Merrem (meropenem) Disease Interactions
There are 5 disease interactions with Merrem (meropenem):
Carbapenems (Includes Merrem) ↔ Cns Disorders
Severe Potential Hazard, Moderate plausibility
Applies to: CNS Disorder
The intravenous use of carbapenems has been associated with central nervous system adverse effects such as seizures (up to 1.5%) and, less frequently, somnolence, encephalopathy, myoclonus, tremor, paresthesia, confusion, agitation, depression, and hallucinations. Therapy with carbapenems, regardless of route of administration, should be administered cautiously in patients with or predisposed to seizures or other neurologic disturbances. The normally recommended dosages should not be exceeded in such patients. In those with a known seizure disorder, anticonvulsant therapy should be continued during carbapenem therapy.
- Duque A, Altimiras J, Garcia-Cases C, Vidal P "Vertigo caused by intravenous imipenem/cilastatin." DICP 25 (1991): 1009
- Frucht S, Eidelberg D "Imipenem-induced myoclonus." Mov Disord 12 (1997): 621-2
- Zazgornik J, Schein W, Heimberger K, et al "Potentiation of neurotoxic side effects by coadministration of imipenem to cyclosporine therapy in a kidney transplant recipient: synergism of side effects or drug." Clin Nephrol 26 (1986): 265-6
Carbapenems (Includes Merrem) ↔ Renal Dysfunction
Severe Potential Hazard, High plausibility
Applies to: Renal Dysfunction
Carbapenems are primarily eliminated by the kidney. Patients with renal impairment may be at greater risk for adverse effects from carbapenems, including seizures and other central nervous system disturbances, due to decreased drug clearance. Dosage adjustments should be considered, with modifications based on degree of renal impairment and severity of infection in accordance with the individual product package labeling. Renal function tests should be performed periodically during therapy.
- Leroy A, Fillastre JP, Borsa-Lebas F, Etienne I, Humbert G "Pharmacokinetics of meropenem (ICI 194,660) and its metabolite (ICI 213,689) in healthy subjects and in patients with renal impairment." Antimicrob Agents Chemother 36 (1992): 2794-8
- Berman SJ, Sugihara JG, Nakamura JM, et al "Multiple-dose study of imipenem/cilastatin in patients with end-stage renal disease undergoing long-term hemodialysis." Am J Med 78 (1985): 113-6
- 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
Antibiotics (Includes Merrem) ↔ Colitis
Moderate Potential Hazard, Moderate plausibility
Applies to: Colitis/Enteritis (Noninfectious)
Pseudomembranous colitis has been reported with most antibacterial agents and may range in severity from mild to life-threatening, with an onset of up to two months following cessation of therapy. Antibiotic therapy can alter the normal flora of the colon and permit overgrowth of Clostridium difficile, whose toxin is believed to be a primary cause of antibiotic- associated colitis. The colitis is usually characterized by severe, persistent diarrhea and severe abdominal cramps, and may be associated with the passage of blood and mucus. The most common culprits are clindamycin, lincomycin, the aminopenicillins (amoxicillin, ampicillin), and the cephalosporins. Therapy with broad-spectrum antibiotics and other agents with significant antibacterial activity should be administered cautiously in patients with a history of gastrointestinal diseases, particularly colitis. There is some evidence that pseudomembranous colitis, if it occurs, may run a more severe course in these patients and that it may be associated with flares in their underlying disease activity. The offending antibiotic(s) should be discontinued if significant diarrhea occurs during therapy. Stool cultures for Clostridium difficile and stool assay for C. difficile toxin may be helpful diagnostically. A large bowel endoscopy may be considered to establish a definitive diagnosis in cases of severe diarrhea.
- Moriarty HJ, Scobie BA "Pseudomembranous colitis in a patient on rifampicin and ethambutol." N Z Med J 04/23/80 (1980): 294-5
- Thomas E, Mehta JB "Pseudomembranous colitis due to oxacillin therapy." South Med J 77 (1984): 532-3
- Harmon T, Burkhart G, Applebaum H "Perforated pseudomembranous colitis in the breast-fed infant." J Pediatr Surg 27 (1992): 744-6
Carbapenems (Includes Merrem) ↔ Hemodialysis
Moderate Potential Hazard, High plausibility
Applies to: hemodialysis
In patients undergoing hemodialysis, carbapenems are recommended only if the benefit outweighs the potential risk of seizures. Carbapenems are removed by hemodialysis and should be administered after dialysis to avoid premature removal of the drug. There is not enough information regarding the use of some carbapenems such as meropenem for injection in patients on dialysis.
- Meyer MM, Munar MY, Kohlhepp SJ, Bryant RE "Meropenem pharmacokinetics in a patient with multiorgan failure from meningococcemia undergoing continuous venovenous hemodiafiltration." Am J Kidney Dis 33 (1999): 790-5
- Thalhammer F, Schenk P, Burgmann H, ElMenyawi I, Hollenstein UM, Rosenkranz AR, SunderPlassmann G, Breyer S, Ratheiser K "Single-dose pharmacokinetics of meropenem during continuous venovenous hemofiltration." Antimicrob Agents Chemother 42 (1998): 2417-20
- "Product Information. Primaxin (imipenem)." Merck & Co, Inc, West Point, PA.
Meropenem (Includes Merrem) ↔ Sodium
Moderate Potential Hazard, High plausibility
Applies to: Congestive Heart Failure, Hypertension, Fluid Retention, Hypernatremia
Parenteral meropenem is formulated with sodium carbonate to adjust the pH of the reconstituted solution and contains 90.2 mg (3.92 mEq) of sodium per each gram of meropenem activity. The sodium content should be considered in patients with conditions that may require sodium restriction, such as congestive heart failure, hypertension, and fluid retention.
- "Product Information. Merrem (meropenem)." Zeneca Pharmaceuticals, Wilmington, DE.
Merrem (meropenem) drug Interactions
There are 46 drug interactions with Merrem (meropenem)
Merrem (meropenem) alcohol/food Interactions
There is 1 alcohol/food interaction with Merrem (meropenem)
Drug Interaction Classification
|Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.|
|Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.|
|Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan.|
|No information available.|
Do not stop taking any medications without consulting your healthcare provider.
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