Loading...
Loading...
Medical Disclaimer: This information is for educational purposes only and is not a substitute for professional medical advice.
Brand Name
Invanz
Generic Name
Ertapenem Sodium
Active Ingredient
ErtapenemCategory
Other
Salt Form
Sodium
Variants
1
Different strengths and dosage forms
| Strength | Form | Route | NDC |
|---|---|---|---|
| 1 g/1 | INJECTION, POWDER, LYOPHILIZED, FOR SOLUTION | INTRAMUSCULAR, INTRAVENOUS | 0006-3843 |
Detailed information about Invanz
This page is for informational purposes only and does not replace medical advice. Before using any prescription or over-the-counter medication for Invanz, you must consult a qualified healthcare professional.
Ertapenem is a broad-spectrum carbapenem antibiotic used to treat moderate to severe bacterial infections. It works by inhibiting bacterial cell wall synthesis and is administered via injection.
The standard adult dosage for ertapenem is 1 gram (g) administered once daily. The duration of therapy typically ranges from 3 to 14 days, depending on the type and severity of the infection, as well as the patient's clinical response. For the prophylaxis of surgical site infections following elective colorectal surgery, a single 1-gram dose is administered intravenously, completed within 1 hour prior to the surgical incision.
Specific durations for common indications include:
Ertapenem is approved for use in pediatric patients aged 3 months to 17 years. The dosage is determined by age and weight:
Ertapenem is not recommended for infants under 3 months of age, as safety and efficacy data are currently insufficient for this population.
Because ertapenem is primarily cleared by the kidneys, dosage adjustments are necessary for patients with significant renal dysfunction. For adults with a creatinine clearance (CrCl) of 30 mL/min/1.73 m² or less, the dose should be reduced to 500 mg once daily. If an adult patient is on hemodialysis and receives the 500 mg daily dose within 6 hours prior to dialysis, a supplementary dose of 150 mg is recommended following the dialysis session. There are no specific dosage adjustment guidelines for pediatric patients with renal impairment.
No dosage adjustment is required for patients with hepatic (liver) impairment. Ertapenem is not significantly metabolized by the liver, so liver function does not meaningfully impact the drug's clearance from the body.
Dosage adjustments are generally not required for elderly patients based on age alone. However, because older adults are more likely to have decreased renal function, healthcare providers should assess kidney function (CrCl) and adjust the dose accordingly if impairment is present.
Ertapenem must be administered by a healthcare professional in a clinical setting (hospital, clinic, or via home infusion services).
In a hospital setting, a missed dose is unlikely as the medical staff manages the schedule. However, if you are receiving home infusion and miss a dose, contact your healthcare provider or infusion nurse immediately. Do not double the dose to catch up. Maintaining a consistent schedule is vital for the antibiotic to effectively clear the infection.
In the event of an overdose, ertapenem should be discontinued, and general supportive treatment should be provided. While ertapenem can be removed by hemodialysis, there is limited information on the effectiveness of dialysis in treating an acute overdose. Symptoms of overdose may include increased severity of side effects, such as seizures or severe gastrointestinal distress.
> Important: Follow your healthcare provider's dosing instructions. Do not adjust your dose or stop treatment early without medical guidance, as this can lead to antibiotic resistance and the return of the infection.
Ertapenem is generally well-tolerated, but like all medications, it can cause side effects. The most common side effects reported in clinical trials include:
> Warning: Stop taking Ertapenem and call your doctor immediately or seek emergency care if you experience any of the following:
Prolonged or repeated use of ertapenem (like any antibiotic) may result in bacterial or fungal overgrowth (superinfection). This can manifest as oral thrush (white patches in the mouth) or a new vaginal yeast infection. Long-term use is generally avoided unless medically necessary to prevent the development of antibiotic-resistant bacteria.
There are currently no FDA black box warnings for ertapenem. However, the drug carries significant warnings regarding hypersensitivity (allergic) reactions and the risk of central nervous system effects like seizures.
Report any unusual symptoms to your healthcare provider. Your medical team will monitor your progress and lab results closely to manage any side effects that arise.
Ertapenem is a potent antibiotic that must be used with caution in certain populations. Before starting treatment, it is essential that your healthcare provider is aware of your full medical history, particularly any history of allergies to other antibiotics. Because ertapenem is administered by injection, patients should be monitored for at least 30 minutes following the first dose to ensure no immediate allergic reaction occurs.
No FDA black box warnings for Ertapenem. However, clinical practitioners emphasize the "Warning and Precautions" section of the label regarding cross-reactivity with other beta-lactams.
Serious and occasionally fatal hypersensitivity (anaphylactic) reactions have been reported in patients receiving beta-lactam antibiotics. Before initiating therapy with ertapenem, careful inquiry should be made concerning previous hypersensitivity reactions to penicillins, cephalosporins, other carbapenems, and other allergens. There is a risk of cross-reactivity; if you are allergic to penicillin, you may also be allergic to ertapenem.
Ertapenem has been associated with CNS side effects, including seizures, encephalopathy (brain dysfunction), and involuntary movements. These risks are highest in patients with known CNS disorders (e.g., history of seizures, brain lesions) and in those with compromised renal function. If focal tremors or seizures occur, the patient should be evaluated neurologically, and the dose of ertapenem should be reviewed to see if it needs adjustment or discontinuation.
Almost all antibacterial agents, including ertapenem, can cause C. diff infection. This occurs because the antibiotic alters the normal flora of the colon, allowing C. diff to flourish. CDAD can range in severity from mild diarrhea to life-threatening inflammation of the colon. It is important to report any diarrhea that occurs during or after treatment (up to two months later).
Prescribing ertapenem in the absence of a proven or strongly suspected bacterial infection is unlikely to provide benefit to the patient and increases the risk of the development of drug-resistant bacteria.
While on ertapenem, your healthcare provider may perform regular laboratory tests to monitor your health and the drug's efficacy:
Ertapenem may cause dizziness, somnolence (sleepiness), or even seizures in some patients. You should avoid driving or operating heavy machinery until you know how the medication affects you. If you experience any confusion or dizziness, notify your doctor immediately.
While there is no direct chemical interaction between alcohol and ertapenem, alcohol can dehydrate the body and strain the liver and kidneys, potentially complicating the recovery from a serious infection. It is generally advised to avoid alcohol while being treated for a severe bacterial infection.
It is vital to complete the full course of ertapenem as prescribed, even if you start to feel better after a few doses. Stopping the medication too early can allow the remaining bacteria to continue growing, which may lead to a relapse of the infection and the development of antibiotic resistance.
> Important: Discuss all your medical conditions with your healthcare provider before starting Ertapenem, especially if you have kidney disease or a history of seizures.
Since ertapenem is administered via injection (IV or IM), there are no direct interactions with food intake. Unlike oral antibiotics, its absorption is not affected by what you eat. However, maintaining adequate hydration is important for renal clearance.
For each major interaction, the mechanism usually involves either competition for renal excretion (Probenecid) or complex metabolic pathways (Valproic acid). The clinical consequence is often either increased toxicity of the antibiotic or reduced efficacy of the co-administered drug.
> Important: Tell your doctor about ALL medications, supplements, and herbal products you are taking, including over-the-counter drugs.
Ertapenem must NEVER be used in the following circumstances:
Conditions requiring a careful risk-benefit analysis before using ertapenem include:
Patients should be aware of cross-sensitivity between different classes of antibiotics. If you have had a rash or hives from Penicillin, Amoxicillin, or Cephalexin (Keflex), you must inform your doctor. While the rate of cross-reactivity between penicillins and carbapenems was once thought to be as high as 10%, more recent studies suggest it is likely lower (around 1%), but the risk of a severe reaction still necessitates caution.
> Important: Your healthcare provider will evaluate your complete medical history, including all past allergic reactions, before prescribing Ertapenem.
Ertapenem is classified as Pregnancy Category B under the older FDA system. This means that animal reproduction studies have failed to demonstrate a risk to the fetus, but there are no adequate and well-controlled studies in pregnant women. Data from animal studies (mice and rats) using doses up to several times the recommended human dose showed no evidence of developmental toxicity. However, because animal studies are not always predictive of human response, ertapenem should be used during pregnancy only if clearly needed and under strict medical supervision.
Ertapenem is excreted in human breast milk. In one study, ertapenem concentrations in breast milk were measured in 5 lactating women; the drug was detectable, but the levels were low. The potential for effects on the nursing infant's gastrointestinal flora (causing diarrhea or thrush) exists. Healthcare providers must decide whether to discontinue nursing or discontinue the drug, taking into account the importance of the drug to the mother.
Ertapenem is FDA-approved for pediatric patients aged 3 months to 17 years. The safety and effectiveness in infants under 3 months of age have not been established. In pediatric clinical trials, the side effect profile was generally similar to that in adults, although diarrhea and infusion site pain were slightly more common in children. Dosing in children is weight-based (15 mg/kg twice daily) to account for the faster clearance of the drug in younger populations.
In clinical trials, approximately 25% of patients were 65 years of age and over, and 12% were 75 and over. No overall differences in safety or effectiveness were observed between these patients and younger patients. However, because ertapenem is primarily excreted by the kidneys, and elderly patients are more likely to have decreased renal function, dose selection should be cautious. Monitoring renal function is highly recommended for geriatric patients.
Renal impairment significantly impacts the clearance of ertapenem. For patients with a CrCl > 30 mL/min/1.73 m², no adjustment is needed. For those with a CrCl ≤ 30 mL/min/1.73 m², the dose must be reduced to 500 mg daily to prevent drug accumulation and toxicity (specifically seizures). Patients on hemodialysis require a supplemental dose if the daily dose is given before the dialysis session.
The pharmacokinetics of ertapenem are not significantly altered in patients with hepatic impairment. In studies of patients with varying degrees of liver dysfunction, no dosage adjustment was found to be necessary. However, clinicians should still monitor liver enzymes during treatment as a general precaution.
> Important: Special populations require individualized medical assessment to ensure the safest and most effective treatment outcome.
Ertapenem is a carbapenem antibiotic that works by inhibiting bacterial cell wall synthesis. It targets and binds to Penicillin-Binding Proteins (PBPs), specifically PBP 2 and PBP 3 in Gram-negative bacteria like E. coli. These proteins are transpeptidases responsible for cross-linking the peptidoglycan chains that form the bacterial cell wall. By inhibiting these enzymes, ertapenem prevents the bacteria from maintaining a stable cell wall, leading to osmotic instability and cell death. Its unique structure, including a 1-beta-methyl group, protects it from degradation by renal dehydropeptidase-I, and its side chain increases its stability against many beta-lactamases.
The antibacterial activity of ertapenem is time-dependent. This means that its efficacy is best predicted by the amount of time that the concentration of the drug in the blood remains above the Minimum Inhibitory Concentration (MIC) of the target bacteria (T > MIC). Because of its long half-life and high protein binding, once-daily dosing is sufficient to maintain these levels for most susceptible pathogens. It also exhibits a post-antibiotic effect (PAE), where bacterial growth continues to be suppressed even after drug levels fall below the MIC.
| Parameter | Value |
|---|---|
| Bioavailability | ~90% (IM) / 100% (IV) |
| Protein Binding | 85% to 95% (concentration-dependent) |
| Half-life | ~4 hours (Adults), ~2.5 hours (Children 3m-12y) |
| Tmax | ~2.3 hours (IM) |
| Metabolism | Hydrolysis of beta-lactam ring (non-CYP) |
| Excretion | Renal 80% (38% unchanged), Fecal 10% |
Ertapenem is classified as a Carbapenem, a sub-class of Beta-lactam antibiotics. It is often referred to as a "Group 1" carbapenem because it has broad activity against Gram-positive and Gram-negative aerobes and anaerobes but lacks significant activity against non-fermentative Gram-negative bacilli like Pseudomonas aeruginosa and Acinetobacter species, which distinguishes it from "Group 2" carbapenems like Meropenem.
Common questions about Invanz
Ertapenem is a broad-spectrum antibiotic used to treat moderate to severe bacterial infections in adults and children aged 3 months and older. It is specifically FDA-approved for complicated intra-abdominal infections, skin and skin structure infections (including diabetic foot infections), and community-acquired pneumonia. It is also used for complicated urinary tract infections and acute pelvic infections. In addition to treating active infections, it is used in adults as a preventive measure (prophylaxis) before elective colorectal surgery. Because it is a potent drug, it is usually reserved for infections that are difficult to treat or caused by bacteria resistant to other antibiotics.
The most frequently reported side effects of ertapenem include diarrhea, which occurs in about 10% of patients, and infusion site reactions like pain or redness. Many patients also experience nausea, headache, and vomiting shortly after the medication is administered. In some cases, patients may develop a mild skin rash or experience a temporary increase in liver enzymes on blood tests. While most of these effects are mild and resolve after treatment, any persistent or severe symptoms should be reported to your medical team immediately. Your doctor will monitor you closely during the course of the injection to manage these common reactions.
There is no known direct chemical interaction between ertapenem and alcohol; however, it is generally recommended to avoid alcohol while being treated for a serious infection. Alcohol can weaken the immune system and cause dehydration, both of which can slow down the healing process. Furthermore, both alcohol and ertapenem can cause side effects like dizziness and nausea, which may be worsened if used together. Alcohol can also put additional stress on the liver and kidneys, which are responsible for processing and clearing medications. It is best to wait until you have fully recovered and finished your course of antibiotics before consuming alcohol.
Ertapenem is considered a 'Pregnancy Category B' medication, meaning there is no evidence of harm to the fetus in animal studies, but there are no adequate studies in humans. Because of this lack of human data, healthcare providers typically only prescribe ertapenem to pregnant women if the potential benefit clearly outweighs the potential risk to the baby. If you are pregnant or planning to become pregnant, you must inform your doctor before starting this antibiotic. They will evaluate the severity of your infection and determine if a different antibiotic with more safety data in pregnancy would be more appropriate. Monitoring during use is essential for the safety of both the mother and the fetus.
Ertapenem begins working against bacteria immediately after the first dose is administered, as it quickly reaches therapeutic levels in the bloodstream and tissues. However, most patients do not feel a significant improvement in their symptoms for 24 to 48 hours. The total duration of treatment usually lasts between 3 and 14 days, depending on the type and severity of the infection. It is crucial to complete the entire course of treatment even if you start to feel better after a few days. Stopping the drug too early can allow the infection to return or lead to the development of antibiotic-resistant bacteria.
You should never stop taking ertapenem suddenly or shorten the duration of treatment without consulting your healthcare provider. Antibiotics must be taken for the full prescribed duration to ensure that all the bacteria causing the infection are completely eradicated. If you stop the medication prematurely, the remaining bacteria may multiply, causing the infection to return, often in a more severe or resistant form. If you are experiencing bothersome side effects, talk to your doctor; they may be able to provide supportive care to help you finish the course safely. Completing the full treatment is the best way to ensure a full recovery.
Since ertapenem is typically administered by a healthcare professional in a hospital or clinic, missing a dose is uncommon. However, if you are receiving the medication at home through an infusion service and you miss a scheduled dose, you should contact your doctor or infusion nurse immediately for instructions. Do not attempt to double the dose to make up for the one you missed, as this can increase the risk of side effects like seizures. Your healthcare provider will help you get back on the correct schedule. Timely administration is important to keep a steady level of the antibiotic in your body to fight the infection effectively.
Weight gain is not a recognized or common side effect of ertapenem. Clinical trials and post-marketing surveillance have not shown a link between short-term use of this antibiotic and changes in body weight. If you experience sudden weight gain or swelling (edema) while taking ertapenem, it could be a sign of a different medical issue, such as kidney problems or a reaction to the intravenous fluids being administered. You should report any unusual swelling or rapid weight changes to your healthcare provider. They will perform an evaluation to determine the underlying cause and ensure your treatment is progressing safely.
Ertapenem can interact with several other medications, so it is vital to provide your doctor with a complete list of everything you are taking. A major interaction occurs with valproic acid (a seizure medication), as ertapenem can significantly lower its levels, potentially leading to seizures. It also interacts with probenecid, which can increase the levels of ertapenem in your blood. Other interactions may occur with live vaccines and blood thinners like warfarin. Your doctor will review your medications to ensure there are no dangerous combinations. In some cases, they may need to adjust your dosages or choose a different antibiotic altogether.
Yes, ertapenem is available as a generic medication. The brand name version, Invanz, was the only form available for many years, but the FDA has since approved generic versions of ertapenem sodium for injection. Generic medications are required to have the same active ingredient, strength, dosage form, and route of administration as the brand-name drug. They must also meet the same rigorous standards for quality and efficacy. Using the generic version can often be more cost-effective for patients and healthcare systems while providing the same therapeutic benefits. Your hospital or insurance provider will determine which version is used for your treatment.
Other drugs with the same active ingredient (Ertapenem)