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Stability of Imipenem and Cilastatin Sodium in Total Parenteral Nutrient Solution

Department of Pharmacy Services, and College of Pharmacy, University of Michigan, Ann Arbor, Michigan

Claudia Sanders Krcmarik, B.S

Department of Pharmacy Services, and College of Pharmacy, University of Michigan, Ann Arbor, Michigan

Robert Wolk, PHARM.D.

Department of Pharmacy Services, and College of Pharmacy, University of Michigan, Ann Arbor, Michigan

Nabil Khalidi, PHARM.D.

Department of Pharmacy Services, and College of Pharmacy, University of Michigan, Ann Arbor, Michigan

The chemical stability and compatibility of imipenem-cilastatin sodium (Primaxin) in two different total parenteral nutrient (TPN) solutions was determined. TPN solutions consisted of 4.25% and 5% amino acids with 25% and 35% dextrose, respectively.

Imipenem-cilastatin sodium was constituted with 10 ml of sterile water and admixed with 90 ml of TPN solution for a final concentration of 5 mg/ml of each drug. The final solutions were assayed at times 0 (immediately after admixture), 15 min, 30 min, 1, 4, 8, and 24 hr by a stability-indicating high-performance liquid chromatographic assay. Concurrently, test TPN solutions were monitored for pH changes, color changes, and precipitate formation. The potential effect of imipenem-cilastatin sodium on the stability of amino acids and other TPN additives was not evaluated.

Imipenem and cilastatin sodium was stable (90% recovered) in each TPN solution at 15 min. A significant (10%) and steady decrease of imipenem recovery occurred at subsequent sampling times. Cilastatin appeared more stable than imipenem in both TPN solutions. A physical color change from colorless to dark orange appeared in each TPN solution over the 24-hr study period.

Imipenem-cilastatin sodium is stable for 15 min in the TPN solutions studied; however, until the stability of the amino acids can be determined, the antibiotic should be administered through a separate line or Y-site while the TPN infusion is interrupted. (Journal of Parenteral and Enteral Nutrition 14:306-309, 1990)

Journal of Parenteral and Enteral Nutrition, Vol. 14, No. 3, 306-309 (1990)
DOI: 10.1177/0148607190014003306


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