surgery Considerations

May be used to prevent or treat surgical site infections. Monitor for signs of infection.

🦷 Dental Procedures

Not typically used for dental infections unless severe and resistant. Consult your dentist and doctor.

💚 Lifestyle Tips for Better Results

🏃
Stay well hydrated during treatment.
🥗
Eat a balanced diet to support recovery.
😴
Get plenty of rest.
💧
Avoid alcohol during treatment.
🧘
Practice good hand hygiene to prevent new infections.

🏋️ Exercise Considerations

Avoid strenuous exercise during treatment, especially if you feel weak or dizzy. Consult your doctor before resuming exercise.

🥗 Diet Recommendations

Drink plenty of fluids
Eat easily digestible foods
Include probiotics if advised by doctor
Avoid alcohol

💼 Impact on Daily Work & Life

This medicine is given in a hospital, so you will need to take time off work. Driving may be unsafe if you experience dizziness or seizures.

🛑 When to Stop This Medicine

Do not stop this medicine without consulting your doctor. Complete the full course as prescribed, even if you feel better.

📅 Long-Term Use Effects

Long-term use may lead to antibiotic resistance and superinfections. Prolonged use requires monitoring of kidney and liver function. Use only for as long as prescribed.

🌿 Non-Medicine Approaches

These can complement medicine but do not replace prescribed treatment.

Other antibiotics

Depending on the infection, other antibiotics like meropenem or piperacillin-tazobactam may be used.

Evidence: Well-established

💉 Vaccination Considerations

💉 If You're Getting Vaccinated

No specific vaccine interactions are established. However, live vaccines should be avoided during antibiotic treatment.

📦 Storage Guide

✅ DO

Store at room temperature (20-25°C)

❌ DON'T

Do not freeze

✅ DO

Keep in original packaging

❌ DON'T

Do not use if solution is discolored or contains particles

✅ DO

Protect from light

❌ DON'T

Do not store in bathroom

✈️ Traveling with This Medicine

This medicine is administered in a hospital setting, so travel is not applicable. If you are traveling after treatment, carry a copy of your prescription and medical records. Store any remaining medication as directed. Consult your doctor before travel if you have ongoing treatment.

💰 Cost Analysis & Savings

👥 Real Patient Stories

Educational, anonymized scenarios. Individual results may vary.

👤 A 60-year-old man with hospital-acquired pneumonia
He was started on this medicine after developing pneumonia during a hospital stay. Within 48 hours, his fever reduced and breathing improved. He completed a 10-day course and recovered fully. He experienced mild nausea, which was managed with anti-nausea medication.
💡 Lesson: This medicine is effective for serious hospital infections when administered promptly and monitored closely.
👤 A 45-year-old woman with complicated urinary tract infection
She had a severe kidney infection resistant to oral antibiotics. She received this medicine intravenously for 7 days. Her symptoms resolved, and kidney function remained normal. She was advised to complete the course and follow up.
💡 Lesson: Resistant infections may require powerful intravenous antibiotics like this medicine, and adherence to the full course is crucial.

💬 Questions Patients Often Ask

Q: How long does it take to work?

A: Improvement is usually seen within 24-48 hours, but the full course must be completed.

Q: Can I take this medicine at home?

A: No, it must be administered by a healthcare professional in a hospital or clinic.

Q: What should I do if I experience side effects?

A: Report any side effects to your doctor immediately, especially severe ones like seizures or difficulty breathing.

🤔 Common Patient Concerns

💭 These are the concerns patients most commonly raise

  • Can I take this medicine if I have kidney disease?
  • Will this medicine interact with my other medications?
  • How long will I need to stay in the hospital?
  • Can I breastfeed while on this medicine?
  • What if I miss a dose?
  • Is this medicine safe for my child?

🔄 Substitutes for zicerot 250mg/250mg injection

View All

Alternative brands with exact same active ingredient:

Medical Note: Always consult your doctor before switching medications.

🛑 Myths vs. Facts

  • Myth: This medicine can be taken orally.
    Fact: This medicine is only available as an injection and must be given by a healthcare professional.
  • Myth: This medicine is safe for mild infections.
    Fact: It is reserved for serious infections to prevent antibiotic resistance.
  • Myth: You can stop the medicine once you feel better.
    Fact: You must complete the full course as prescribed to prevent recurrence and resistance.

🔄 Alternative Options

Generic Alternatives

  • Imipenem and Cilastatin Injection

Brand Alternatives

  • Emilast Injection

📊 Comparison with Similar Medicines

[{"medicine":"Meropenem","difference":"Similar spectrum but does not require cilastatin; lower seizure risk."},{"medicine":"Doripenem","difference":"Similar spectrum; less experience in some infections."},{"medicine":"Ertapenem","difference":"Longer half-life; once-daily dosing; narrower spectrum against Pseudomonas."}]

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