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Merrem Dosage

Generic name: MEROPENEM 1g in 30mL
Dosage form: injection

The information at Drugs.com is not a substitute for medical advice. Always consult your doctor or pharmacist.

Adult Patients

The recommended dose of MERREM IV is 500 mg given every 8 hours for skin and skin structure infections and 1 gram given every 8 hours for intra-abdominal infections. When treating complicated skin and skin structure infections caused by P. aeruginosa, a dose of 1 gram every 8 hours is recommended.

MERREM IV should be administered by intravenous infusion over approximately 15 minutes to 30 minutes. Doses of 1 gram may also be administered as an intravenous bolus injection (5 mL to 20 mL) over approximately 3 minutes to 5 minutes.

Use in Adult Patients with Renal Impairment

Dosage should be reduced in patients with creatinine clearance of 50 mL/min or less. (See dosing table below.)

When only serum creatinine is available, the following formula (Cockcroft and Gault equation)5 may be used to estimate creatinine clearance.

Males: Creatinine Clearance (mL/min) =

Weight (kg) x (140 - age)

72 x serum creatinine (mg/dL)

Females: 0.85 x above value

Table 1: Recommended MERREM IV Dosage Schedule for Adult Patients with Renal Impairment

Creatinine Clearance (mL/min)

Dose (dependent on type of infection)

Dosing Interval

Greater than 50

Recommended dose (500 mg cSSSI and 1 gram Intra-abdominal)

Every 8 hours

26-50

Recommended dose

Every 12 hours

10-25

One-half recommended dose

Every 12 hours

Less than 10

One-half recommended dose

Every 24 hours

There is inadequate information regarding the use of MERREM IV in patients on hemodialysis or peritoneal dialysis.

Use in Pediatric Patients

Pediatric Patients 3 Months of Age and Older

For pediatric patients 3 months of age and older, the MERREM IV dose is 10 mg/kg, 20 mg/kg or 40 mg/kg every 8 hours (maximum dose is 2 grams every 8 hours), depending on the type of infection (cSSSI, cIAI, intra-abdominal infection or meningitis). See dosing table 2 below.
For pediatric patients weighing over 50 kg administer MERREM IV at a dose of 500 mg every 8 hours for cSSSI, 1 gram every 8 hours for cIAI and 2 grams every 8 hours for meningitis.
Administer MERREM IV as an intravenous infusion over approximately 15 minutes to 30 minutes or as an intravenous bolus injection (5 mL to 20 mL) over approximately 3 minutes to 5 minutes.
There is limited safety data available to support the administration of a 40 mg/kg (up to a maximum of 2 grams) bolus dose.
Table 2: Recommended MERREM IV Dosage Schedule for Pediatric Patients 3 Months of Age and Older with Normal Renal Function

Type of Infection

Dose (mg/kg)

Up to a Maximum Dose

Dosing Interval

Complicated skin and skin structure infections

10

500 mg

Every 8 hours

Complicated intra-abdominal infections

20

1 gram

Every 8 hours

Meningitis

40

2 grams

Every 8 hours

There is no experience in pediatric patients with renal impairment.

When treating cSSSI caused by P. aeruginosa, a dose of 20 mg/kg (or 1 gram for pediatric patients weighing over 50 kg) every 8 hours is recommended.

Pediatric Patients Less Than 3 Months of Age

For pediatric patients (with normal renal function) less than 3 months of age, with complicated intra-abdominal infections, the MERREM IV dose is based on gestational age (GA) and postnatal age (PNA). See dosing table 3 below. MERREM IV should be given as intravenous infusion over 30 minutes.

Table 3: Recommended MERREM IV Dosage Schedule for Pediatric Patients Less than 3 Months of Age with Complicated Intra-abdominal Infections and Normal Renal Function

Age Group

Dose (mg/kg)

Dose Interval

Infants less than 32 weeks GA and PNA less than 2 weeks

20

Every 12 hours

Infants less than 32 weeks GA and PNA 2 weeks and older

20

Every 8 hours

Infants 32 weeks and older GA and PNA less than 2 weeks

20

Every 8 hours

Infants 32 weeks and older GA and PNA 2 weeks and older

30

Every 8 hours

There is no experience in pediatric patients with renal impairment.

Preparation and Administration of MERREM IV

Important Administration Instructions:

Parenteral drug products should be inspected visually for particulate matter and discoloration prior to administration,

whenever solution and container permit.

For Intravenous Bolus Administration

Re-constitute injection vials (500 mg and 1 gram) with sterile Water for Injection (see table 4 below). Shake to dissolve and let stand until clear.

Table 4: Volume of Sterile Water for Injection for Reconstitution of Injection Vials

Vial Size

Amount of Diluent Added (mL)

Approximate Withdrawable Volume

(mL)

Approximate Average Concentration (mg/mL)

500 mg

10

10

50

1 gram

20

20

50

For Infusion

Injection vials (500 mg and 1 gram) may be directly re-constituted with a compatible infusion fluid.
Alternatively, an injection vial may be re-constituted, then the resulting solution added to an intravenous container and further diluted with an appropriate infusion fluid [see Dosage and Administration (2.5) and (2.6)].
Do not use flexible container in series connections.

Compatibility

Compatibility of MERREM IV with other drugs has not been established. MERREM IV should not be mixed with or physically added to solutions containing other drugs.

Stability and Storage

Freshly prepared solutions of MERREM IV should be used. However, re-constituted solutions of MERREM IV maintain satisfactory potency under the conditions described below. Solutions of intravenous MERREM IV should not be frozen.

Intravenous Bolus Administration

MERREM IV injection vials re-constituted with sterile Water for Injection for bolus administration (up to 50 mg/mL of MERREM IV) may be stored for up to 3 hours at up to 25oC (77oF) or for 13 hours at up to 5oC (41oF).

Intravenous Infusion Administration

Solutions prepared for infusion (MERREM IV concentrations ranging from 1 mg/mL to 20 mg/mL) re-constituted with Sodium Chloride Injection 0.9% may be stored for 1 hour at up to 25oC (77oF) or 15 hours at up to 5oC (41oF).

Solutions prepared for infusion (MERREM IV concentrations ranging from 1 mg/mL to 20 mg/mL) re-constituted with Dextrose Injection 5% should be used immediately.

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