Indications
Complicated Skin and Skin Structure Infections
Intra-abdominal Infections
Bacterial Meningitis (Pediatric patients > 3 months only)
Community-Acquired Pneumonia and Nosocomial Pneumonia
Febrile Neutropenia
Urinary Tract Infections
Gynaecological Infections, such as endometritis and pelvic inflammatory disease.
Contraindications
Meropenem is contraindicated in patient with known hypersensitivity to any component of this
product or to other drugs in the same class or in patients who have demonstrated anaphylactic
reactions to β-lactams.
Dosage and Administration
Adults: The adult dose is 500 mg to 1 g by intravenous infusion over 15-30 minutes or as
intravenous bolus (5 to 20 ml) over 3-5 minutes every 8 hours.
Pneumonia, urinary tract infections, gynaecological infections such as endometritis, skin and skin
structure infections: 500 mg IV every 8 hours.
Nosocomial pneumonias, peritonitis, presumed infections in neutropenic patients and septicaemia:
1g IV every 8 hours. Intra-abdominal infections: 500 mg to 1 g every 8 hours. Meningitis: 2 g IV
every 8 hours.
Children: Complicated skin and skin structure infections: 10 mg/kg (maximum of 500 mg) every
8 hours;
Intra-abdominal infections: 20 mg/kg (maximum of 1 g) Every 8 hours;
Meningitis: 40 mg/kg (maximum of 2 g) Every 8 hours.
Reconstitution
For 500 mg IV injection dissolve contents of vial in 10 ml water for injection vigorously. For 1 g
IV injection dissolve contents of vial in 20 ml water for injection vigorously. Vials constituted
with sterile Water for Injection for bolus administration may be stored for up to 2 hours at
controlled room temperature 15-25°C (59-77°F) or for up to 12 hours at 4°C (39°F). Intravenous
bolus injection should be administered over approximately 3-5 minutes.
Infusion vials constituted with Sodium Chloride Injection 0.9% (concentrations ranging from 2.5
to 50 mg/ml) are stable for up to 2 hours at controlled room temperature 15-25°C (59-77°F) or for
up to 18 hours at 4°C (39°F). Intravenous infusion should be administered over approximately 15-
30 minutes.
Adverse Reactions
The most common adverse reactions (>2%) are nausea, headache, diarrhea, vomiting, and
dizziness.
Precautions
If an allergic reaction to Meropenem occurs, the drug should be discontinued and appropriate
measures taken. Use of Meropenem in patients with hepatic disease should be made with careful
monitoring of transaminase and bilirubin levels.
Meropenem has been associated with headache, tingling or pricking skin and convulsions. Any of
this could affect the ability to drive or operate machines. If you have a condition which requires
you to monitor your sodium intake please inform your doctor or nurse because Meropenem
contains sodium.
Side Effects
Seizures and other adverse CNS experiences have been reported during treatment with Meropenem
injection. These experiences have occurred most commonly in patients with CNS disorders (e.g.,
brain lesions or history of seizures) or with bacterial meningitis and/or compromised renal
function.
Use in Special Population
Adults with Hepatic Insufficiency: No dosage adjustment is necessary in patients with impaired
hepatic function.
Renal Impairment Patients: Dosage should be reduced in patients with creatinine clearance less
than 51 ml/min. (see dosing table below).
Recommended Dosage Schedule for Adults with Impaired Renal Function
Creatinine Dose Dosing Interval
Clearance (dependent on
(ml/min) type of infection)
26- 50 Recommended dose Every 12 hours
10 -25 One-half recommended dose Every 12 hours
<10 One-half recommended dose Every 24 hours
Elderly Patients: No dosage adjustment is required for elderly patients with creatinine clearance
values above 50 ml/min. Pediatric Patients: For pediatric patients from 3 months of age and older.
Drug Interaction
Probenecid competes with meropenem for active tubular secretion and thus inhibits the renal
excretion, with the effect of increasing the elimination half-life and plasma concentration of
meropenem. Meropenem may reduce serum valproic acid levels. Sub therapeutic levels may be
reached in some patients.
Use in Pregnancy and Lactation
Pregnancy: Category B. this drug should be used during pregnancy only if clearly needed.
Lactation: Meropenem is detectable at very low concentrations in animal breast milk. Meropenem
should not be used in breast-feeding women unless the potential benefit justifies the potential risk
to the baby.
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