Cilastatin-imipenem + Sodium picosulfate

MediHelp rates the interaction as moderate. Cilastatin-imipenem and Sodium picosulfate 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. Sodium picosulfate is a prodrug that needs colonic bacteria to be converted to its active laxative form. Systemic antibiotics such as imipenem may disturb the colonic flora and reduce this activation, which can lead to a poorer bowel cleansing result before colonoscopy.

MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Where possible, avoid scheduling bowel preparation during an antibiotic course, or confirm the quality of bowel cleansing before the procedure. Consider an alternative preparation not dependent on bacterial activation if cleansing is likely to be inadequate.

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