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meropenem

Pronunciation

Generic Name: meropenem (mer oh PEH nem)
Brand Name: Merrem, Merrem Novaplus

What is meropenem?

Meropenem is an antibiotic that fights bacteria.

Meropenem is used to treat severe infections of the skin or stomach. Meropenem is also used to treat bacterial meningitis (infection of brain or spinal cord).

Meropenem may also be used for purposes not listed in this medication guide.

What is the most important information I should know about meropenem?

You should not use this medication if you have a history of allergies to certain antibiotic medications, such as penicillin.

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What should I discuss with my healthcare provider before using meropenem?

You should not use meropenem if you are allergic to it, or if you have a history of allergy to certain antibiotic medications, such as:

  • amoxicillin, ampicillin, Augmentin, Timentin, Unasyn, Zosyn;

  • cefdinir, cefprozil, cefuroxime, cephalexin, and other cephalosporin antibiotics;

  • dicloxacillin, nafcillin, oxacillin, ticarcillin; or

  • any penicillin antibiotic.

To make sure meropenem is safe for you, tell your doctor if you have:

  • history of head injury or brain tumor;

  • epilepsy or other seizure disorder; or

  • kidney disease (or if you are on dialysis).

FDA pregnancy category B. Meropenem is not expected to harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant during treatment.

It is not known whether meropenem passes into breast milk or if it could harm a nursing baby. Tell your doctor if you are breast-feeding a baby.

How is meropenem given?

Meropenem is injected into a vein through an IV. You may be shown how to use an IV at home. Do not self-inject this medicine if you do not understand how to give the injection and properly dispose of used needles, IV tubing, and other items used to inject the medicine.

Meropenem is usually given every 8 hours. Follow all directions on your prescription label. Do not use this medicine in larger or smaller amounts or for longer than recommended.

Meropenem must be mixed with a liquid (diluent) before using it. If you are using the injections at home, be sure you understand how to properly mix and store the medicine.

Do not mix other injectable medications in the same IV bag or tubing used to given your meropenem injection.

Use a disposable needle only once, then throw away in a puncture-proof container (ask your pharmacist where you can get one and how to dispose of it). Keep this container out of the reach of children and pets.

Use this medication for the full prescribed length of time. Your symptoms may improve before the infection is completely cleared. Skipping doses may also increase your risk of further infection that is resistant to antibiotics. Meropenem will not treat a viral infection such as the common cold or flu.

If you use this medication long-term, you may need frequent medical tests at your doctor's office.

Store unopened vials at cool room temperature away from moisture and heat.

After mixing your medicine, you will need to use it within a certain number of hours. This will depend on the diluent and how you store the mixture (at cool room temperature, or in a refrigerator). Carefully follow the mixing and storage instructions provided with your medicine. Ask your pharmacist if you have questions.

What happens if I miss a dose?

Use the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not use extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

What should I avoid while using meropenem?

This medication may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be alert.

Antibiotic medicines can cause diarrhea, which may be a sign of a new infection. If you have diarrhea that is watery or bloody, stop using meropenem and call your doctor. Do not use anti-diarrhea medicine unless your doctor tells you to.

Meropenem side effects

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Call your doctor at once if you have:

  • diarrhea that is watery or bloody;

  • seizure (convulsions);

  • sores or white patches in your mouth or throat (yeast infection or "thrush"); or

  • pale skin, feeling light-headed or short of breath, rapid heart rate, trouble concentrating.

Common side effects may include:

  • headache;

  • mild diarrhea, constipation;

  • nausea, vomiting;

  • mild skin rash, numbness or tingly feeling;

  • vaginal itching or discharge; or

  • pain, swelling, or bruising where the medicine was injected.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

See also: Side effects (in more detail)

Meropenem dosing information

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

Approved indication: As a single agent therapy for 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, and Peptostreptococcus species

Usual Adult Dose for Intraabdominal Infection:

1 g IV every 8 hours

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

Usual Adult Dose for Meningitis:

(Not approved by FDA)

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:

(Not approved by FDA)

American Thoracic Society, IDSA recommendations: 1 g IV every 8 hours
Duration of therapy: If the causative organism is not P aeruginosa, the duration of therapy should be as short as clinically possible (e.g., as little as 7 days) to reduce the risk of superinfections with resistant organisms.

Comments:
-Initial empiric treatment with broad-spectrum coverage according to the hospital's and/or ICU's antibiogram is recommended if multidrug-resistant organisms are suspected.

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

Comments:
-Limited safety data available to support use of 40 mg/kg (maximum of 2 g) bolus dose.

Approved indication: As a single agent therapy for 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, and Peptostreptococcus species

Usual Pediatric Dose for Intraabdominal Infection:

3 months or older: 20 mg/kg IV every 8 hours
Maximum dose: 1 g/dose

Comments:
-Limited safety data available to support use of 40 mg/kg (maximum of 2 g) bolus dose.

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

Usual Pediatric Dose for Meningitis:

3 months or older: 40 mg/kg IV every 8 hours
Maximum dose: 2 g/dose

Comments:
-Limited safety data available to support use of 40 mg/kg (maximum of 2 g) bolus dose.
-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.

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

What other drugs will affect meropenem?

Tell your doctor about all medicines you use, and those you start or stop using during your treatment with meropenem, especially:

  • divalproex sodium;

  • probenecid; or

  • valproic acid.

This list is not complete. Other drugs may interact with meropenem, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed in this medication guide.

Where can I get more information?

  • Your doctor or pharmacist can provide more information about meropenem.
  • Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
  • Disclaimer: Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

Copyright 1996-2012 Cerner Multum, Inc. Version: 3.01. Revision Date: 2013-05-14, 3:48:26 PM.

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