Imipenem with Cilastatin and Relebactam (Recarbrio®)
General Information
Carbapenem with dehydropeptidase inhibitor and beta-lactamase inhibitor
Restricted formulary antimicrobial: For details see OUH netFormulary
AWaRe antibiotic classification: 'Reserve'. All indications to be discussed with Micro/ID.
For all information regarding interactions, contraception, pregnancy and breastfeeding and additional information, see BNF
Note: There is an EPR powerplan associated with this drug.
Standard dose
|
Intravenous dose |
|
|
Standard dose
|
1250mg (500mg imipenem, 500mg cilastatin and 250mg relebactam) QDS
|
- Each vial contains 500 mg imipenem, 500 mg cilastatin and 250 mg relebactam.
- Standard dose of 1250mg (500mg imipenem, 500mg cilastatin and 250mg relebactam) is 1 vial
Renal and hepatic impairment
Renal impairment
|
Creatinine Clearance (mL/min)* |
Recommended dosage of Recarbrio® (imipenem/cilastatin/relebactam) |
Frequency |
|
90 or over |
Dose as in normal renal function |
|
|
60-89 |
1000mg (400mg/400mg/200mg) |
QDS |
|
30-59 |
750mg (300mg/300mg/150mg) |
QDS |
|
15-29 |
500mg (200mg/200mg/100mg) |
QDS |
|
End stage renal disease (ESRD) on haemodialysis** |
500mg (200mg/200mg/100mg) |
QDS (Administration should be timed to follow haemodialysis) |
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**Manufacturer advises that patients with creatinine clearance less than 15 mL/min should not receive Recarbrio® (imipenem/cilastatin/relebactam) unless haemodialysis is instituted within 48 hours. |
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*dose ranges use creatinine clearance, rather than eGFR.
Note: Patients with Creatinine clearance of 150 mL/min or more – discuss with Micro/ID as dose may need adjusting
Hepatic impairment
No dosage adjustment required.
MHRA Drug Safety Alerts
MHRA Drug Safety Update (December 2014) Carbapenems: concomitant use with valproic acid not recommended
- 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 the patient is already prescribed sodium valproate or valproic acid and imipenem-cilastatin-relebactam is recommended, discuss with Micro/ID and the relevant clinical team.
- OUH Weekly Safety Message 365 about Interaction between Sodium Valproate and Carbapenem Antibiotics can be found HERE (February 2026)
References
- Merck Sharp & Dohme (UK) Limited. Recarbrio 500 mg/500 mg/250 mg powder for solution for infusion summary of product characteristics. Electronic medicines compendium. Last revision of the text 2/2/26. Accessed via www.medicines.org.uk Accessed 16/2/26.
- British National Formulary. Imipenem-cilastatin-relebactam. BNF online accessed via www.medicinescomplete.com Accessed 16/2/26.
- The Renal Drug Database. Imipenem-cilastatin-relebactam (Recarbrio). Last updated 8/11/23. Accessed via https://renaldrugdatabase.com Accessed 16/2/26.
- Sanford Guide [online]. Imipenem-cilastatin-relebactam. Last updated 21/1/26. Accessed via https://webedition.sanfordguide.com Accessed 13/2/26
- MHRA. Drug Safety update (December 2014). Carbapenems: concomitant use with valproic acid not recommended. Available at https://www.gov.uk/drug-safety-update/carbapenems-concomitant-use-with-valproic-acid-not-recommended