What are the side effects of Invanz (ertapenem)?

Side Effects of Invanz (Ertapenem)

Invanz (ertapenem) most commonly causes diarrhea, nausea, headache, and infused vein complications, with diarrhea being the most frequent adverse effect. 1

Common Side Effects (≥5% of patients)

• Gastrointestinal effects:

  • Diarrhea
  • Nausea
  • Vomiting (especially in pediatric patients)

• Neurological effects:

  • Headache

• Administration site reactions:

  • Infused vein complications
  • Infusion site pain (more common in pediatric patients)
  • Phlebitis/thrombophlebitis

Less Common but Important Side Effects

Hypersensitivity Reactions

• Serious anaphylactic reactions (as with other β-lactam antibiotics)
• Rash
• Urticaria

Neurological Effects

• Seizures
• Dizziness
• Central nervous system adverse experiences

Drug Interactions

• Valproic acid/divalproex sodium: Ertapenem reduces serum concentration of valproic acid, potentially increasing seizure risk 1
• Probenecid: Inhibits renal excretion of ertapenem (co-administration not recommended) 1

Other Notable Effects

• Clostridioides difficile-associated diarrhea (ranging from mild to severe colitis)
• Liver enzyme elevations (ALT increases reported in approximately 8% of patients) 2
• Local reactions at injection site when administered intramuscularly

Special Populations Considerations

Renal Impairment

• Dose adjustment necessary for patients with creatinine clearance ≤30 mL/min/1.73 m² 1

Elderly Patients

• No overall differences in safety observed between elderly (≥65 years) and younger patients 2

Pediatric Patients

• Side effect profile similar to adults
• Higher frequency of vomiting and infusion site pain compared to adults 1

Monitoring Recommendations

1. Monitor for signs of hypersensitivity reactions, especially during initial administration
2. Watch for diarrhea that could indicate C. difficile infection
3. Monitor renal function in patients with renal impairment
4. Be alert for seizures in patients with CNS disorders or on valproic acid

Comparison to Other Carbapenems

Ertapenem has a safety profile comparable to other antibiotics in its class but with some advantages:

• Once-daily dosing (due to 4-hour half-life) 3
• Safety profile similar to comparator antibiotics like piperacillin-tazobactam and ceftriaxone 2
• No QTc interval prolongation observed in clinical studies 2

Ertapenem is generally well tolerated with most adverse events being mild to moderate in severity, making it a valuable option for treating various bacterial infections requiring parenteral antibiotic therapy.