Merrem Side Effects

Generic Name: meropenem

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

Not all side effects for Merrem may be reported. You should always consult a doctor or healthcare professional for medical advice. Side effects can be reported to the FDA here.

For the Consumer

Applies to meropenem: intravenous powder for solution

In addition to its needed effects, some unwanted effects may be caused by meropenem (the active ingredient contained in Merrem). In the event that any of these side effects do occur, they may require medical attention.

If any of the following side effects occur while taking meropenem, check with your doctor or nurse immediately:

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 of the side effects that can occur with meropenem may not need medical attention. As your body adjusts to the medicine during treatment these side effects may go away. Your health care professional may also be able to tell you about ways to reduce or prevent some of these side effects. If any of the following side effects continue, are bothersome or if you have any questions about them, check with your health care professional:

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

General

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

Gastrointestinal

Common (1% to 10%): Nausea, diarrhea, nausea/vomiting, constipation, gastrointestinal disorder
Uncommon (0.1% to 1%): Oral moniliasis, flatulence, ileus, dyspepsia, intestinal obstruction
Frequency not reported: Clostridium difficile associated diarrhea[Ref]

Nervous system

Common (1% to 10%): Headache
Uncommon (0.1% to 1%): Dizziness, seizure, paresthesia, somnolence, syncope, asthenia
Frequency not reported: Hearing loss, other adverse CNS experiences[Ref]

Seizures and other adverse CNS experiences have been reported. They have occurred most commonly in patients with CNS disorders (e.g., history of seizures, brain lesions) or with bacterial meningitis and/or renal dysfunction.

Seizures occurred more often in patients with moderately severe renal dysfunction.[Ref]

Hematologic

Common (1% to 10%): Anemia, hypochromic anemia, bleeding events (including gastrointestinal hemorrhage, melena, epistaxis, hemoperitoneum)
Uncommon (0.1% to 1%): Increased platelets, increased eosinophils, decreased platelets, decreased hemoglobin, decreased hematocrit, decreased white blood cells, decreased prothrombin time, decreased partial thromboplastin time, leukocytosis
Postmarketing reports: Agranulocytosis, neutropenia, leukopenia, positive Coombs test (direct or indirect), hemolytic anemia[Ref]

Other

Shock occurred more often in patients with moderately severe renal dysfunction.[Ref]

Common (1% to 10%): Pain, sepsis, shock, accidental injury
Uncommon (0.1% to 1%): Abdominal pain, chest pain, fever, back pain, chills, pelvic pain, peripheral edema, abdominal enlargement[Ref]

Local

Common (1% to 10%): Inflammation at the injection site
Uncommon (0.1% to 1%): Injection site reactions, phlebitis/thrombophlebitis, pain at the injection site, edema at the injection site[Ref]

Dermatologic

Common (1% to 10%): Rash (including diaper area moniliasis), pruritus
Uncommon (0.1% to 1%): Urticaria, sweating, skin ulcer
Postmarketing reports: Toxic epidermal necrolysis, Stevens-Johnson syndrome, angioedema, erythema multiforme[Ref]

Respiratory

Common (1% to 10%): Apnea, pharyngitis, pneumonia
Uncommon (0.1% to 1%): Respiratory disorder, dyspnea, pleural effusion, asthma, increased cough, hypoxia, lung edema[Ref]

Cardiovascular

Heart failure occurred more often in patients with moderately severe renal dysfunction.[Ref]

Common (1% to 10%): Peripheral vascular disorder
Uncommon (0.1% to 1%): Heart failure, heart arrest, tachycardia, hypertension, myocardial infarction, pulmonary embolus, bradycardia, hypotension[Ref]

Metabolic

Common (1% to 10%): Hypoglycemia
Uncommon (0.1% to 1%): Anorexia, hypervolemia, hypokalemia, increased alkaline phosphatase, increased lactate dehydrogenase[Ref]

Hepatic

Uncommon (0.1% to 1%): Increased AST, increased ALT, increased bilirubin, hepatic failure, cholestatic jaundice/jaundice[Ref]

Renal

Kidney failure occurred more often in patients with moderately severe renal dysfunction.[Ref]

Uncommon (0.1% to 1%): Kidney failure, increased creatinine, increased BUN[Ref]

Psychiatric

Uncommon (0.1% to 1%): Insomnia, agitation/delirium, confusion, nervousness, hallucinations, anxiety, depression

Genitourinary

Uncommon (0.1% to 1%): Dysuria, vaginal moniliasis, urinary incontinence, red blood cells in urine[Ref]

Hypersensitivity

Frequency not reported: Serum sickness-like reactions, cross-sensitivity in penicillin-allergic and cephalosporin-allergic patients[Ref]

Musculoskeletal

Frequency not reported: Myalgia, arthralgia[Ref]

References

1. "Product Information. Merrem (meropenem)." Zeneca Pharmaceuticals, Wilmington, DE.

2. Zhanel GG, Wiebe R, Dilay L, et al. "Comparative Review of the Carbapenems." Drugs 67 (2007): 1027-1052

3. Baldwin CM, Lyseng-Williamson KA, Keam SJ "Meropenem : a review of its use in the treatment of serious bacterial infections." Drugs 68 (2008): 803-38

4. Wilson SE "Results of a randomized, multicenter trial of meropenem versus clindamycin/tobramycin for the treatment of intra-abdominal infections." Clin Infect Dis 24 Suppl 2 (1997): s197-206

5. Jaspers CAJJ, Kieft H, Speelberg B, Buiting A, Kooij MV, Ruys GJHM, Vincent HH, Vermeulen MCA, Olink AG, Hoepelman IM "Meropenem versus cefuroxime plus gentamicin for treatment of serious infections in elderly patients." Antimicrob Agents Chemother 42 (1998): 1233-8

6. Embil JM, Soto NE, Melnick DA "A post hoc subgroup analysis of meropenem versus imipenem/cilastatin in a multicenter, double-blind, randomized study of complicated skin and skin-structure infections in patients with diabetes mellitus." Clin Ther 28 (2006): 1164-74

7. Hemsell DL, Martens MG, Faro S, Gall S, Mcgregor JA "A multicenter study comparing intravenous meropenem with clindamycin plus gentamicin for the treatment of acute gynecologic and obstetric pelvic infections in hospitalized women." Clin Infect Dis 24 ( Suppl (1997): s222-30

8. Kempf P, Bauernfeind A, Muller A, Blum J "Meropenem monotherapy versus cefotaxime plus metronidazole combination treatment for serious intra-abdominal infections." Infection 24 (1996): 473-9

9. Bax RP, Bastain W, Featherstone A, Wilkinson DM, Hutchison M, Haworth SJ "The pharmacokinetics of meropenem in volunteers." J Antimicrob Chemother 24(suppl a (1989): 311-20

10. Shah PM, Heller A, Fuhr HG, Walther F, Halir S, Schaumann R, Bohme A, Jung B, Kohler A, Lipsschulte C, Stille W "Empirical monotherapy with meropenem versus imipenem/cilastatin for febrile episodes in neutropenic patients." Infection 24 (1996): 480-4

11. Nilsson-Ehle I, Hutchison M, Haworth SJ, Norrby SR "Pharmacokinetics of meropenem compared to imipenem-cilastatin in young, healthy males." Eur J Clin Microbiol Infect Dis 10 (1991): 85-8

12. Mouton YJ, Beuscart C "Empirical monotherapy with meropenem in serious bacterial infections. Meropenem Study Group." J Antimicrob Chemother 36(suppl a (1995): 145-56

13. Huizinga WK, Warren BL, Baker LW, Valleur P, Pezet DM, Hoogkamp-Korstanjep JA, Karran SJ "Antibiotic monotherapy with meropenem in the surgical management of intra-abdominal infections." J Antimicrob Chemother 36(suppl a (1995): 179-89

14. Byrne S, Maddison J, Connor P, Doughty I, Dodd M, Jenney M, Webb AK, David TJ "Clinical evaluation of meropenem versus ceftazidime for the treatment of Pseudomonas spp. infections in cystic fibrosis patients." J Antimicrob Chemother 36(suppl a (1995): 135-43

15. Hamacher J, Vogel F, Lichey J, Kohl FV, Diwok K, Wendel H, Lode H "Treatment of acute bacterial exacerbations of chronic obstructive pulmonary disease in hospitalised patients--a comparison of meropenem and imipenem/cilastatin. COPD Study Group." J Antimicrob Chemother 36(suppl a (1995): 121-33

16. Liu TJ, Lam JP "Piperacillin-tazobactam-induced acute interstitial nephritis with possible meropenem cross-sensitivity in a patient with osteomyelitis." Am J Health Syst Pharm 69 (2012): 1109

17. Paquet P, Jacob E, Damas P, Pierard GE "Recurrent fatal drug-induced toxic epidermal necrolysis (Lyell's syndrome) after putative beta-lactam cross-reactivity: Case report and scrutiny of antibiotic imputability." Crit Care Med 30 (2002): 2580-3

18. Ralph ED, John M, Rieder MJ, Bombassaro AM "Serum Sickness-like Reaction Possibly Associated with Meropenem Use." Clin Infect Dis 36 (2003): E149-E151

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