Meropenem

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Generic Name: Meropenem Brand Name(s): Generics only. No brands available.

Uses

What is Meropenem used for?

Meropenem is used to treat a wide variety of bacterial infections. This medication is known as a carbapenem-type antibiotic. It works by stopping the growth of bacteria.

How should I take Meropenem?

This medication is given by injection into a vein as directed by your doctor, usually every 8 hours.

If you are using this medication at home, learn all preparation and usage instructions from your health care professional. Before using, check this product visually for particles or discoloration. If either is present, do not use the liquid. Learn how to store and discard medical supplies safely.

The dosage is based on your medical condition and response to treatment. In children, the dosage is also based on age and weight.

For the best effect, use this antibiotic at evenly spaced times. To help you remember, use this medication at the same time(s) every day.

Continue to use this medication until the full prescribed treatment period is finished, even if symptoms disappear after a few days. Stopping the medication too early may result in a return of the infection.

Tell your doctor if your condition lasts or gets worse.

How do I store Meropenem?

Freshly prepared solutions of Meropenem for injection (I.V.) should be used. However, re-constituted solutions of Meropenem for injection (I.V.) maintain satisfactory potency under the conditions described below. Solutions of intravenous Meropenem for injection (I.V.) should not be frozen.

Intravenous Bolus Administration

Meropenem for injection (I.V.) vials re-constituted with sterile Water for Injection for bolus administration (up to 50 mg/mL of Meropenem for injection (I.V.) may be stored for up to 3 hours at up to 25°C (77°F) or for 13 hours at up to 5°C (41°F).

Intravenous Infusion Administration

Solutions prepared for infusion (Meropenem for injection (I.V.) concentrations ranging from 1 mg/mL to 20 mg/mL) re-constituted with Sodium Chloride Injection 0.9% may be stored for 1 hour at up to 25°C (77°F) or 15 hours at up to 5°C (41°F).

Solutions prepared for infusion (Meropenem for injection (I.V.) concentrations ranging from 1 mg/mL to 20 mg/mL) re-constituted with Dextrose Injection 5% should be used immediately.

Precautions & warnings

What should I know before using Meropenem?

Before using meropenem, tell your doctor or pharmacist if you are allergic to it; or to penicillins or cephalosporins; or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.

Before using this medication, tell your doctor or pharmacist your medical history, especially of: brain disorders (such as seizures, head injury, tumor), kidney disease, stomach/intestinal diseases (such as colitis).

This drug may rarely cause headaches, numb/tingling skin, or seizures. Do not drive, use machinery, or do any activity that requires alertness or clear vision until you are sure you can perform such activities safely.

Some forms of this medication have sodium. Consult your doctor or pharmacist if you are on a salt-restricted diet or if you have a condition that could get worse if you have more salt (such as congestive heart failure).

Meropenem may cause live bacterial vaccines (such as typhoid vaccine) to not work as well. Do not have any immunizations/vaccinations while using this medication unless your doctor tells you to.

Before having surgery, tell your doctor or dentist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products).

Tell your doctor if you are pregnant before using this medication.

This medication passes into breast milk. Consult your doctor before breast-feeding.

Is it safe during pregnancy or breast-feeding?

There are no adequate studies in women for determining risk when using this Meropenem during pregnancy or while breastfeeding. Please always consult with your doctor to weigh the potential benefits and risks before taking Meropenem. Meropenem is pregnancy risk category B according to the US Food and Drug Administration (FDA).

FDA pregnancy risk category reference below:

  • A=No risk,
  • B=No risk in some studies,
  • C=There may be some risk,
  • D=Positive evidence of risk,
  • X=Contraindicated,
  • N=Unknown

Side effects

What side effects can occur from Meropenem?

Swelling, redness, pain, or soreness at the injection site may occur. Upset stomach, headache, nausea, vomiting, constipation, or diarrhea may also occur. If any of these effects last or get worse, tell your doctor or pharmacist promptly.

Remember that your doctor has prescribed this medication because he or she has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.

Tell your doctor right away if you have any serious side effects, such as: easy bruising/bleeding, hearing changes (such as decreased hearing, ringing in the ears), mental/mood changes (such as confusion), numb/tingling skin, swelling ankles/feet, unusual weight gain, unusual tiredness.

Get medical help right away if you have any very serious side effects, such as: seizures, unusual weakness.

This medication may rarely cause a severe intestinal condition (Clostridium difficile-associated diarrhea) due to a type of resistant bacteria. This condition may occur during treatment or weeks to months after treatment has stopped. Tell your doctor right away if you develop: diarrhea that doesn’t stop, abdominal or stomach pain/cramping, blood/mucus in your stool.

Do not use anti-diarrhea products or narcotic pain medications if you have any of these symptoms because these products may make them worse.

Use of this medication for prolonged or repeated periods may result in oral thrush or a new yeast infection. Contact your doctor if you notice white patches in your mouth, a change in vaginal discharge, or other new symptoms.

A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, such as: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.

Not everyone experiences these side effects. There may be some side effects not listed above. If you have any concerns about a side-effect, please consult your doctor or pharmacist.

Interactions

What drugs may interact with Meropenem?

Some products that may interact with this drug include: valproic acid and related drugs (such as divalproex sodium, sodium valproate).

Although most antibiotics are unlikely to affect hormonal birth control such as pills, patch, or ring, a few antibiotics (such as rifampin, rifabutin) can decrease their effectiveness. This could result in pregnancy. If you use hormonal birth control, ask your doctor or pharmacist for more details.

Meropenem may interact with other drugs that you are currently taking, which can change how your drug works or increase your risk for serious side effects. To avoid any potential drug interactions, you should keep a list of all the drugs you are using (including prescription drugs, nonprescription drugs and herbal products) and share it with your doctor and pharmacist. For your safety, do not start, stop, or change the dosage of any drugs without your doctor’s approval.

Does food or alcohol interact with Meropenem?

Meropenem may interact with food or alcohol by altering the way the drug works or increase the risk for serious side effects. Please discuss with your doctor or pharmacist any potential food or alcohol interactions before using this drug.

What health conditions may interact with Meropenem?

Meropenem may interact with your health condition. This interaction may worsen your health condition or alter the way the drug works. It is important to always let your doctor and pharmacist know all the health conditions you currently have.

Dosage

The information provided is not a substitute for any medical advice. You should ALWAYS consult with your doctor or pharmacist before using this Meropenem.

What is the dose of Meropenem for an adult?

Usual Adult Dose for Skin and Structure Infection

500 mg IV every 8 hours

-Complicated infections due to Pseudomonas aeruginosa: 1 g IV every 8 hours

Uses: As a single agent therapy for the treatment of complicated skin and skin structure infections due to Staphylococcus aureus (methicillin-susceptible isolates only), Streptococcus pyogenes, S agalactiae, viridans group streptococci, Enterococcus faecalis (vancomycin-susceptible isolates only), P aeruginosa, Escherichia coli, Proteus mirabilis, Bacteroides fragilis, Peptostreptococcus species

Usual Adult Dose for Intraabdominal Infection

1 g IV every 8 hours

Uses: As a single agent therapy for the treatment of complicated intraabdominal infections (including appendicitis and peritonitis) due to viridans group streptococci, E coli, Klebsiella pneumoniae, P aeruginosa, B fragilis, B thetaiotaomicron, Peptostreptococcus species

Usual Adult Dose for Meningitis

Infectious Diseases Society of America (IDSA) recommendations: 2 g IV every 8 hours for 7 to 21 days

Comments:

-Recommended as an alternative therapy

Usual Adult Dose for Nosocomial Pneumonia

American Thoracic Society, IDSA recommendations: 1 g IV every 8 hours

Duration of therapy: As short as 7 days recommended (reducing from traditional 14 to 21 days) if causative organism is not P aeruginosa and patient has good clinical response

Comments:

-Recommended as empiric therapy of hospital-acquired pneumonia (including ventilator-associated pneumonia) and healthcare-associated pneumonia

-If multidrug-resistant organisms suspected, initial empiric treatment with broad-spectrum coverage (according to the hospital’s and/or ICU’s antibiogram) is recommended.

-Shortening the duration of therapy may reduce the risk of superinfections with resistant organisms.

Renal Dose Adjustments

Adults:

Greater than 50 mL/min: Recommended dose every 8 hours

CrCl greater than 25 to 50 mL/min: Recommended dose every 12 hours

CrCl 10 to 25 mL/min: One-half recommended dose every 12 hours

CrCl less than 10 mL/min: One-half recommended dose every 24 hours

Liver Dose Adjustments

No adjustment recommended.

Other Comments

Administration advice:

-Adults: Administer by IV infusion over about 15 to 30 minutes; alternatively, doses of 1 g may be administered as an IV bolus injection over about 3 to 5 minutes.

-Pediatric patients 3 months or older: Administer as IV infusion over about 15 to 30 minutes or as an IV bolus injection over about 3 to 5 minutes; limited safety data available to support use of a 40 mg/kg (maximum of 2 g) bolus dose.

-Pediatric patients younger than 3 months: Administer as IV infusion over 30 minutes.

-Do not use flexible container in series connections.

Storage requirements:

-Dry powder: Store at controlled room temperature 20C to 25C (68F to 77F)

-Constituted solution for IV bolus: If unable to use freshly prepared solution immediately, may store up to 3 hours at up to 25C (77F) or for 13 hours at up to 5C (41F)

-Solution for IV infusion when constituted with Sodium Chloride Injection 0.9%: If unable to use freshly prepared solution immediately, may store for 1 hour at up to 25C (77F) or 15 hours at up to 5C (41F)

-Solution for IV infusion when constituted with Dextrose Injection 5%: Freshly prepared solution should be used immediately.

-Do not freeze IV solutions.

Reconstitution/preparation techniques:

-For IV bolus: Constitute injection vials with sterile Water for Injection; shake to dissolve then let stand until clear.

-For IV infusion: May constitute infusion vials directly with compatible infusion fluid; alternatively, may constitute an injection vial, add the resulting solution to an IV container, then further dilute with an appropriate infusion fluid

IV compatibility:

-Compatible for IV bolus: Sterile Water for Injection

-Compatible for IV infusion: Sodium Chloride Injection 0.9%, Dextrose Injection 5%

-Compatibility with other drugs not established; this drug should not be mixed with or physically added to solutions containing other drugs.

General:

-Culture and susceptibility information should be considered when selecting treatment or, if no data are available, local epidemiology and susceptibility patterns may be considered when selecting empiric therapy.

-This drug is useful as presumptive therapy in the indicated condition before causative organism is identified due to broad spectrum of bactericidal activity.

-Concentration of solution for IV bolus: Up to 50 mg/mL

-Concentration of solution for IV infusion: Ranges from 1 to 20 mg/mL

Monitoring:

-General: Organ system functions (periodically during prolonged therapy)

-Hematologic: Hematopoietic organ system functions (periodically during prolonged therapy)

-Hepatic: Hepatic organ system functions (periodically during prolonged therapy)

-Renal: Renal organ system functions (periodically during prolonged therapy); renal function in elderly patients

Patient advice:

-Avoid missing doses and complete the entire course of therapy.

-Do not operate machinery or motorized vehicles until it is reasonable well established that this drug is well tolerated.

What is the dose of Meropenem for a child?

Usual Pediatric Dose for Skin and Structure Infection

3 months or older: 10 mg/kg IV every 8 hours

Maximum dose: 500 mg/dose

-Complicated infections due to P aeruginosa: 20 mg/kg IV every 8 hours

Maximum dose: 1 g/dose

Uses: As a single agent therapy for the treatment of complicated skin and skin structure infections due to S aureus (methicillin-susceptible isolates only), S pyogenes, S agalactiae, viridans group streptococci, E faecalis (vancomycin-susceptible isolates only), P aeruginosa, E coli, P mirabilis, B fragilis, Peptostreptococcus species

Usual Pediatric Dose for Intraabdominal Infection

Less than 3 months:

-Infants less than 32 weeks gestational age (GA) and postnatal age (PNA) less than 2 weeks: 20 mg/kg IV every 12 hours

-Infants less than 32 weeks GA and PNA 2 weeks or older: 20 mg/kg IV every 8 hours

-Infants 32 weeks or older GA and PNA less than 2 weeks: 20 mg/kg IV every 8 hours

-Infants 32 weeks or older GA and PNA 2 weeks or older: 30 mg/kg IV every 8 hours

3 months or older: 20 mg/kg IV every 8 hours

Maximum dose: 1 g/dose

Uses: As a single agent therapy for the treatment of complicated intraabdominal infections (including appendicitis and peritonitis) due to viridans group streptococci, E coli, K pneumoniae, P aeruginosa, B fragilis, B thetaiotaomicron, Peptostreptococcus species

Usual Pediatric Dose for Meningitis

3 months or older: 40 mg/kg IV every 8 hours

Maximum dose: 2 g/dose

Comments:

-Effective in eliminating concurrent bacteremia associated with bacterial meningitis.

-Efficacy as monotherapy in the treatment of meningitis due to penicillin nonsusceptible isolates of S pneumoniae has not been established.

Uses: As a single agent therapy for the treatment of bacterial meningitis due to S pneumoniae, Haemophilus influenzae, Neisseria meningitidis

IDSA recommendations:

Infants and children: 40 mg/kg IV every 8 hours

Maximum dose: 2 g/dose

Comments:

-Recommended as an alternative therapy

How is Meropenem available?

Meropenem is available in the following dosage forms and strengths:

  • Intravenous solution,
  • Intravenous powder for injection.

What should I do in case of an emergency or overdose?

In case of an emergency or an overdose, call your local emergency services or go to your nearest emergency room.

What should I do if I miss a dose?

If you miss a dose of Meropenem, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and take your regular dose as scheduled. Do not take a double dose.

Hello Health Group does not provide medical advice, diagnosis or treatment.

Review Date: March 23, 2018 | Last Modified: March 23, 2018

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