Merrem Side Effects

Generic Name: meropenem

Note: This document contains side effect information about meropenem. Some of the dosage forms listed on this page may not apply to the brand name Merrem.

Some side effects of Merrem may not be reported. Always consult your doctor or healthcare specialist for medical advice. You may also report side effects to the FDA.

For the Consumer

Applies to meropenem: intravenous powder for solution

Along with its needed effects, meropenem (the active ingredient contained in Merrem) may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor or nurse immediately if any of the following side effects occur while taking meropenem:

More common
  • Redness and swelling at the injection site
Less common
  • Bluish lips or skin
  • chills
  • cold, clammy skin
  • confusion
  • dizziness
  • fainting
  • fast heartbeat
  • fast, weak pulse
  • fever
  • itching skin
  • lightheadedness
  • not breathing
  • pain at the injection site
  • rapid, shallow breathing
  • skin rash and itching
  • sweating
  • wheezing
Rare
  • Abdominal or stomach cramps and severe pain
  • agitation
  • black, bloody, or tarry stools
  • black, bloody vomit
  • bloating or swelling of the face, arms, hands, lower legs, or feet
  • blurred vision
  • burning while urinating
  • burning, crawling, itching, numbness, prickling, "pins and needles", or tingling feelings
  • convulsions (seizures)
  • cough
  • dark urine
  • decreased urine output
  • depression
  • diarrhea (watery and severe), which may also be bloody
  • difficult or painful urination
  • difficulty with breathing
  • dilated neck veins
  • extreme fatigue
  • fever with or without chills
  • headache
  • hostility
  • irregular breathing
  • irritability
  • lethargy
  • light-colored stools
  • loss of consciousness
  • muscle twitching
  • nausea
  • no blood pressure or pulse
  • nosebleed
  • pale skin
  • pounding in the ears
  • rapid weight gain
  • severe constipation
  • severe vomiting
  • slow, irregular heartbeat
  • stopping of the heart
  • stupor
  • tightness in the chest
  • troubled breathing with exertion
  • unconsciousness
  • unpleasant breath odor
  • unusual bleeding or bruising
  • unusual tiredness or weakness
  • unusual weight gain or loss
  • vomiting of blood or material that looks like coffee grounds
  • weight gain
  • yellow eyes or skin
Incidence not known
  • Back, leg, or stomach pains
  • bleeding gums
  • blistering, peeling, or loosening of the skin
  • chest pain
  • cough or hoarseness
  • general body swelling
  • general feeling of tiredness or weakness
  • joint or muscle pain
  • large, hive-like swelling on the face, eyelids, tongue, throat, hands, legs, feet, or sex organs
  • loss of appetite
  • lower back or side pain
  • red skin lesions, often with a purple center
  • red, irritated eyes
  • shortness of breath
  • sore throat
  • sores, ulcers, or white spots in the mouth or on the lips
  • swollen glands

Some side effects of meropenem may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common
  • Constipation
Less common
  • Body aches or pain
  • cold hands and feet
  • cold sweats
  • congestion
  • cool pale skin
  • dryness or soreness of the throat
  • increased hunger
  • indigestion
  • nightmares
  • passing of gas
  • redness, swelling, or soreness of the tongue
  • runny nose
  • shakiness
  • slurred speech
  • sneezing
  • stomach pain, fullness, or discomfort
  • trouble with swallowing
  • vaginal yeast infection
  • voice changes
Rare
  • Acid or sour stomach
  • belching
  • excess air or gas in the stomach or intestines
  • full feeling
  • heartburn
  • hives or welts
  • redness of the skin
  • seeing, hearing, or feeling things that are not there
  • sleepiness or unusual drowsiness
  • trouble sleeping
  • white patches in the mouth, tongue, or throat

For Healthcare Professionals

Applies to meropenem: intravenous powder for injection

Gastrointestinal

Clostridium difficile associated diarrhea (CDAD) has been reported in patients treated with carbapenem antibiotics. If diarrhea occurs and it is unresponsive to discontinuation of the drug and/or standard therapy, CDAD should be considered.

Gastrointestinal side effects have included diarrhea (4.8%), nausea/vomiting (3.6%), and constipation (1.4%). Oral moniliasis, anorexia, flatulence, ileus, dyspepsia, and intestinal obstruction have been reported in greater than 0.1% to 1% of patients.

Hepatic

Hepatic side effects have included increased AST, ALT, alkaline phosphatase, LDH, and bilirubin in greater than 0.2% of patients. Hepatic failure, cholestatic jaundice, and jaundice have been reported in greater than 0.1% to 1% of patients.

Nervous system

Seizures have been infrequently reported in clinical trials (0.5% of patients). They have occurred most commonly in patients with renal insufficiency, history of seizure, or CNS abnormality.

Nervous system side effects have included headache (2.3%) and hearing loss (9% greater than 60 dB; 8% 40 to 60 dB; 20% 20 to 40 dB). Insomnia, agitation/delirium, confusion, dizziness, seizure, nervousness, paresthesia, hallucinations, somnolence, anxiety, depression, and asthenia have been reported in greater than 0.1% to 1% of patients. Seizures occur more commonly in patients with moderately severe renal dysfunction.

Local

Local side effects have included inflammation at the injection site (2.4%), injection site reactions (0.9%), phlebitis/thrombophlebitis (0.8%), pain at the injection site (0.4%), and edema at the injection site (0.2%).

Hypersensitivity

A 75-year-old female developed toxic epidermal necrolysis (TEN) over 40% of her body surface area after receiving cefotaxime. After cefotaxime discontinuation and some improvement, meropenem (the active ingredient contained in Merrem) was started. The TEN immediately recurred and spread to previously unaffected areas of the skin, and the patient died. The authors recommend avoiding chemically similar drugs to the precipitating drug when treating patients with drug-induced TEN.

Hypersensitivity side effects including rash and pruritus were reported in 1.7% and 1.6% of patients (respectively) receiving meropenem. Toxic epidermal necrolysis, Stevens-Johnson syndrome, and serum sickness-like reactions have also been reported. Cross-sensitivity may occur in penicillin-allergic and cephalosporin-allergic patients.

Hematologic

Hematologic side effects have included epistaxis (0.2%), gastrointestinal hemorrhage (0.5%), melena (0.3%), and hemoperitoneum (0.2%). Anemia, hypochromic anemia, and hypervolemia have been reported in greater than 0.1% to 1%. Increased platelets, increased eosinophils, decreased platelets, decreased hemoglobin, decreased hematocrit, decreased WBC, decreased prothrombin time, decreased partial thromboplastin time, and leukocytosis have been reported in more than 0.2% of patients. Agranulocytosis, neutropenia, leukopenia, a positive Coombs test (direct or indirect), and hemolytic anemia have been reported during postmarketing experience.

Musculoskeletal

Musculoskeletal side effects have rarely included myalgia and arthralgia.

Dermatologic

Dermatologic side effects have included rash (1.9%), pruritus (1.2%), and diaper area moniliasis (3.1% of pediatric patients). Urticaria, sweating, and skin ulcer have been reported in greater than 0.1% to 1% of patients. Toxic epidermal necrolysis, Stevens-Johnson syndrome, angioedema, and erythema multiforme have been reported during postmarketing experience.

Renal

Renal side effects have included kidney failure in greater than 0.1% to 1% of patients. Increased creatinine and BUN have been reported in more than 0.2% of patients. Kidney failure occurs more commonly in patients with moderately severe renal dysfunction.

Respiratory

Respiratory side effects have included apnea (1.3%), and respiratory disorder, dyspnea, pleural effusion, asthma, increased cough, and lung edema in greater than 0.1% to 1% of patients.

Genitourinary

Genitourinary side effects have included dysuria, vaginal moniliasis, and urinary incontinence in greater than 0.1% to 1% of patients. Urine RBCs have been reported in more than 0.2%.

General

In clinical trials (n=2904), meropenem (the active ingredient contained in Merrem) was discontinued in 1.2% due to adverse events and 5 deaths were possibly related to meropenem.

Other

Other side effects have included sepsis (1.6%) and shock (1.2%). Pain, abdominal pain, chest pain, back pain, chills, pelvic pain, and abdominal enlargement have been reported in greater than 0.1% to 1% of patients. Shock occurs more commonly in patients with moderately severe renal dysfunction.

Cardiovascular

Cardiovascular side effects have included heart failure, heart arrest, tachycardia, hypertension, myocardial infarction, pulmonary embolus, bradycardia, hypotension, and syncope in greater than 0.1% to 1% of patients. Heart failure occurs more commonly in patients with moderately severe renal dysfunction.

Metabolic

Metabolic side effects have included peripheral edema and hypoxia in greater than 0.1% to 1% of patients and hypokalemia in more than 0.2%.

Disclaimer: Every effort has been made to ensure that the information provided is accurate, up-to-date and complete, but no guarantee is made to that effect. In addition, the drug information contained herein may be time sensitive and should not be utilized as a reference resource beyond the date hereof. This material does not endorse drugs, diagnose patients, or recommend therapy. This information is a reference resource designed as supplement to, and not a substitute for, the expertise, skill , knowledge, and judgement of healthcare practitioners in patient care. The absence of a warning for a given drug or combination thereof in no way should be construed to indicate safety, effectiveness, or appropriateness for any given patient. Drugs.com does not assume any responsibility for any aspect of healthcare administered with the aid of materials provided. 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 substances you are taking, check with your doctor, nurse, or pharmacist.

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