Ertapenem

Pronunciation: Not provided.

Generic name: ertapenem
Brand names: INVANZ
Drug class: Carbapenem antibiotic
Form: Single-dose vial containing 1 g ertapenem for reconstitution
Route: Intravenous infusion or intramuscular injection
Legal status: Prescription-only antibiotic

Availability and supply rules vary by country

Trade names by country: United States · Canada

What ertapenem is and how it works

Ertapenem is a carbapenem antibiotic used to treat susceptible bacterial infections, including complicated intra-abdominal infections, complicated skin and skin-structure infections, community-acquired pneumonia, complicated urinary tract infections, acute pelvic infections, and surgical-site infection prophylaxis after elective colorectal surgery. (1)

Treatment must be clinician-directed. Dose, route, duration, and renal adjustment require the current label. Ertapenem is for proven or strongly suspected susceptible bacterial infections only; completing the prescribed course reduces resistance risk.

Mechanism of action: how ertapenem works

Ertapenem is a carbapenem antibiotic that inhibits bacterial cell wall synthesis by binding penicillin-binding proteins, leading to bacterial lysis. It has in vitro activity against a range of aerobic and anaerobic Gram-positive and Gram-negative bacteria. (1)

What ertapenem is used for

Complicated intra-abdominal infection

Ertapenem may be used for complicated intra-abdominal infections caused by susceptible bacteria. (1)

Complicated skin and skin-structure infection

Ertapenem may be used for complicated skin and skin-structure infections, including diabetic foot infection without osteomyelitis, caused by susceptible bacteria. (1)

Community-acquired pneumonia

Ertapenem may be used for community-acquired pneumonia caused by susceptible bacteria. (1)

Complicated urinary tract infection including pyelonephritis

Ertapenem may be used for complicated urinary tract infections, including pyelonephritis, caused by susceptible bacteria. (1)

Acute pelvic infection

Ertapenem may be used for acute pelvic infections caused by susceptible bacteria. (1)

Prophylaxis of surgical-site infection after elective colorectal surgery

Ertapenem may be used for surgical-site infection prophylaxis in patients undergoing elective colorectal surgery. (1)

Before taking ertapenem

Do not take / not appropriate for

Do not receive ertapenem after a severe hypersensitivity reaction to ertapenem, other carbapenems, or beta-lactam antibiotics (e.g., penicillins, cephalosporins) unless the responsible specialist determines otherwise. (all products) (1)
Do not use probenecid while receiving ertapenem. (all indications) (1)
Do not use ertapenem to treat viral or fungal infections or infections caused by resistant bacteria. (all indications) (1)

Tell your clinician about

Any history of seizures or other central nervous system disorders.
Kidney disease or reduced kidney function (especially if creatinine clearance is ≤30 mL/min/1.73 m²).
Use of valproic acid or divalproex sodium.
Previous antibiotic-associated diarrhoea (including C. difficile).
Pregnancy, plans for pregnancy, or breastfeeding.
All prescription and over-the-counter medicines, vitamins, and supplements.

(1)

How to take ertapenem

Ertapenem is administered by a healthcare professional as an intravenous infusion over 30 minutes or intramuscular injection.
The dose, frequency, and duration are determined by the infection type and patient-specific factors.
Do not alter the administration schedule. Complete the full prescribed course even if you feel better.
Do not abruptly reduce or stop corticosteroid, antiepileptic, or other background therapy without clinician guidance.

(1)

Procedures and treatment changes

Tell the treating team before surgery, procedures, or any medicine change. Do not alter treatment without the responsible clinician. (1)

Missed dose

If a dose is missed, contact the prescribing clinician for instructions. Do not give an extra injection or alter the next dose or interval without specialist advice.

Overdose

If an overdose is suspected, contact the prescribing service or poison-information service urgently. Supportive care and monitoring for neurological symptoms may be required. (1)

Side effects

Side effects can vary. Anaphylaxis and seizures are uncommon but can be serious.

Gastrointestinal symptoms

What to notice: Nausea, vomiting, diarrhoea, or abdominal discomfort.

What to do: Tell the treatment team if severe, persistent, or accompanied by signs of dehydration or C. difficile infection. (1)

Headache or injection-site reaction

What to notice: Headache, pain, redness, or swelling at the injection site.

What to do: Discuss persistent or troublesome symptoms with the prescribing team rather than stopping treatment yourself. (1)

Allergic reaction or anaphylaxis

What to notice: Rash, hives, swelling of the face/limbs/throat, difficulty breathing, chest tightness.

What to do: Seek emergency care immediately. (1)

Severe diarrhoea or possible C. difficile infection

What to notice: Frequent, watery, or bloody diarrhoea, abdominal pain, fever.

What to do: Contact the clinician promptly for assessment. (1)

Neurological symptoms or seizure

What to notice: Tremors, confusion, unusual movements, or convulsions.

What to do: Seek medical attention immediately if a seizure occurs or neurological symptoms worsen. (1)

Serious warnings

Anaphylaxis and severe hypersensitivity — emergency

Symptoms: Wheezing or breathing difficulty, throat or tongue swelling, trouble swallowing, hives, flushing, faintness, weak or rapid heartbeat.

Action: Use prescribed emergency medicine immediately and call emergency services. Anaphylaxis can occur after any dose. (1)

Seizures and central nervous system reactions — emergency

Symptoms: Convulsions, confusion, altered consciousness, or involuntary movements.

Action: Seek emergency care immediately. Patients with a history of seizures or CNS disorders are at increased risk. (1)

C. difficile-associated diarrhoea — urgent

Symptoms: Severe or persistent diarrhoea that may be watery or bloody, abdominal cramps.

Action: Contact the prescribing clinician promptly for assessment. Do not use anti-diarrhoeal medicines without guidance. (1)

Reduced valproic acid levels and breakthrough seizures — serious

Symptoms: Increased seizure frequency or changed seizure pattern in patients taking valproic acid or divalproex.

Action: Contact the clinician immediately if breakthrough seizures occur. Do not alter the antiepileptic regimen without clinician direction. (1)

Interactions

Medicine or test	Effect	Action
Probenecid	Coadministration increases ertapenem plasma concentrations and is not recommended.	Avoid use while receiving ertapenem. (1)
Valproic acid and divalproex sodium	Ertapenem may significantly reduce serum valproic acid levels, potentially leading to loss of seizure control.	The prescriber must monitor valproic acid levels closely and consider alternative antibiotic or antiepileptic therapy. (1)
Other antibiotics and immunomodulating medicines	Combined treatment can complicate adverse-reaction assessment and may increase C. difficile risk.	Give the clinician and pharmacist a complete treatment list before administration. (1)

Pregnancy, breastfeeding, kidney/liver function, age

Renal impairment

Dose adjustment is necessary for patients with creatinine clearance ≤30 mL/min/1.73 m². The clinician must calculate the individual dose and monitor renal function. (1)

Central nervous system disorders

Patients with a history of seizures, brain lesions, or other CNS conditions may have an increased risk of neurological adverse reactions. Discuss risks with the prescriber. (1)

Pregnancy and breastfeeding

Use only if clearly needed. Discuss benefits and risks with the specialist. Uncontrolled infection can also pose harm during pregnancy. (1)

Elderly patients

Dose selection should consider age-related decline in renal function and the frequency of concomitant disease or other drug therapy. (1)

Monitoring

Before starting

Confirm the diagnosis, susceptibility testing when available, and local antibiotic stewardship guidelines.
Assess renal function (calculate creatinine clearance) and adjust dose accordingly.
Review history of seizures, CNS disorders, severe beta-lactam hypersensitivity, and use of valproic acid/divalproex.
Ascertain all current medicines to evaluate for interactions.

During treatment

Monitor renal function periodically, especially in those with impairment or changing clinical status.
Observe for signs of hypersensitivity, seizures, CNS reactions, and severe diarrhoea.
Assess treatment response and complete the prescribed duration to reduce resistance risk.
Monitor valproic acid levels if coadministered and watch for breakthrough seizures.

(1)

Storage

Ertapenem vials are stored according to the product label. Reconstituted solutions must be used as directed; do not freeze or heat. Follow sharps disposal instructions.

Professional information

Clinician-facing context only. Use the current local indication, dosing table, reconstitution/administration instructions, and institutional stewardship policy.

United States

Indication: Most susceptible infections

Dose summary: Typical dose: 1 g intravenously or intramuscularly once daily. For surgical prophylaxis: 1 g IV single dose 1 hour prior to incision. For patients with creatinine clearance ≤30 mL/min/1.73 m², reduce to 500 mg once daily.

Renal context: Dose reduction to 500 mg once daily if CrCl ≤30 mL/min/1.73 m². No dosage adjustment in patients with CrCl >30 mL/min/1.73 m². Renal function should be monitored. (1)

Mechanism of action

Hepatic guidance

No specific dosage adjustment for hepatic impairment is provided in the U.S. label; use clinical judgement.

Overdose note

Overdose management includes symptomatic and supportive care. Ertapenem is not significantly removed by haemodialysis. (1)

Frequently asked questions

What is ertapenem used for?

Ertapenem is an antibiotic used to treat a variety of serious bacterial infections, including infections in the abdomen, skin, lungs, urinary tract, and pelvic area. It is also used to prevent infections after certain colorectal surgeries. (1)

Can I take ertapenem if I am allergic to penicillin?

You must inform your clinician about any penicillin or cephalosporin allergies before receiving ertapenem. Severe allergic reactions may make it unsafe, and the clinician will decide on an alternative treatment. (1)

What should I do if I miss a dose of ertapenem?

Contact your prescribing clinician for instructions on rescheduling. Do not give an extra dose or alter your schedule without guidance. (1)

What is the mechanism of action of ertapenem?

What is the generic name of Ertapenem?

The generic name is ertapenem. It is sold under brand names including INVANZ. (1)

What class of drug is ertapenem?

Ertapenem is classed as: Carbapenem antibiotic. (1)

References

INVANZ (ertapenem) for injection, for intravenous or intramuscular use — prescribing informationU.S. National Library of Medicine DailyMed · United States · dated 2026-02 · accessed 2026-08-11 · source 1
INVANZ (ERTAPENEM SODIUM) INJECTION, POWDER, LYOPHILIZED, FOR SOLUTION [MERCK SHARP & DOHME LLC] — US prescribing information (DailyMed SPL)U.S. National Library of Medicine (DailyMed) · US · accessed 2026-08-14 · source 2
Ertapenem Injection — patient drug information (MedlinePlus)U.S. National Library of Medicine (MedlinePlus) · US · accessed 2026-08-14 · source 3
Ertapenem — FDA approval record (Drugs@FDA ANDA218067)U.S. Food and Drug Administration · US · accessed 2026-08-14 · source 4
ertapenem — RxNorm normalized drug concept (RXCUI 325642)U.S. National Library of Medicine (RxNorm) · US · accessed 2026-08-14 · source 5

Brand names by country

Single-ingredient ertapenem names are shown separately by country. Product availability, strengths, and supply rules can change; combination products are not included here.

Priority countries

United States

INVANZ1 g · merck sharp & dohme llc

Canada

INVANZ

View brands in additional countries.