Adult

Ertapenem

General Information

Restricted formulary antimicrobial: For details see OUH netFormulary

AWaRe antibiotic classification: 'Reserve'. All indications to be discussed with Micro/ID.

Renal and hepatic impairment

Renal impairment

eGFR (mL/min/1.73m2)

IV dose

More than 30

Dose as in normal renal function

10-30

Use 50-100% of dose

Less than 10

1g three times a week
HD/HDF/High Flux/PD

Dose as in eGFR less than 10ml/min/1.73m2.

Dialysed; give after dialysis


Hepatic impairment
No dose adjustment required in hepatic impairment.

Pregnancy and breastfeeding

Pregnancy

Use only if potential benefit outweighs risk

Breastfeeding

Discuss with pharmacy.

Additional information

  • There is a clinically significant interaction between carbapenems and sodium valproate or valproic acid which results in reduced valproate plasma concentrations with potential for inadequate seizure control. If patient is already prescribed sodium valproate or valproic acid and ertapenem is recommended discuss with Micro/ID and relevant medical team.
  • Discuss dosing for obese patients with Micro/ID.

References

  1. Summary of Product Characteristics (SPC) for Invanz 1g powder for concentrate for solution for infusion. Accessed via www.medicines.org.uk 26/03/18. Last updated 15/02/16
  2. The Renal Drug Database. Ertapenem. Accessed via renaldrugdatabase.com 26/03/18. Last updated 19/12/17
  3. MHRA. Drug Safety update (December 2014). Carbapenems: concomitant use with valproic acid not recommended. Accessed at https://www.gov.uk/drug-safety-update/carbapenems-concomitant-use-with-valproic-acid-not-recommended