Merrem (meropenem)
Last reviewed · Source: First Databank (FDB) drug data
Overview
Meropenem is a synthetic carbapenem beta-lactam antibiotic
Meropenem is a synthetic carbapenem antibiotic. Meropenem usually is bactericidal in action. Like other beta-lactam antibiotics, the antibacterial activity of meropenem results from inhibition of bacterial cell wall synthesis.
Meropenem has a broad spectrum of antibacterial activity and is active against many gram-positive and gram-negative bacteria and some anaerobic bacteria.
Meropenem is distributed into most body tissues and fluids, including bronchial mucosa, lung, bile, gynecologic tissue (endometrium, myometrium, ovary, cervix, fallopian tube), muscle, heart valves, skin, interstitial and peritoneal fluid, and CSF. Plasma protein binding is approximately 2%. The drug is partially metabolized to at least one microbiologically inactive metabolite.
Approximately 70% of a dose of meropenem is excreted unchanged in the urine within 12 hours. The plasma half-life of meropenem is approximately 1 hour in adults with normal renal function and 1.5 hours in children 3 months to 2 years of age. The plasma half-life of meropenem increases beyond 1.5 hours in infants <3 months of age.
Plasma half-life is increased and clearance of the drug is decreased in patients with renal impairment.
Meropenem should only be used to treat or prevent infections that are proven or strongly suspected to be caused by susceptible bacteria to reduce the development of drug resistance and maintain the effectiveness of meropenem. When available, culture and susceptibility patterns should be considered in selecting or modifying antibacterial therapy. Local epidemiology and susceptibility patterns may contribute to empiric selection of antibiotic therapy in the absence of culture and susceptibility data.
Generic name: meropenem
Pronunciation: (MER-oh-PEN-em)
Reference product & biosimilars
No reference, biosimilar or interchangeable associated with this drug.
Today’s intelligence on Merrem
Indications
The following indications are listed for Merrem:
- Bacterial Meningitis
- Bacteroides Complicated Appendicitis
- Bacteroides Peritonitis
- Complicated Appendicitis
- Complicated Skin And Skin Structure Infection
- E. Coli Complicated Appendicitis
- E. Coli Peritonitis
- H. Influenzae Meningitis
- Infectious Disease Of Abdomen
- Intra-Abdominal Abscess
- Klebsiella Complicated Appendicitis
- Klebsiella Pneumoniae Peritonitis
- Meningococcal Meningitis
- Peptostreptococcus Complicated Appendicitis
- Peptostreptococcus Peritonitis
- Peritonitis
- Pneumococcal Meningitis
- Pseudomonas Aeruginosa Complicated Appendicitis
- Pseudomonas Aeruginosa Peritonitis
- Streptococcal Meningitis
- Streptococcal Peritonitis
- Streptococcus Complicated Appendicitis
Also known as: Abdominal Abscess, Complicated Appendicitis Due To Bacteroides Species, Complicated Appendicitis Due To E. Coli, Complicated Appendicitis Due To Escherichia Coli, Complicated Appendicitis Due To Klebsiella Species, Complicated Appendicitis Due To Peptostreptococcus, Complicated Appendicitis Due To Pseudomonas Aeruginosa, Complicated Appendicitis Due To Streptococcus Species, Complicated Bacterial Skin And Skin Structure Infection, Complicated Skin And Skin Soft Tissue Infection, Complicated Skin And Skin Structure Bacterial Infection, H. Flu Meningitis, Haemophilus Influenzae Meningitis, Influenzae Bacillus Meningitis, Intra-Abdominal Infection, Meningitis Due To Haemophilus Influenzae, Meningitis Due To Hemophilus Influenzae, Peritonitis Due To Bacteroides, Peritonitis Due To Escherichia Coli, Peritonitis Due To Klebsiella Pneumoniae, Peritonitis Due To Peptostreptococcus, Peritonitis Due To Pseudomonas Aeruginosa, Peritonitis Due To Streptococcus Species, Pfeiffer's Bacillus Meningitis, Streptococcus Pneumoniae Meningitis.
Dosing
Meropenem is commercially available as the trihydrate; potency and dosage of the drug are expressed on the anhydrous basis.
Meropenem is administered by IV injection or IV infusion. Safety data supporting the administration of a 40 mg/kg (up to a maximum of 2 g) dose via IV injection are limited; administration by IV infusion is recommended for these higher doses.
Meropenem is available as a powder for injection in single-dose vials or with 0.9% sodium chloride in single-dose, dual-chamber containers. The dual-chamber containers should only be used in patients requiring an entire 500 mg or 1 gram dose of meropenem and not any fraction thereof.
Store vials of powder for injection at 20-25degreesC. Store unactivated dual-chamber units at 20-25degreesC (excursions permitted between 15-30degreesC); protect from freezing.
No dosing information is available for this tab.
No dosing information is available for this tab.
Drug interactions
There is no enhanced messaging for this drug.
There are no contraindication interactions for this drug.
There are no severe interactions for this drug.
There are no moderate interactions for this drug.
Contraindications
*Known hypersensitivity to meropenem, other carbapenems, or any ingredient in the formulation.
*History of anaphylactic reaction to beta-lactams.
There are no contraindication contraindications for this drug.
There are no severe contraindications for this drug.
There are no moderate contraindications for this drug.
Adverse reactions
Adverse effects reported in <=2% of patients receiving meropenem include headache, nausea, constipation, diarrhea, anemia, vomiting, and rash.
There are no severe adverse reactions for this drug.
There are no less severe adverse reactions for this drug.
Precautions
No enhanced messaging available.
Safety and efficacy of meropenem have been established in children >=3 months of age with complicated skin and skin structure infections and bacterial meningitis.
Safety and efficacy of meropenem have been established for the treatment of intra-abdominal infections in pediatric patients of all ages.
Data on meropenem use during pregnancy are insufficient to establish a drug-associated risk of birth defects or miscarriage.
Fetal toxicity and malformations were not reported in pregnant rats and monkeys when IV meropenem was administered during organogenesis at doses up to 2.4 and 2.3 times the maximum recommended human dose (MRHD) based on body-surface area (BSA), respectively. Additionally, no adverse effects were reported in rat offspring when meropenem was administered at doses 3.2 times the MRHD during late pregnancy and lactation.
Meropenem is excreted into breast milk; however, no information is available on the effects of meropenem on the breast-fed child or the effects on milk production. The developmental and health benefits of breast-feeding should be considered along with the mother's clinical need for the drug and the potential for any adverse effects on the breast-fed child from the drug or from the underlying maternal condition.
Although the manufacturer makes no specific dosage recommendations in geriatric patients, these patients are more likely to have reduced renal function compared with younger adults; therefore, caution should be undertaken during dosage selection. Monitoring of renal function may be useful in geriatric patients receiving meropenem.
In clinical studies of meropenem, approximately 1100 patients (30%) were >=65 years of age and 400 patients (11%) were >=75 years of age. No substantial differences in safety and efficacy were identified relative to younger adults, but increased sensitivity cannot be ruled out.
A pharmacokinetic study in geriatric patients showed that the reduction in the plasma clearance of meropenem correlates with age-associated reductions in creatinine clearance.
ICD codes
No ICD codes are available for this drug.
Formulary status
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Last reviewed · Source: First Databank (FDB) drug data
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