Drug interactions
Cilastatin-imipenem + Sodium picosulfate / magnesium oxide / anhydrous citric acid
Severity: Moderate
Cilastatin-imipenem and Sodium picosulfate / magnesium oxide / anhydrous citric acid: 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
The picosulfate component of this bowel preparation depends on colonic bacteria for activation. Imipenem may alter the gut flora and weaken the laxative effect, risking incomplete bowel cleansing.
What this interaction means in plain words
Cilastatin-imipenem and Sodium picosulfate / magnesium oxide / anhydrous citric acid 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.
Why it happens
Antibiotic-induced suppression of colonic bacteria reduces conversion of picosulfate to its active metabolite.
What to do
Assess bowel cleansing adequacy before the procedure and consider rescheduling or using a non-prodrug preparation if the patient is on antibiotics. The magnesium citrate component partly preserves the osmotic effect.
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?
Pro+ members
Unlock the full page
Create an account and start a Pro+ trial to unlock the full management advice for Cilastatin-imipenem and Sodium picosulfate / magnesium oxide / anhydrous citric acid, the additional notes, the evidence detail and the whole-prescription interaction checker.
- Full clinical management advice
- Additional notes
- Evidence detail
- Interaction checker for a whole prescription
Try Pro+ free for 7 days on the web. No card needed.
Other interactions of Cilastatin-imipenem
Frequently asked questions
Can I take Cilastatin-imipenem with Sodium picosulfate / magnesium oxide / anhydrous citric acid?
MediHelp rates the interaction as moderate. Cilastatin-imipenem and Sodium picosulfate / magnesium oxide / anhydrous citric acid 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. The picosulfate component of this bowel preparation depends on colonic bacteria for activation. Imipenem may alter the gut flora and weaken the laxative effect, risking incomplete bowel cleansing.
How serious is the interaction between Cilastatin-imipenem and Sodium picosulfate / magnesium oxide / anhydrous citric acid?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Assess bowel cleansing adequacy before the procedure and consider rescheduling or using a non-prodrug preparation if the patient is on antibiotics. The magnesium citrate component partly preserves the osmotic effect.
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.
Full monographs, dosing and an interaction checker in the MediHelp app
Open the complete reference, check multi-drug interactions and use dosing tools in the MediHelp app.
