Imipenem, Cilastatin, and Relebactam Injection
A combination antibiotic given by IV infusion, used to treat serious bacterial infections including hospital-acquired pneumonia, complicated urinary tract infections, and complicated abdominal infections caused by hard-to-treat gram-negative bacteria.
🧬 Where this information comes from Click to expand
The clinical label records used on this page are FDA-filed Structured Product Labeling (SPL) retrieved through openFDA. We identified 1 clinical label set within the page’s selected clinical scope after exact ingredient or ingredient-combination matching and applicable route/form matching. Forms, routes, brands, labelers, strengths, and NDC product-record counts are built separately from matching FDA National Drug Code Directory records. The linked DailyMed document is a representative official source for verification, not the page’s only clinical source. View the linked label on DailyMed →
📖 Imipenem, Cilastatin, and Relebactam Injection: Patient Information Guide
A plain-language walkthrough of Imipenem, Cilastatin, and Relebactam Injection — what it treats, how it works, how it’s taken, side effects, warnings and interactions. Tap any section to expand it.
🎯What it's used for▾
Recarbrio is a combination IV antibiotic approved for serious gram-negative bacterial infections in adults and children weighing at least 2 kg. It covers the following conditions:
- Hospital-acquired bacterial pneumonia (HABP) and ventilator-associated bacterial pneumonia (VABP) — lung infections that develop in the hospital or while on a breathing machine
- Complicated urinary tract infections (cUTI), including pyelonephritis — Recarbrio is approved for this use only in patients who have limited or no other treatment options
- Complicated intra-abdominal infections (cIAI) — serious infections inside the abdominal cavity — Recarbrio is approved here only for patients with limited or no other treatment options
- Recarbrio is not recommended in premature infants under 37 weeks corrected age, or in children weighing less than 30 kg who have kidney problems
⚙️How it works▾
Recarbrio works through three ingredients acting together. Imipenem kills bacteria by interfering with the construction of their cell walls — bacteria that can't build proper cell walls die. Cilastatin blocks an enzyme in the kidneys that would otherwise break imipenem down, ensuring enough antibiotic reaches the urinary tract. Relebactam is a beta-lactamase inhibitor: it disables the enzymes that certain resistant bacteria use to neutralize imipenem, allowing imipenem to work against bacteria that would otherwise survive it.
This combination is specifically designed to tackle gram-negative bacteria — including strains like Pseudomonas aeruginosa and Klebsiella pneumoniae — that are often resistant to other antibiotics.
💊How it's taken▾
Recarbrio is given only as an intravenous (IV) infusion in a hospital or clinical setting — it is not available as a pill or home injection. For most adults with normal kidney function, it is infused over 30 minutes, four times a day (every 6 hours). Pediatric dosing depends on the child's weight and age; very young infants receive it every 8 hours over a 60-minute infusion, while older or heavier children follow schedules closer to the adult regimen. Treatment typically lasts 4 to 14 days.
- Patients with reduced kidney function need lower doses — your care team calculates this based on kidney function tests
- Patients on hemodialysis receive their dose after each dialysis session
- Follow your prescriber's instructions exactly; do not adjust doses on your own
🤒Side effects — in detail▾
Like all antibiotics, Recarbrio can cause side effects. The most commonly reported ones include:
- Diarrhea, nausea, or vomiting
- Headache
- Elevated liver enzyme levels (seen on blood tests, usually without symptoms)
- Anemia (low red blood cell count)
- Low potassium or sodium levels in the blood
- Rash
- Constipation
- Pain, redness, or swelling at the IV infusion site
Seek medical attention immediately for signs of a severe allergic reaction (difficulty breathing, facial swelling, or sudden drop in blood pressure), new seizures or muscle jerking, or severe or persistent diarrhea — these could signal serious complications that need prompt treatment.
⚠️Warnings & precautions▾
- Severe allergic reactions: Life-threatening anaphylaxis has occurred with beta-lactam antibiotics. Tell your care team about any prior antibiotic allergies before starting Recarbrio. Treatment must be stopped immediately if a serious reaction occurs.
- Seizures and nervous system effects: Seizures, confusion, and involuntary muscle twitching have been reported — most commonly in patients with brain conditions or significant kidney problems. Existing anti-seizure medications should be continued during treatment.
- Valproic acid interaction and seizure risk: Recarbrio can dramatically lower blood levels of valproic acid (Depakote) or divalproex sodium, potentially triggering breakthrough seizures in people using those drugs for seizure control. These combinations should be avoided when possible.
- C. difficile-associated diarrhea: Like most antibiotics, Recarbrio can disrupt gut bacteria and allow Clostridioides difficile (C. diff) to overgrow, causing severe diarrhea or dangerous colitis. This can happen weeks after finishing the antibiotic.
- Antibiotic resistance: Recarbrio should only be used for proven or strongly suspected bacterial infections to preserve its effectiveness and reduce the development of resistant bacteria.
🔀What it interacts with▾
Recarbrio has two important drug interactions to know about:
- Valproic acid / divalproex sodium (Depakote): Recarbrio can significantly reduce blood levels of these anti-seizure medications, raising the risk of breakthrough seizures. These should not be used together unless there is no alternative antibiotic — in which case close monitoring is essential.
- Ganciclovir (antiviral): Combining ganciclovir with imipenem/cilastatin (components of Recarbrio) has been linked to generalized seizures. This combination should be avoided unless the benefits clearly outweigh the risks.
This is not a complete list of interactions. Always talk with your doctor or pharmacist before starting, stopping, or changing any medication.
📋Before taking it▾
- Allergy history: Tell your doctor if you've ever had a serious allergic reaction to a carbapenem, penicillin, cephalosporin, or any other beta-lactam antibiotic.
- Seizure history or brain conditions: Patients with prior seizures, brain lesions, or structural brain issues face a higher risk of seizure-related side effects.
- Kidney disease: Doses must be adjusted based on kidney function. Recarbrio should not be given to patients with very low kidney function unless they are receiving hemodialysis within 48 hours.
- Pregnancy: Animal studies showed potential risks to the fetus. There are no adequate human studies. Discuss the risks and benefits with your doctor if you are pregnant.
- Breastfeeding: It is not known whether imipenem, cilastatin, or relebactam pass into human breast milk. Discuss this with your doctor before breastfeeding.
- Premature infants: Recarbrio is not recommended for infants younger than 37 weeks corrected gestational age.
- Children under 30 kg with kidney problems: There is not enough data to dose Recarbrio safely in this group; it is not recommended.
- Older adults: Kidney function naturally declines with age, which may require dose adjustments. Your care team will monitor kidney function during treatment.
🚑If you take too much▾
If too much Recarbrio is given, treatment should be stopped and supportive care started right away. Imipenem, cilastatin, and relebactam can all be removed from the body by hemodialysis (a kidney-filtering procedure), which may be used to help clear the drug if needed. There is no specific antidote, and management focuses on treating symptoms as they arise.
📡Pharmacodynamics — effects in the body▾
For imipenem, the antibiotic's effectiveness depends on how long its concentration stays above the level needed to inhibit bacterial growth throughout each dosing interval. For relebactam, effectiveness is tied to the total amount of drug the body is exposed to over 24 hours relative to the bacterial inhibitory concentration. At doses nearly 5 times the recommended amount, relebactam does not meaningfully affect heart rhythm (QTc interval), which is reassuring from a cardiac safety standpoint.
🔬Pharmacokinetics — how your body processes it▾
Recarbrio is given intravenously and distributes throughout the body; imipenem and relebactam both reach the fluid lining the lungs at roughly 54–55% of their unbound blood concentrations, which supports their use in pneumonia. All three components — imipenem, cilastatin, and relebactam — are eliminated primarily by the kidneys, with short half-lives of about 1 to 1.2 hours. Because the kidneys do most of the work clearing these drugs, reduced kidney function leads to higher drug exposure and requires dose adjustments. Relebactam is minimally broken down in the body; more than 90% exits unchanged in the urine. Hemodialysis effectively removes all three components from the bloodstream.
📦How to store it▾
Store RECARBRIO vials at 20°C to 25°C (68°F to 77°F), excursions permitted between 15°C to 30°C (between 59°F to 86°F) .
📄 Written from Imipenem, Cilastatin, and Relebactam Injection’s FDA-approved label information, summarized in plain language with AI, and reviewed by our pharmacy team before publication. Every point is grounded in that labeling — nothing is invented. How we use AI →
Supplements & herbs that interact with Imipenem, Cilastatin, and Relebactam Injection
33 supplements and herbal products have documented interactions with Imipenem, Cilastatin, and Relebactam Injection in the licensed clinical database we use. Most are manageable — but your pharmacist should know about everything you take, including vitamins and herbals.
- Moderate · 32
- Minor · 1
Educational information from a licensed clinical database (Natural Medicines) — see our data sources & update cadence. Not medical advice: an interaction being documented does not mean it will happen to you; do not start or stop medications or supplements without professional guidance.
Nutrient depletion considerations
Imipenem, Cilastatin, and Relebactam Injection has been associated with lower levels of 7 nutrients in the clinical literature. This does not mean a deficiency will occur — it means these may be worth discussing with your pharmacist or healthcare provider, especially with long-term use.
- Higher significance · 6
- Moderate · 1
Educational information from a licensed clinical database (Natural Medicines) — not medical advice. Do not start or stop medications or supplements without professional guidance.
🩺 Pharmacist Counseling Corner
Quick, plain-English answers to the questions patients ask most about Imipenem, Cilastatin, and Relebactam Injection — the kind of thing our pharmacy team would talk through with you at the counter.
Why am I getting this antibiotic instead of one in a pill form? ▾
How long will I need to be on this antibiotic? ▾
I take Depakote (valproic acid) for seizures. Is that a problem? ▾
What side effects should I actually watch out for while I'm receiving this? ▾
I have kidney problems — does that affect how this antibiotic is given? ▾
Is this antibiotic safe during pregnancy? ▾
Is Imipenem, Cilastatin, and Relebactam Injection available over the counter? ▾
When was Imipenem, Cilastatin, and Relebactam Injection first available? ▾
💬 Answers drafted from Imipenem, Cilastatin, and Relebactam Injection’s FDA-approved label information, summarized in plain language with AI, and reviewed by our pharmacy team before publication. Grounded in that labeling — nothing is made up. How we use AI →
🧰 Keep exploring
💊 How Imipenem, Cilastatin, and Relebactam Injection comes
Imipenem, Cilastatin, and Relebactam Injection is available in 1 form. Different forms and brands can have different approved uses, doses, schedules, and directions. Follow the instructions for your exact product, and do not switch forms without guidance from your prescriber or pharmacist.
Injection
How this form is used
- Recarbrio is used to treat hospital-acquired bacterial pneumonia and ventilator-associated bacterial pneumonia (HABP/VABP) in adults and children weighing at least 2 kg
- Recarbrio is used to treat complicated urinary tract infections (cUTI), including pyelonephritis, in adults and children weighing at least 2 kg who have limited or no other treatment options
- Recarbrio is used to treat complicated intra-abdominal infections (cIAI) in adults and children weighing at least 2 kg who have limited or no other treatment options
- Recarbrio is given as an intravenous (IV) infusion by a healthcare provider — it cannot be taken by mouth
- Recarbrio is typically infused over 30 minutes every 6 hours in adults and in children weighing 30 kg or more with normal kidney function; smaller pediatric patients receive a 60-minute infusion
- Recarbrio must be prepared from a dry powder vial, dissolved and diluted into an IV bag before infusion — preparation is done by pharmacy or clinical staff
- Recarbrio dose is reduced in patients with impaired kidney function and must not be used in patients with very low kidney function unless they are on hemodialysis
📊 Imipenem, Cilastatin, and Relebactam Injection across the U.S. market
How Imipenem, Cilastatin, and Relebactam Injection appears in the FDA’s National Drug Code Directory — including its dosage forms, strengths, brand names, manufacturers, and FDA-listed product records. These are directory records, not sales or prescription volume.
📈 How widely Imipenem, Cilastatin, and Relebactam Injection is used
A general measure of how commonly Imipenem, Cilastatin, and Relebactam Injection is prescribed, based on Medicaid — one of the largest public drug programs. The figure below is prescriptions filled in Q1–Q4 2025, summed across every form and brand of the drug.
Think of this as a proxy for how widely Imipenem, Cilastatin, and Relebactam Injection is used, drawn from freely available public data. Medicaid is just one program — these numbers don’t include Medicare, other government coverage, or commercial and cash-pay prescriptions, so real-world use is higher than what’s shown here.
How commonly is Imipenem, Cilastatin, and Relebactam Injection prescribed? Of the 1,594 medications we measure, Imipenem, Cilastatin, and Relebactam Injection ranks #1,508 by Medicaid prescriptions — more than 5% of them.
Utilization by Imipenem, Cilastatin, and Relebactam Injection product
Pick a product to see its own Medicaid numbers. Each chip is one clinical product — a specific strength & dosage form as defined by RxNorm — with brand-name and generic versions combined.
cilastatin 500 MG / imipenem 500 MG / relebactam 250 MG Injection
Summed across the 1 of 2 listed NDC products with Medicaid activity — every brand and generic of this exact strength & form. RxNorm 2184142
Shares are of the Medicaid prescriptions shown here. Product grouping follows RxNorm (the National Library of Medicine’s drug terminology), so “one product” means one strength & dosage form regardless of manufacturer. Dollar figures are gross Medicaid reimbursement before mandatory rebates — rebates (often large, especially for brand-name drugs) are confidential, so actual net cost to Medicaid is lower than shown.
Source: Medicaid State Drug Utilization Data (CMS), aggregated by generic ingredient — summed across every NDC (all brands, strengths, salt forms and dosage forms) of Imipenem, Cilastatin, and Relebactam Injection, and across all states and both fee-for-service and managed-care claims. A general popularity signal; it excludes Medicare, commercial insurance and cash prescriptions, so it is not total U.S. use. Based on the 1 of 2 listed Imipenem, Cilastatin, and Relebactam Injection NDCs with Medicaid activity.
🔍 Compare Imipenem, Cilastatin, and Relebactam Injection products
A representative set of FDA-listed product records for Imipenem, Cilastatin, and Relebactam Injection — across manufacturers, strengths, and dosage forms, grouped by form with each product’s manufacturer and how the FDA approved it. The same medicine may be made and packaged by different companies, so a single drug can have many directory entries. (It’s also why a refill can look different — a new shape, color, or box — even though it contains the same medication.)
| Strength | Route | Manufacturer / Labeler | Category ⓘ | Details |
|---|---|---|---|---|
| 💊Injection | ||||
| IMIPENEM ANHYDROUS 500 mg/100 mL; CILASTATIN 500 mg/100 mL; RELEBACTAM ANHYDROUS 250 mg/100 mL | Intravenous | Merck Sharp & Dohme LLC | NDA | View NDC → |
| IMIPENEM ANHYDROUS 500 mg/100 mL; CILASTATIN 500 mg/100 mL; RELEBACTAM ANHYDROUS 250 mg/100 mL | — | Merck Sharp & Dohme LLC | DRUG FOR FURTHER PROCESSING | View NDC → |
| 500; 500; 250 mg/100 mL; mg/100 mL; mg/100 mL | Intravenous | Merck Sharp & Dohme LLC × 2 listings | NDA | View NDC → |
Showing 4 of 4 products — FDA National Drug Code Directory. See every product, package size and price: browse all 4 Imipenem, Cilastatin, and Relebactam Injection NDCs →
📈 What people report — real-world data (FDA FAERS)
After a medicine reaches the market, patients, doctors and drugmakers can send the FDA reports of problems they think may be linked to it. Here’s what’s been reported for Imipenem, Cilastatin, and Relebactam Injection — a signal of what to watch for, not proof the drug caused it.
Source: openFDA, from the FDA Adverse Event Reporting System (FAERS). These are voluntary reports — they don’t prove the drug caused the effect, and counts reflect how often something was reported, not how often it actually happens. Reports also often name the very problem the medicine is taken for — a common reason to file one is that the drug didn’t help — so for a pain reliever you may see “pain” high on the list; that points to why the report was filed, not to the drug causing the symptom. This counts every report that lists Imipenem, Cilastatin, and Relebactam Injection in any role, so the total runs higher than the FDA’s official dashboard, which counts only cases where the drug is the suspect. For the authoritative figures, see the FDA FAERS Public Dashboard. Always talk to your pharmacist or doctor.
🏛️ The road to your pharmacy
How Imipenem, Cilastatin, and Relebactam Injection went from FDA review to the pharmacy shelf — the key milestones in its regulatory journey.
Source: Drugs@FDA.
🚨 Recall history
A recall is when a specific batch of a medicine is pulled from the market — usually a manufacturing issue, not a problem with the drug itself. Class I is most serious, Class III least.
Source: openFDA drug enforcement (recall) reports.
RxNorm Concept Web — From Ingredient to Every Form and Strength
This page starts with one exact multiple-ingredient concept (MIN). The branches below show its dose-form concepts (SCDF), then the available clinical drug and strength concepts (SCD). A product with a different ingredient combination belongs on a different page.
RxCUI 2184141 1 dose form · 1 strength
-
Dose form (SCDF) Injection RxCUI 2184140In current FDA listingsClinical drug / strength (SCD) cilastatin 500 MG / imipenem 500 MG / relebactam 250 MGRxCUI 2184142
Look up RxCUI 2184141 in the RxCUI Atlas →
RxNorm is the U.S. National Library of Medicine’s normalized drug vocabulary. Its concept hierarchy can include forms that are not currently marketed; the status on each branch compares that concept with current FDA listings. RxCUIs identify vocabulary concepts, not individual packages or manufacturers.
📦 Supply & shortage status
Whether Imipenem, Cilastatin, and Relebactam Injection is in short supply in the U.S. right now, plus any shortage history the FDA has on record. A shortage usually reflects a manufacturing or demand issue — not a safety problem with the drug.
Source: openFDA, from the FDA Drug Shortages database.
🏷️ Sold under these brand names
🏭 Manufacturers & labelers
RxNorm drug class
Imipenem, Cilastatin, and Relebactam Injection belongs to the beta Lactamase Inhibitor class.
Classified by RxNorm RxClass — the U.S. National Library of Medicine's standardized drug-classification service (Established Pharmacologic Class from the FDA, the ATC drug family from the WHO, and mechanism of action). Reference only, not medical advice.
🔬 Where this comes from
Core label, product, RxNorm, safety, and utilization data on this page come from the sources identified below. AI-written, editorial, and licensed sections are labeled separately.
How we combine label and product data
HelloPharmacist combines public FDA and NLM records; we don’t author the underlying clinical facts. We identified 1 FDA-filed SPL label set within the page’s selected clinical scope after exact ingredient or ingredient-combination matching and applicable route/form matching. The representative label is the starting point for the displayed reference monograph; the 12 largest stored in-scope SPL records, which may include that representative, are compared section by section, and the longest available version of each section is retained. Forms, routes, brands, labelers, product-listed strengths, and product-record counts are aggregated separately from ingredient-matched FDA NDC Directory records; package records listed above are associated with the linked SPL; and the normalized concept hierarchy comes from NLM RxNorm.
Where a section is identified as AI-written, its plain-language text is generated from bounded label evidence. New draft drug pages remain in the admin review queue before first publication. Merck Sharp & Dohme LLC is the representative DailyMed label linked for verification and dates; it is not the sole source used for the page.
This is general education, not medical advice — always consult your doctor or pharmacist about your medications and any medical condition. For the exact wording of the linked representative label, view that label on DailyMed; some displayed composite sections may come from other in-scope SPL labels. Learn how we use AI and our data sources & update cadence.