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Drug interactions

Bcg intravesical live + Cilastatin-imipenem

Severity: Moderate

Bcg intravesical live and Cilastatin-imipenem: moderate interaction.

Last updated

For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.

Summary

Intravesical BCG is a live attenuated mycobacterium that must remain viable to act. Systemic antibiotics, particularly those with antimycobacterial activity, may reduce its effect. Imipenem has limited mycobacterial activity, but BCG labeling advises postponing unnecessary antimicrobials.

What this interaction means in plain words

Bcg intravesical live and Cilastatin-imipenem can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken.

Evidence level: Low

Why it happens

Antibacterial activity may reduce the viability and local immune-stimulating effect of live BCG.

What to do

Defer elective antibiotic therapy during BCG instillations where possible. If an infection requires imipenem, consider holding the instillation until treatment is complete.

What to ask your pharmacist

  • Should I take them at different times of day?
  • Does the dose of either medicine need to change?
  • Is there anything I should avoid, such as alcohol or certain foods, while on both?

Bring a full list of your medicines, including over-the-counter products, supplements and herbal remedies, to every pharmacy visit.

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Frequently asked questions

Can I take Bcg intravesical live with Cilastatin-imipenem?

MediHelp rates the interaction as moderate. Bcg intravesical live and Cilastatin-imipenem can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken. Intravesical BCG is a live attenuated mycobacterium that must remain viable to act. Systemic antibiotics, particularly those with antimycobacterial activity, may reduce its effect. Imipenem has limited mycobacterial activity, but BCG labeling advises postponing unnecessary antimicrobials.

How serious is the interaction between Bcg intravesical live and Cilastatin-imipenem?

MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Defer elective antibiotic therapy during BCG instillations where possible. If an infection requires imipenem, consider holding the instillation until treatment is complete.

What other medicines interact with Cilastatin-imipenem?

MediHelp also lists interactions of Cilastatin-imipenem with, for example, Divalproex, Ganciclovir, Valproic acid. The full list is on the Cilastatin-imipenem page.

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