TheraRadar
Data updated: May 26, 2026

RECARBRIO (cilastatin sodium)

Dipeptidase Inhibitors
Priority Review Fast Track
Infectious Disease Approved 2019-07-16

Recarbrio is a combination of imipenem (a penem antibacterial), cilastatin (a renal dehydropeptidase inhibitor), and relebactam (a beta-lactamase inhibitor). It is indicated for adult and pediatric patients weighing at least 2 kg for the treatment of hospital-acquired and ventilator-associated bacterial pneumonia (HABP/VABP). It is also indicated for complicated urinary tract infections (cUTI) and complicated intra-abdominal infections (cIAI) in patients with limited or no alternative treatment options. Usage is restricted to infections caused by susceptible gram-negative bacteria. Recarbrio is not recommended for pediatric patients less than 37 weeks post-menstrual age or those weighing less than 30 kg with renal impairment.

Source: FDA Label • Merck • Renal Dehydropeptidase Inhibitor

How RECARBRIO Works

Recarbrio exerts its effect through the synergistic action of three components: imipenem, cilastatin, and relebactam. Imipenem inhibits bacterial cell wall synthesis by binding to penicillin-binding proteins (PBPs), leading to cell death. Cilastatin limits the renal metabolism of imipenem by inhibiting the enzyme dehydropeptidase I in the renal tubule, thereby increasing therapeutic concentrations in the urine. Relebactam protects imipenem from degradation by certain beta-lactamase enzymes (specifically Class A and Class C), extending the antibiotic's spectrum of activity against resistant gram-negative bacteria.

3
Indications
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Phase 3 Trials
2
Priority Reviews
6
Years on Market

Details

Status
Prescription
First Approved
2019-07-16
Patent Cliff
2033

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Routes
INTRAVENOUS
Dosage Forms
POWDER

Companies

Active Ingredient: CILASTATIN SODIUM , IMIPENEM , RELEBACTAM

RECARBRIO Approval History

2020
2021
2022
2023
2024
2025
2026
Original
New Indication
New Form
Label Update
3 FDA actions from 2019 to 2025 · 2 indication expansions
Dec 2025 SUPPL
Efficacy
Jun 2020 SUPPL Priority
Efficacy
Jul 2019 ORIGINAL Priority
Update · Type 1 - New Molecular Entity and Type 4 - New Combination

What RECARBRIO Treats

5 indications

RECARBRIO is approved for 5 conditions since its original approval in 2019. These indications span multiple therapeutic areas including oncology, immunology, and more.

  • Hospital-Acquired Bacterial Pneumonia
  • Ventilator-Associated Bacterial Pneumonia
  • Complicated Urinary Tract Infection
  • Pyelonephritis
  • Complicated Intra-Abdominal Infection
Source: FDA Label

RECARBRIO Competitive Set

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Filters applied: drops same-active-ingredient (505(b)(2) reformulations), route-mismatch (topical vs systemic), and cross-therapeutic-area matches in same-indication rings.

Drugs Similar to RECARBRIO

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FDA-approved drugs for similar conditions. Compare mechanisms and indications to understand treatment alternatives.

AVYCAZ
AVIBACTAM SODIUM
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AbbVie
Shared indications:
PyelonephritisHospital-acquired Bacterial PneumoniaVentilator-associated Bacterial Pneumonia
ZERBAXA
CEFTOLOZANE SULFATE
3 shared
CUBIST PHARMS LLC
Shared indications:
PyelonephritisHospital-acquired Bacterial PneumoniaVentilator-associated Bacterial Pneumonia
FETROJA
CEFIDEROCOL SULFATE TOSYLATE
2 shared
SHIONOGI
Shared indications:
Complicated Urinary Tract InfectionPyelonephritis
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Clinical Trial Registry

2 trials
Trial Sponsor ID Phase Status Title
NCT06886464 PONTiAK NEPH24-1191 Ph 2 recruiting Prevention of Nephrotoxin-Induced Acute Kidney Injury Using Cilastatin
NCT02493764 RESTORE-IMI 2 results posted 7655A-014 2015-000246-34, 163240 Ph 3 completed Imipenem/Relebactam/Cilastatin Versus Piperacillin/Tazobactam for Treatment of Participants With Bacterial Pneumonia (MK-7655A-014)
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Active Pipeline

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Key Completed Trials

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Trial Timeline

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Understanding FDA Approval Types
Count Type What it means
- ORIG Original approval - drug first enters market
- SUPPL - Efficacy New indication (new disease/condition approved)
- SUPPL - Labeling Label text changes (warnings, dosing updates)
- SUPPL - Manufacturing Production changes (new facility)
- SUPPL - Chemistry Formulation changes (new dosage strength)

Green lines in the timeline show ORIG and Efficacy approvals - the clinically meaningful milestones.

RECARBRIO FDA Label Details

Indications & Usage

FDA Label (PDF)

RECARBRIO is indicated for the treatment of Hospital-Acquired Bacterial Pneumonia; Ventilator-Associated Bacterial Pneumonia; Complicated Urinary Tract Infection; Pyelonephritis; Complicated Intra-Abdominal Infection.

View full patent landscape →
1 OB patents · 1 families · 94 international docs across 39 countries

RECARBRIO Patents & Exclusivity

Latest Patent: Mar 2033
Exclusivity: Jul 2029

Patents (1 active)

US8487093 Expires Mar 21, 2033

Exclusivity

NCE Until Jul 2024
NPP Until Dec 2028
GAIN Until Jul 2029
Source: FDA Orange Book

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Patent Timeline

  • Cliff: 2033
  • 3 active patents

Trial Analysis

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  • Development stage analysis

Competitive Landscape

  • 13 similar drugs
  • Same target/indication analysis
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Data Sources

Data sourced from official FDA and NIH databases. Click links to verify on original sources.