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antibiotic

Cilastatin

Combined with an antibiotic (imipenem) to prolong its action. This molecule appears in 132 of the medicines we have indexed.

Our answerAn active ingredient to consider

The active ingredient to consider

  • Probioticsa single documented strain, for example Saccharomyces boulardii, with the CFU count stated

We do not make a formula for this treatment. Talk to your doctor or pharmacist about this active ingredient.

See the details

By the Layer Nutrition editorial teamHow the atlas classifies the 664 molecules

Class
antibiotic
Indexed medicines
132
Our answer
An active ingredient to consider
Updated
October 2026
01The medication

What this medicine is for

This molecule belongs to the “antibiotic” category. Antibiotics treat infections caused by bacteria. They are taken as a course, over a set duration, until the end of the prescription.

In practice: Combined with an antibiotic (imipenem) to prolong its action. Its use is generally limited in time and adjusted to the situation.

The name on your box may be here.

These names come from the public registers of 32 countries: the ANSM for France, the AEMPS for Spain, the AIFA for Italy, the HPRA for Ireland, Swissmedic for Switzerland, and the European Medicines Agency for the others.

Most widespread

  • RECARBRIO
  • ANDATIN
  • ENAROS
  • MIRON
  • NIMEDINE
  • МИРОН
  • CILOPEN
  • IMICIL
  • IMICILAST
  • IMPECIN
  • LMIPENEM/CILASTATIN STERISCIENCE
  • PRIMAGAL
See all names, country by countryHide the list by country

France8

  • RECARBRIO
  • IMIPENEM/CILASTATINE ACS DOBFAR
  • IMIPENEM/CILASTATINE ARROW
  • IMIPENEM/CILASTATINE HIKMA
  • IMIPENEM CILASTATINE PANPHARMA
  • IMIPENEM/CILASTATINE SUN
  • IMIPENEM/CILASTATINE TAMRISA
  • IMIPENEM CILASTATINE VIATRIS

Germany8

  • RECARBRIO
  • IMIPENEM/CILASTATIN BASICS
  • IMIPENEM/CILASTATIN EBERTH
  • IMIPENEM/CILASTATIN HIKMA
  • IMIPENEM/CILASTATIN KABI
  • IMIPENEM/CILASTATIN NORIDEM
  • IMIPENEM CILASTATIN PANPHARMA
  • IMIPENEM/CILASTATIN STERISCIENCE

Spain7

  • ENAROS
  • RECARBRIO
  • IMIPENEM/CILASTATINA AUROVITAS
  • IMIPENEM/CILASTATINA HIKMA
  • IMIPENEM/CILASTATINA KABI
  • IMIPENEM/CILASTATINA NORIDEM
  • IMIPENEM/CILASTATINA STERISCIENCE

Italy7

  • RECARBRIO
  • IMIPENEM E CILASTATINA STERISCIENCE
  • IMIPENEM CILASTATINA KABI
  • IMIPENEM E CILASTATINA AUROBINDO
  • IMIPENEM E CILASTATINA HIKMA
  • IMIPENEM E CILASTATINA NORIDEM
  • IMIPENEM E CILASTATINA SUN

United Kingdom4

  • IMIPENEM/CILASTATIN ACCORD HEALTHCARE
  • IMIPENEM/CILASTATIN FRESENIUS KABI
  • IMIPENEM/CILASTATIN HIKMA FARMACÊUTICA
  • IMIPENEM/CLIASTATIN FRESENIUS KABI

Ireland2

  • RECARBRIO
  • IMIPENEM/CILASTATIN

Switzerland2

  • IMIPENEM-CILASTATIN LABATEC
  • IMIPENEM-CILASTATIN-MEPHA I.V.

Austria5

  • RECARBRIO
  • IMIPENEM/CILASTATIN APTAPHARMA
  • IMIPENEM/CILASTATIN EBERTH
  • IMIPENEM/CILASTATIN HIKMA
  • IMIPENEM/CILASTATIN KABI

Belgium1

  • RECARBRIO

Bulgaria2

  • МИРОН
  • RECARBRIO

Cyprus6

  • IMICILAST
  • MIRON
  • RECARBRIO
  • IMIPENEM/CILASTATIN APTAPHARMA
  • IMIPENEM/CILASTATIN NORIDEM
  • IMIPENEM + CILASTATINA VENUS PHARMA

Croatia4

  • MIRON
  • RECARBRIO
  • IMIPENEM/CILASTATIN APTAPHARMA
  • IMIPENEM/CILASTATIN KABI

Denmark3

  • ANDATIN
  • RECARBRIO
  • IMIPENEM/CILASTATIN NORIDEM

Estonia2

  • RECARBRIO
  • IMIPENEM/CILASTATIN KABI

Finland3

  • ANDATIN
  • RECARBRIO
  • IMIPENEM/CILASTATIN NORIDEM

Greece5

  • IMICIL
  • NIMEDINE
  • PRIMAGAL
  • RECARBRIO
  • IMIPENEM+CILASTATIN/KABI

Hungary5

  • IMPECIN
  • RECARBRIO
  • IMIPENEM/CILASTATIN APTAPHARMA
  • IMIPENEM/CILASTATIN KABI
  • IMIPENEM/CILASTATIN STERISCIENCE

Iceland1

  • RECARBRIO

Latvia2

  • RECARBRIO
  • IMIPENEM/CILASTATIN SUN

Liechtenstein1

  • RECARBRIO

Lithuania3

  • RECARBRIO
  • STINEM
  • IMIPENEM/CILASTATIN SUN

Luxembourg1

  • RECARBRIO

Malta4

  • MIRON
  • NIMEDINE
  • RECARBRIO
  • IMIPENEM/CILASTATIN APTAPHARMA

Norway4

  • ANDATIN
  • RECARBRIO
  • IMIPENEM/CILASTATIN FRESENIUS KABI
  • IMIPENEM/CILASTATIN NORIDEM

Netherlands5

  • RECARBRIO
  • TIENAM
  • IMIPENEM/CILASTATINE FRESENIUS KABI
  • IMIPENEM/CILASTATINE HIKMA
  • IMIPENEM/CILASTATINE NORIDEM

Poland5

  • RECARBRIO
  • IMIPENEM + CILASTATIN APTAPHARMA
  • IMIPENEM/CILASTATIN KABI
  • IMIPENEM + CILASTATIN NORIDEM
  • IMIPENEM + CYLASTATYNA RANBAXY

Portugal8

  • ENAROS
  • RECARBRIO
  • TIENALIE
  • IMIPENEM + CILASTATINA AUROVITAS
  • IMIPENEM + CILASTATINA COLOR
  • IMIPENEM/CILASTATINA HIKMA
  • IMIPENEM/CILASTATINA KABI
  • IMIPENEM + CILASTATINA VENUS PHARMA

Romania7

  • CILOPEN
  • LMIPENEM/CILASTATIN STERISCIENCE
  • RECARBRIO
  • IMIPENEM/CILASTATIN APTAPHARMA
  • IMIPENEM/CILASTATIN ATB
  • IMIPENEM/CILASTATIN NORIDEM
  • IMIPENEM/CILASTATINA KABI

Slovakia4

  • RECARBRIO
  • IMIPENEM/CILASTATIN APTAPHARMA
  • IMIPENEM/CILASTATIN KABI
  • IMIPENEM/CILASTATIN NORIDEM

Slovenia4

  • RECARBRIO
  • IMIPENEM/CILASTATIN APTAPHARMA
  • IMIPENEM/CILASTATIN KABI
  • IMIPENEM/CILASTATIN TEVA

Sweden4

  • RECARBRIO
  • IMIPENEM/CILASTATIN FRESENIUS KABI
  • IMIPENEM/CILASTATIN NORIDEM
  • IMIPENEM/CILASTATIN STERISCIENCE

Czechia5

  • ENAROS
  • RECARBRIO
  • IMIPENEM/CILASTATIN APTAPHARMA
  • IMIPENEM/CILASTATIN KABI
  • IMIPENEM/CILASTATIN NORIDEM
02Its place in the atlas

One answer out of three.

The atlas gives each molecule one of these three answers. Most call for nothing.

  • Our formula31 molecules
  • An active ingredient to consider59 moleculesincluding this one
  • Nothing to add574 molecules
Fig. 1The outlined square: Cilastatin, one molecule among the 664 in the atlas. List: ANSM. Classification: Layer Nutrition.
03On your plate

On your plate: supporting the gut flora

A course of imipenem/cilastatin targets the bacteria responsible for the infection, but it also affects some of those that populate the gut. Food helps maintain this ecosystem, with foods rich in live cultures and in fibre.

Fermented foods provide live cultures that take part in the balance of the flora. Plain yoghurt remains the simplest and most regular source to keep up day after day. Aged cheese also contains them. Built into ordinary meals, these foods sustain a varied bacterial presence in the gut.

Fibre serves as food for the beneficial bacteria of the colon. It is found in oats, barley, pulses such as lentils, chickpeas and beans, as well as in bananas and wholegrain cereals. Varying these sources over the course of the week supports the flora, in addition to your treatment.

Bowl of plain yoghurt, a source of live cultures
Plain yoghurt
Oat flakes rich in fibre
Oats
Raw lentils in a pile
Legumes
Ripe bananas rich in fibre
Banana
04The file

Why this answer

How cilastatin works

Cilastatin does not act against bacteria. It is always given together with imipenem, an antibiotic in the carbapenem family. When imipenem circulates on its own, a kidney enzyme called dehydropeptidase I breaks it down, leaving low concentrations in the urine. Cilastatin inhibits precisely this enzyme.

By blocking dehydropeptidase I, cilastatin prevents the kidney from destroying imipenem. The antibiotic then remains active in the body for longer and reaches concentrations high enough to work, including in the urine. Its role comes down to protecting and prolonging the action of imipenem, not to fighting the infection itself.

Why and how it is given

The imipenem/cilastatin combination treats certain serious bacterial infections. The active antibiotic component, imipenem, belongs to the carbapenems, a broad-spectrum class. The medicine is given by infusion into a vein: 500 mg is delivered over 20 to 30 minutes, 1000 mg over 40 to 60 minutes. The intramuscular route is also possible.

The infusions are repeated every 6 to 8 hours, on a regular schedule set by the care team. The plasma half-life of each of the two components is about 1 hour, which explains the closely spaced doses. Elimination is renal: about 70 % of imipenem is found in the urine within 10 hours. This treatment is given in hospital and follows the duration decided by the doctor, without stopping early.

The side effects to be aware of

In adults, the most common side effects are the following. Phlebitis, an inflammation of the infused vein, affects 3.1 % of patients. Next come nausea (2.0 %), diarrhoea (1.8 %), vomiting (1.5 %) and skin rash (0.9 %). Seizures are rarer, at 0.4 %.

Like most antibiotics, imipenem/cilastatin can upset the gut flora and trigger Clostridioides difficile diarrhoea. Its severity varies, from mild diarrhoea to colitis that can be fatal. Diarrhoea that persists or worsens during or after treatment warrants medical advice.

Kidneys, seizures and laboratory tests

The risk of seizures increases when the kidneys function poorly. Adults whose creatinine clearance is less than or equal to 30 mL/min, whether on dialysis or not, have a higher risk of seizures than people with normal kidney function. The dose is therefore adjusted according to kidney status, and kidney function is monitored during treatment.

Treatment can alter several blood parameters. A drop in sodium, a rise in potassium and chloride, an increase in liver enzymes (ALT, AST, alkaline phosphatase), a rise in eosinophils and platelets, or a fall in haemoglobin and haematocrit are sometimes observed. The medicine itself provides sodium: the 500 mg form contains 37.5 mg per dose. Blood tests accompany the follow-up.

Drug interactions

Two combinations bear on the risk of seizures. With ganciclovir, an antiviral, generalised seizures have been reported in patients receiving both medicines at the same time. With valproic acid or divalproex sodium, the carbapenem lowers valproate concentrations, which causes loss of seizure control and increases the epileptic risk.

Probenecid affects the fate of imipenem: taken at the same time, it increases the plasma level and half-life of the antibiotic. These interactions make it important to give the care team the complete list of current treatments. Follow-up combines clinical monitoring, dose adjustment and laboratory tests.

05The active ingredients

Supplements to consider

Beyond the plate, a single isolated nutrient can be worth discussing, to confirm with your doctor or pharmacist. Here is which one and in which form.

Probiotics

Probiotics are live micro-organisms, mainly lactobacilli and bifidobacteria. The CFU count and the number of strains are among the selection criteria; gastro-resistant capsules protect the bacteria from stomach acidity.

Preferred forma single documented strain, for example Saccharomyces boulardii, with the CFU count stated

To be confirmed with your doctor or pharmacist.

07Another treatment

Do you also take another treatment?

Type the name written on the box. The atlas gives you its answer.

For example Panadol, Doliprane or paracetamol.

08Questions

Frequently asked questions

What is cilastatin and what is it used for?

Cilastatin is not an antibiotic: it is combined with imipenem, an antibiotic from the carbapenem family. Its role is to block a kidney enzyme that would otherwise break down imipenem, so that the antibiotic stays active in the body. For the details of how it works, refer to the package leaflet and speak with your doctor or pharmacist.

Is cilastatin an antibiotic?

No. In the combination, imipenem is the antibiotic; cilastatin only serves to protect it from being broken down by the kidney. The two are used together in an injectable form. Your pharmacist or doctor can explain the role of each component.

What are the side effects of imipenem-cilastatin?

The package leaflet notably mentions digestive problems such as nausea, vomiting or diarrhoea, as well as reactions at the injection site. The full list and rarer effects are given in the leaflet. If you experience any troublesome or unexpected symptom, contact your doctor or pharmacist without delay.

Are there any drug interactions to be aware of with imipenem-cilastatin?

The package leaflet reports interactions, in particular with valproic acid (sodium valproate) and with ganciclovir. Tell your doctor about all the medicines you take, including those obtained without a prescription. What to do about it is a matter for the leaflet and for your doctor or pharmacist.

How is imipenem-cilastatin administered?

It is an injectable treatment, usually given intravenously in a hospital setting under medical supervision. The exact arrangements are decided by the care team and detailed in the package leaflet. Direct any question about administration to your doctor or pharmacist.

Why keep an eye on the gut flora with an antibiotic such as imipenem, and what can be considered?

Imipenem is a broad-spectrum antibiotic, and studies link antibiotic treatments to an imbalance of the gut microbiome, which can show up as digestive problems. To support your gut flora during and after treatment, the active to consider is a probiotic, for example yeasts such as Saccharomyces boulardii or Lactobacillus-type strains, in capsule or sachet form. This nutrition point does not replace the advice of your doctor or pharmacist.

These answers draw on the patient leaflet and on the published literature. For any question about your medicine, the patient leaflet and your doctor or pharmacist are the reference.