Imipenem/cilastatin | GlobalRPh Renal Dosing Master

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These are the historical source weight-based tables, not a claim that they reproduce current PRIMAXIN labeling. Indexed thresholds and the unindexed printed clearance formula require reconciliation.

Usual Dosing (Adults)

PRIMAXIN IV doses represent the imipenem component, with an equivalent amount of cilastatin. Infuse 125, 250 or 500 mg over 20 to 30 minutes; infuse 750 or 1000 mg over 40 to 60 minutes. Slow the infusion if nausea occurs. Total daily dose depends on infection type/severity, pathogen susceptibility, renal function and body weight, in equally divided doses.

Table I applies to body weight >=70 kg and CrCl >=71 mL/min/1.73 m2. Reduce for CrCl <=70 and/or weight <70 kg.

Infection	Fully susceptible organisms, including gram-positive/gram-negative aerobes and anaerobes	Moderately susceptible organisms, primarily some P. aeruginosa
Mild	250 mg every 6 hours (1 g/day)	500 mg every 6 hours (2 g/day)
Moderate	500 mg every 8 hours (1.5 g/day) or every 6 hours (2 g/day)	500 mg every 6 hours (2 g/day) or 1 g every 8 hours (3 g/day)
Severe, life-threatening only	500 mg every 6 hours (2 g/day)	1 g every 8 hours (3 g/day) or every 6 hours (4 g/day)
Uncomplicated urinary tract	250 mg every 6 hours (1 g/day)	250 mg every 6 hours (1 g/day)
Complicated urinary tract	500 mg every 6 hours (2 g/day)	500 mg every 6 hours (2 g/day)

Maximum total daily dosage should not exceed 50 mg/kg/day or 4 g/day, whichever is lower; higher doses have no evidence of greater efficacy. Patients >12 years with cystic fibrosis and normal renal function have been treated up to 90 mg/kg/day in divided doses, not exceeding 4 g/day.

Renal Dosing - Method

Reduce with CrCl <=70 mL/min/1.73 m2 and/or weight <70 kg. The source prints Cockcroft-Gault: male CrCl = [(140 - age in years) x weight in kg] / [72 x serum creatinine in mg/dL], female result x0.85.

Select a normal total daily dose from Table I, then the corresponding subsection of Table II or III. Select the body weight closest to the patient and the creatinine-clearance column; their intersection gives the reduced regimen.

In the following source tables, all amounts are milligrams of imipenem per dose, accompanied by an equal amount of cilastatin. The source creatinine-clearance units are mL/min/1.73 m2.

Renal Dosing - Table II, baseline 1 g/day

Weight (kg)	CrCl >=71	CrCl 41 to 70	CrCl 21 to 40	CrCl 6 to 20
>=70	250 mg every 6 hours	250 mg every 8 hours	250 mg every 12 hours	250 mg every 12 hours
60	250 mg every 8 hours	125 mg every 6 hours	250 mg every 12 hours	125 mg every 12 hours
50	125 mg every 6 hours	125 mg every 6 hours	125 mg every 8 hours	125 mg every 12 hours
40	125 mg every 6 hours	125 mg every 8 hours	125 mg every 12 hours	125 mg every 12 hours
30	125 mg every 8 hours	125 mg every 8 hours	125 mg every 12 hours	125 mg every 12 hours

Renal Dosing - Table II, baseline 1.5 g/day

Weight (kg)	CrCl >=71	CrCl 41 to 70	CrCl 21 to 40	CrCl 6 to 20
>=70	500 mg every 8 hours	250 mg every 6 hours	250 mg every 8 hours	250 mg every 12 hours
60	250 mg every 6 hours	250 mg every 8 hours	250 mg every 8 hours	250 mg every 12 hours
50	250 mg every 6 hours	250 mg every 8 hours	250 mg every 12 hours	250 mg every 12 hours
40	250 mg every 8 hours	125 mg every 6 hours	125 mg every 8 hours	125 mg every 12 hours
30	125 mg every 6 hours	125 mg every 8 hours	125 mg every 8 hours	125 mg every 12 hours

Renal Dosing - Table II, baseline 2 g/day

Weight (kg)	CrCl >=71	CrCl 41 to 70	CrCl 21 to 40	CrCl 6 to 20
>=70	500 mg every 6 hours	500 mg every 8 hours	250 mg every 6 hours	250 mg every 12 hours
60	500 mg every 8 hours	250 mg every 6 hours	250 mg every 8 hours	250 mg every 12 hours
50	250 mg every 6 hours	250 mg every 6 hours	250 mg every 8 hours	250 mg every 12 hours
40	250 mg every 6 hours	250 mg every 8 hours	250 mg every 12 hours	250 mg every 12 hours
30	250 mg every 8 hours	125 mg every 6 hours	125 mg every 8 hours	125 mg every 12 hours

Renal Dosing - Table III, baseline 3 g/day

Weight (kg)	CrCl >=71	CrCl 41 to 70	CrCl 21 to 40	CrCl 6 to 20
>=70	1000 mg every 8 hours	500 mg every 6 hours	500 mg every 8 hours	500 mg every 12 hours
60	750 mg every 8 hours	500 mg every 8 hours	500 mg every 8 hours	500 mg every 12 hours
50	500 mg every 6 hours	500 mg every 8 hours	250 mg every 6 hours	250 mg every 12 hours
40	500 mg every 8 hours	250 mg every 6 hours	250 mg every 8 hours	250 mg every 12 hours
30	250 mg every 6 hours	250 mg every 8 hours	250 mg every 8 hours	250 mg every 12 hours

Renal Dosing - Table III, baseline 4 g/day

Weight (kg)	CrCl >=71	CrCl 41 to 70	CrCl 21 to 40	CrCl 6 to 20
>=70	1000 mg every 6 hours	750 mg every 8 hours	500 mg every 6 hours	500 mg every 12 hours
60	1000 mg every 8 hours	750 mg every 8 hours	500 mg every 8 hours	500 mg every 12 hours
50	750 mg every 8 hours	500 mg every 6 hours	500 mg every 8 hours	500 mg every 12 hours
40	500 mg every 6 hours	500 mg every 8 hours	250 mg every 6 hours	250 mg every 12 hours
30	500 mg every 8 hours	250 mg every 6 hours	250 mg every 8 hours	250 mg every 12 hours

Renal Dosing - Limitations

At CrCl 6 to 20 mL/min/1.73 m2, use 125 or 250 mg every 12 hours for most pathogens; 500 mg every 12 hours may increase seizure risk. At CrCl <=5, do not give unless hemodialysis is instituted within 48 hours. Information is inadequate to recommend use in peritoneal dialysis.

Hemodialysis

For CrCl <=5 with HD, use the CrCl 6 to 20 recommendations. HD clears both imipenem and cilastatin. Give after HD and every 12 hours timed from the end of that session. Monitor dialysis patients carefully, especially with pre-existing CNS disease; use only if benefits outweigh seizure risk.

Source revision: Historical source; revision not established here | Retrieved: 2026-09-05. Retrieval date is not the revision date.

Source: https://globalrph.com/renal/imipenemcilastin/

Scope: Preserved historical source; no fresh clinical approval GlobalRPh v6.6.

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Retrieved: 2026-09-05

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Usual Dosing (Adults)Renal Dosing - Method Renal Dosing - Table II, baseline 1 g/day Renal Dosing - Table II, baseline 1.5 g/day Renal Dosing - Table II, baseline 2 g/day Renal Dosing - Table III, baseline 3 g/day Renal Dosing - Table III, baseline 4 g/day Renal Dosing - Limitations Hemodialysis Read this complete source summary

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Important source distinctions

These are the historical source weight-based tables, not a claim that they reproduce current PRIMAXIN labeling. Indexed thresholds and the unindexed printed clearance formula require reconciliation.

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Clinical facts and comments transcribed into a structured reading format. This is not a byte-for-byte HTML archive. Original source: https://globalrph.com/renal/imipenemcilastin/

Usual Dosing (Adults)

Table I applies to body weight >=70 kg and CrCl >=71 mL/min/1.73 m2. Reduce for CrCl <=70 and/or weight <70 kg.

Infection	Fully susceptible organisms, including gram-positive/gram-negative aerobes and anaerobes	Moderately susceptible organisms, primarily some P. aeruginosa
Mild	250 mg every 6 hours (1 g/day)	500 mg every 6 hours (2 g/day)
Moderate	500 mg every 8 hours (1.5 g/day) or every 6 hours (2 g/day)	500 mg every 6 hours (2 g/day) or 1 g every 8 hours (3 g/day)
Severe, life-threatening only	500 mg every 6 hours (2 g/day)	1 g every 8 hours (3 g/day) or every 6 hours (4 g/day)
Uncomplicated urinary tract	250 mg every 6 hours (1 g/day)	250 mg every 6 hours (1 g/day)
Complicated urinary tract	500 mg every 6 hours (2 g/day)	500 mg every 6 hours (2 g/day)

GRPH-imipenemcilastin-01 · Source section: Usual Dosing (Adults)Renal section finder

Renal Dosing - Method

In the following source tables, all amounts are milligrams of imipenem per dose, accompanied by an equal amount of cilastatin. The source creatinine-clearance units are mL/min/1.73 m2.

GRPH-imipenemcilastin-02 · Source section: Renal Dosing - MethodRenal section finder

Renal Dosing - Table II, baseline 1 g/day

Weight (kg)	CrCl >=71	CrCl 41 to 70	CrCl 21 to 40	CrCl 6 to 20
>=70	250 mg every 6 hours	250 mg every 8 hours	250 mg every 12 hours	250 mg every 12 hours
60	250 mg every 8 hours	125 mg every 6 hours	250 mg every 12 hours	125 mg every 12 hours
50	125 mg every 6 hours	125 mg every 6 hours	125 mg every 8 hours	125 mg every 12 hours
40	125 mg every 6 hours	125 mg every 8 hours	125 mg every 12 hours	125 mg every 12 hours
30	125 mg every 8 hours	125 mg every 8 hours	125 mg every 12 hours	125 mg every 12 hours

GRPH-imipenemcilastin-03 · Source section: Renal Dosing - Table II, baseline 1 g/dayRenal section finder

Renal Dosing - Table II, baseline 1.5 g/day

Weight (kg)	CrCl >=71	CrCl 41 to 70	CrCl 21 to 40	CrCl 6 to 20
>=70	500 mg every 8 hours	250 mg every 6 hours	250 mg every 8 hours	250 mg every 12 hours
60	250 mg every 6 hours	250 mg every 8 hours	250 mg every 8 hours	250 mg every 12 hours
50	250 mg every 6 hours	250 mg every 8 hours	250 mg every 12 hours	250 mg every 12 hours
40	250 mg every 8 hours	125 mg every 6 hours	125 mg every 8 hours	125 mg every 12 hours
30	125 mg every 6 hours	125 mg every 8 hours	125 mg every 8 hours	125 mg every 12 hours

GRPH-imipenemcilastin-04 · Source section: Renal Dosing - Table II, baseline 1.5 g/dayRenal section finder

Renal Dosing - Table II, baseline 2 g/day

Weight (kg)	CrCl >=71	CrCl 41 to 70	CrCl 21 to 40	CrCl 6 to 20
>=70	500 mg every 6 hours	500 mg every 8 hours	250 mg every 6 hours	250 mg every 12 hours
60	500 mg every 8 hours	250 mg every 6 hours	250 mg every 8 hours	250 mg every 12 hours
50	250 mg every 6 hours	250 mg every 6 hours	250 mg every 8 hours	250 mg every 12 hours
40	250 mg every 6 hours	250 mg every 8 hours	250 mg every 12 hours	250 mg every 12 hours
30	250 mg every 8 hours	125 mg every 6 hours	125 mg every 8 hours	125 mg every 12 hours

GRPH-imipenemcilastin-05 · Source section: Renal Dosing - Table II, baseline 2 g/dayRenal section finder

Renal Dosing - Table III, baseline 3 g/day

Weight (kg)	CrCl >=71	CrCl 41 to 70	CrCl 21 to 40	CrCl 6 to 20
>=70	1000 mg every 8 hours	500 mg every 6 hours	500 mg every 8 hours	500 mg every 12 hours
60	750 mg every 8 hours	500 mg every 8 hours	500 mg every 8 hours	500 mg every 12 hours
50	500 mg every 6 hours	500 mg every 8 hours	250 mg every 6 hours	250 mg every 12 hours
40	500 mg every 8 hours	250 mg every 6 hours	250 mg every 8 hours	250 mg every 12 hours
30	250 mg every 6 hours	250 mg every 8 hours	250 mg every 8 hours	250 mg every 12 hours

GRPH-imipenemcilastin-06 · Source section: Renal Dosing - Table III, baseline 3 g/dayRenal section finder

Renal Dosing - Table III, baseline 4 g/day

Weight (kg)	CrCl >=71	CrCl 41 to 70	CrCl 21 to 40	CrCl 6 to 20
>=70	1000 mg every 6 hours	750 mg every 8 hours	500 mg every 6 hours	500 mg every 12 hours
60	1000 mg every 8 hours	750 mg every 8 hours	500 mg every 8 hours	500 mg every 12 hours
50	750 mg every 8 hours	500 mg every 6 hours	500 mg every 8 hours	500 mg every 12 hours
40	500 mg every 6 hours	500 mg every 8 hours	250 mg every 6 hours	250 mg every 12 hours
30	500 mg every 8 hours	250 mg every 6 hours	250 mg every 8 hours	250 mg every 12 hours

GRPH-imipenemcilastin-07 · Source section: Renal Dosing - Table III, baseline 4 g/dayRenal section finder

Renal Dosing - Limitations

GRPH-imipenemcilastin-08 · Source section: Renal Dosing - LimitationsRenal section finder

Hemodialysis

GRPH-imipenemcilastin-09 · Source section: HemodialysisRenal section finder

Provenance and preservation

Additional summaries stored on this page: 0 official-label, 0 RX List, 0 professional, 0 handbook. Empty additional-source groups are not shown. A missing layer is not a no-adjustment recommendation.

Original source: https://globalrph.com/renal/imipenemcilastin/
Source retrieval: 2026-09-05. This is not the source publication or label revision date.
Original source type: globalrph individual
Local text SHA-256: 9850aa776f5582cb4853e12046ac72a37efd2a72ed3a49873a475972319bcc2e
Import versus clinical validation: Source-section locators identify where retained content came from. A source-section identifier does not assert that every numeric statement has been independently corroborated. The local text hash is not a hash of original HTML, an FDA PDF or SPL XML.

The original individual GlobalRPh pages commonly cite NIH/NLM DailyMed and instruct readers to review the applicable package insert for updates. That historical reference is preserved as context; it is not counted as an independently retrieved current label.

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