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MEROPENEM 500MG POWDER FOR SOLUTION FOR INJECTION OR INFUSION

Active substance(s): MEROPENEM TRIHYDRATE

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PACKAGE LEAFLET:
INFORMATION FOR THE USER
Meropenem 500 mg and 1 g
Powder for Solution for Injection or Infusion
meropenem
Read all of this leaflet carefully before you start using this
medicine because it contains important information for you.
• Keep this leaflet. You may need to read it again.
• If you have any further questions, ask your doctor or nurse.
• This medicine has been prescribed for you only. Do not pass it on
to others. It may harm them, even if their signs of illness are the
same as yours.
• If you get any side effects, talk to you doctor or nurse. This includes
any possible side effects not listed in this leaflet. See section 4.
What is in this leaflet:
1. What Meropenem is and what it is used for
2. What you need to know before you use Meropenem
3. How to use Meropenem
4. Possible side effects
5. How to store Meropenem
6. Contents of the pack and other information

1. WHAT MEROPENEM IS AND WHAT IT IS USED FOR
Meropenem belongs to a group of medicines called carbapenem
antibiotics. It works by killing bacteria, which can cause serious infections.
• Infection affecting the lungs (pneumonia)
• Lung and bronchial infections in patients suffering from cystic fibrosis
• Complicated urinary tract infections
• Complicated infections in the abdomen
• Infections that you can catch during or after delivery
• Complicated skin and soft tissue infections
• Acute bacterial infection of the brain (meningitis)
Meropenem may be used in the management of neutropenic patients with
fever that is suspected to be due to bacterial infection.
Meropenem may be used to treat bacterial infection of the blood which
might be associated with a type of infection mentioned above.

2. WHAT YOU NEED TO KNOW BEFORE YOU USE MEROPENEM
Do not use Meropenem
• if you are allergic to meropenem or any of the other ingredients of
Meropenem (listed in Section 6)
• if you are allergic (hypersensitive) to other antibiotics such as
penicillins, cephalosporins, or carbapenems as you may also be allergic
to meropenem

Warnings and precautions
Talk to your doctor or nurse before using Meropenem:
• if you have health problems, such as liver or kidney problems.
• if you have had severe diarrhoea after taking other antibiotics.
You may develop a positive test (Coombs test) which indicates the
presence of antibodies that may destroy red blood cells. Your doctor will
discuss this with you.
If you are not sure if any of the above applies to you, talk to your doctor or
nurse before using Meropenem.

Other medicines and Meropenem
Tell your doctor if you are taking, have recently taken or might take any
other medicines. This is because Meropenem can affect the way some
medicines work and some medicines can have an effect on Meropenem.
In particular, tell your doctor or nurse if you are taking any of the following
medicines:
• Probenecid (used to treat gout).
• Valproic acid/sodium valproate/valpromide (used to treat epilepsy).
Meropenem should not be used because it may decrease the effect of
sodium valproate.
• Oral anti-coagulant agent (used to treat or prevent blood clots).

Pregnancy, breast-feeding and fertility
If you are pregnant or breast-feeding, think you may be pregnant or
are planning to have a baby, ask your doctor for advice before taking
this medicine. It is preferable to avoid the use of meropenem during
pregnancy.
Your doctor will decide whether you should use Meropenem.
It is important that you tell your doctor if you are breast-feeding or if you
intend to breast-feed before receiving Meropenem. Small amounts of
this medicine may pass into the breast milk and it may affect the baby.
Therefore, your doctor will decide whether you should use Meropenem
while breast-feeding.
Ask your doctor for advice before taking any medicine.

Driving and using machines
No studies on the effect on the ability to drive and use machines have
been performed.

Meropenem contains sodium.
Meropenem 500 mg: This medicinal product contains approximately
2.0 mEq of sodium per 500 mg dose which should be taken into
consideration by patients on a controlled sodium diet.
Meropenem 1 g: This medicinal product contains approximately 4.0 mEq
of sodium per 1 g dose which should be taken into consideration by
patients on a controlled sodium diet.
If you have a condition which requires you to monitor your sodium intake
please inform your doctor or nurse.

3. HOW TO USE MEROPENEM
Always use this medicine exactly as your doctor has told you. Check with
your doctor if you are not sure.

Use in adults
• The dose depends on the type of infection that you have, where the
infection is in the body and how serious the infection is. Your doctor will
decide on the dose that you need.
• The dose for adults is usually between 500 mg (milligrams) and 2 g
(gram). You will usually receive a dose every 8 hours. However you
may receive a dose less often if your kidneys do not work very well.

Use in children and adolescents
• The dose for children over 3 months old and up to 12 years of age
is decided using the age and weight of the child. The usual dose is
between 10 mg and 40 mg of Meropenem for each kilogram (kg) that
the child weighs. A dose is usually given every 8 hours. Children who
weigh over 50 kg will be given an adult dose.

Method of administration
• Meropenem will be given to you as an injection or infusion into a large
vein.
• Your doctor or nurse will normally give Meropenem to you.
• However, some patients, parents and carers are trained to give
Meropenem at home. Instructions for doing this are provided in this
leaflet (in the section called ‘Instructions for giving Meropenem to
yourself or someone else at home’). Always use Meropenem exactly as
your doctor has told you. You should check with your doctor if you are
not sure.
• Your injection should not be mixed with or added to solutions that
contain other medicines.
• The injection may take about 5 minutes or between 15 and 30 minutes.
Your doctor will tell you how to give Meropenem.
• You should normally have your injections at the same times each day.

If you use more Meropenem than you should
If you accidentally use more than your prescribed dose, contact your
doctor or nearest hospital straight away.

If you forget to use Meropenem
If you miss an injection, you should have it as soon as possible. However,
if it is almost time for your next injection, skip the missed injection. Do
not take a double dose (two injections at the same time) to make up for a
forgotten dose.

If you stop using Meropenem
Do not stop having Meropenem until your doctor tells you to.
If you have any further questions on the use of this product, ask your
doctor or nurse.

4. POSSIBLE SIDE EFFECTS
Like all medicines, this medicine can cause side effects, although not
everybody gets them.
The frequency of possible side effects listed below;

Severe allergic reactions
If you have a severe allergic reaction, stop having Meropenem and see
a doctor straight away. You may need urgent medical treatment. The
signs may include a sudden onset of:
• Severe rash, itching or hives on the skin.
• Swelling of the face, lips, tongue or other parts of the body.
• Shortness of breath, wheezing or trouble breathing.

The following information is intended for medical or healthcare
professionals only:

Instructions for giving Meropenem to yourself or someone else at home
Some patients, parents and carers are trained to give Meropenem at home.
Warning - You should only give this medicine to yourself or someone
else at home after a doctor or nurse has trained you.
• The medicine must be mixed with another liquid (the diluent). Your doctor
will tell you how much of the diluent to use.
• Use the medicine straight after preparing it. Do not freeze it.

How to prepare this medicine
1. Wash your hands and dry them very well. Prepare a clean working area.
2. Remove the Meropenem vial from the packaging. Check the vial and the
expiry date. Check that the vial is intact and has not been damaged.
3. Remove the cap and clean the rubber stopper with an alcohol wipe. Allow
the rubber stopper to dry.
4. Connect a new sterile needle to a new sterile syringe, without touching the
ends.
5. Draw up the recommended amount of sterile ‘Water for Injections’ into the
syringe. The amount of liquid that you need is shown in the table below:
Dose of Meropenem

Amount of ‘Water for Injections’ needed for dilution

500 mg (milligrams)

10 ml (millilitres)

1 g (gram)

20 ml

1.5 g

30 ml

2g

40 ml

Please note: If your prescribed dose of Meropenem is more than 1 g, you will
need to use more than 1 vial of Meropenem. You can then draw the liquid in
the vials into the one syringe.
6. Put the needle of the syringe through the centre of the rubber stopper and
inject the recommended amount of Water for Injections into the vial or vials
of Meropenem.
7. Remove the needle from the vial and shake the vial well for about
5 seconds, or until all the powder has dissolved. Clean the rubber stopper
once more with a new alcohol wipe and allow the rubber stopper to dry.
8. With the plunger of the syringe pushed fully into the syringe, put the needle
back through the rubber stopper. You must then hold both the syringe and
the vial and turn the vial upside down.
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Damage to red blood cells (not known)
The signs include:
• Being breathless when you do not expect it.
• Red or brown urine.
If you notice any of the above, see a doctor straight away.

Other possible side effects:
Common (may affect up to 1 in 10 people)
• Abdominal (stomach) pain.
• Feeling sick (nausea).
• Being sick (vomiting).
• Diarrhoea.
• Headache.
• Skin rash, itchy skin.
• Pain and inflammation.
• Increased number of platelets in your blood (shown in a blood test).
• Changes in blood tests, including tests that show how well your liver is
working.
Uncommon (may affect up to 1 in 100 people)
• Changes in your blood. These include reduced numbers of platelets
(which may make you bruise more easily), increased numbers of
some white blood cells, decreased numbers of other white cells and
increased amounts of a substance called ‘bilirubin’. Your doctor may do
blood tests from time to time.
• Changes in blood tests, including tests that show how well your kidneys
are working.
• A tingling feeling (pins and needles).
• Infections of the mouth or the vagina that are caused by a fungus
(thrush).
Rare (may affect up to 1 in 1,000 people)
• Fits (convulsions).

Other possible side effects of unknown frequency (frequency
cannot be estimated from the available data)
• Inflammation of the bowel with diarrhoea.
• Sore veins where Meropenem is injected.
• Other changes in your blood. The symptoms include frequent
infections, high temperature and sore throat. Your doctor may do blood
tests from time to time.
• Sudden onset of a severe rash or blistering or peeling skin. This may
be associated with a high fever and joint pains.

Reporting of side effects
If you get any side effects, talk to your doctor or pharmacist. This includes
any possible side effects not listed in this leaflet. You can also report side
effects directly via
United Kingdom
The UK Yellow Card Scheme.
Website www.mhra.gov.uk/yellowcard
Malta
ADR Reporting
Website: www.medicinesauthority.gov.mt/adrportal
By reporting side effects you can help provide more information on the
safety of this medicine.

5. HOW TO STORE MEROPENEM
Keep this medicine out of the sight and reach of children.
Do not use this medicine after the expiry date which is stated on the vial
label and carton after ‘EXP’. The expiry date refers to the last day of that
month.
Prior to reconstitution or dilution, this medicinal product does not require
any special storage conditions.
After reconstitution: The reconstituted solutions for intravenous injection
or infusion should be used immediately. The product should be inspected
visually for particulate matter, damage to the container or discolouration
(solution should be colourless to pale yellow) prior to administration.
Discard the product if such defects are observed.
The time interval between the beginning of reconstitution and the end of
intravenous injection or infusion should not exceed one hour.
Do not freeze the reconstituted solution.
Do not throw away any medicine via wastewater or household waste. Ask
your pharmacist how to throw away medicines you no longer use. These
measures will help to protect the environment.

6. CONTENTS OF THE PACK AND OTHER INFORMATION
What Meropenem contains
Each 0.5 g vial contains meropenem trihydrate equivalent to 500 mg
anhydrous meropenem.
Each 1 g vial contains meropenem trihydrate equivalent to 1 g anhydrous
meropenem.
The other ingredient is sodium carbonate, anhydrous.

What Meropenem looks like and contents of the pack
• Meropenem is a white to pale yellow crystalline powder for solution for
injection or infusion in vials. Pack sizes of 1 or 10 vials.

Marketing Authorisation Holder and Manufacturer
Hospira UK Limited, Queensway, Royal Leamington Spa, Warwickshire,
CV31 3RW, UK
This medicinal product is authorised in the Member States of the
EEA under the following names:
Austria: Meropenem Hospira
Cyprus: Meropenem Hospira
Czech Republic: Meropenem Hospira
Denmark: Merospira
Finland: Meropenem Hospira
Greece: Meropenem Hospira
Hungary: Meropenem Hospira
Italy: Meropenem Hospira
Latvia: Meropenem Hospira
Lithuania: Meropenem Hospira
Malta: Meropenem Hospira
Portugal: Meropenem Hospira
Slovakia: Meropenem Hospira
Slovenia: Meropenem Hospira
Spain: Meropenem Hospira
United Kingdom: Meropenem
This leaflet was last approved in January 2015
Advice/medical education
Antibiotics are used to treat infections caused by bacteria. They have
no effect against infections caused by viruses.
Sometimes an infection caused by bacteria does not respond to a
course of an antibiotic. One of the commonest reasons for this to
occur is because the bacteria causing the infection are resistant to the
antibiotic that is being taken. This means that they can survive and
even multiply despite the antibiotic.
Bacteria can become resistant to antibiotics for many reasons.
Using antibiotics carefully can help to reduce the chance of bacteria
becoming resistant to them.
When your doctor prescribes a course of an antibiotic it is intended to
treat only your current illness. Paying attention to the following advice
will help prevent the emergence of resistant bacteria that could stop
the antibiotic working.
1. It is very important that you take the antibiotic at the right dose,
at the right times and for the right number of days. Read the
instructions on the label and if you do not understand anything ask
your doctor or pharmacist to explain.
2. You should not take an antibiotic unless it has been prescribed
specifically for you and you should use it only to treat the infection
for which it was prescribed.
3. You should not take antibiotics that have been prescribed for other
people even if they had an infection that was similar to yours.
4. You should not give antibiotics that were prescribed for you to other
people.
5. If you have any antibiotic left over when you have taken the course
as directed by your doctor you should take the remainder to a
pharmacy for appropriate disposal.

9. Keeping the end of the needle in the liquid, pull back the plunger and draw
all the liquid in the vial into the syringe.
10. Remove the needle and syringe from the vial and throw the empty vial
away in a safe place.
11. Hold the syringe upright, with the needle pointing upwards. Tap the syringe
so that any bubbles in the liquid rise to the top of the syringe.
12. Remove any air in the syringe by gently pushing the plunger until all the air
has gone.
13. If you are using Meropenem at home, dispose of any needles and infusion
lines that you have used in an appropriate way. If your doctor decides to
stop treatment, dispose of any unused Meropenem in an appropriate way.

Giving the injection
You can either give this medicine through a short cannula or venflon, or
through a port or central line.

Giving Meropenem through a short cannula or venflon
1. Remove the needle from the syringe and throw the needle away carefully in
your sharps bin.
2. Wipe the end of the short cannula or venflon with an alcohol wipe and allow
it to dry. Open the cap on your cannula and connect the syringe.
3. Slowly push the plunger of the syringe to give the antibiotic steadily over
about 5 minutes.
4. Once you have finished giving the antibiotic and the syringe is empty,
remove the syringe and use a flush as recommended by your doctor or
nurse.
5. Close the cap of your cannula and carefully throw the syringe away in your
sharps bin.

Giving Meropenem through a port or central line

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1. Remove the cap on the port or line, clean the end of the line with an alcohol
wipe and allow it to dry.
2. Connect the syringe and slowly push the plunger on the syringe to give the
antibiotic steadily over about 5 minutes.
3. Once you have finished giving the antibiotic, remove the syringe and use a
flush as recommended by your doctor or nurse.
4. Place a new clean cap on your central line and carefully throw the syringe
away in your sharps bin.

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Source: Medicines and Healthcare Products Regulatory Agency

Disclaimer: Every effort has been made to ensure that the information provided here is accurate, up-to-date and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. This information has been compiled for use by healthcare practitioners and consumers in the United States. The absence of a warning for a given drug or combination thereof in no way should be construed to indicate that the drug or combination is safe, effective or appropriate for any given patient. If you have questions about the substances you are taking, check with your doctor, nurse or pharmacist.

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