Adults

Standard dose is 500 mg to 1 gm intravenously every 8 hours, depending on the type and severity of infection. For bacterial meningitis or severe infections, doses up to 2 gm every 8 hours may be used.

Elderly

No dose adjustment is required in elderly patients with normal renal function. Dosage should be adjusted based on renal function.

Renal_impairment

Dose adjustment is necessary for patients with creatinine clearance <50 mL/min. For CrCl 26-50 mL/min, 1 gm every 12 hours. For CrCl 10-25 mL/min, 500 mg every 12 hours. For CrCl <10 mL/min, 500 mg every 24 hours.

Onset

Rapid, within minutes of IV administration.

Excretion

Approximately 70% of the administered dose is excreted unchanged in the urine within 12 hours. Renal elimination is the primary route.

Half life

Approximately 1 hour in adults with normal renal function.

Absorption

Rapidly absorbed after intravenous administration, reaching peak plasma concentrations within minutes.

Metabolism

Primarily metabolized by hydrolysis of the beta-lactam ring, mainly by dehydropeptidase-I, but minimal hepatic metabolism.

Probenecid

Probenecid competes with meropenem for active tubular secretion, resulting in increased plasma concentrations and a prolonged half-life of meropenem. Co-administration of probenecid is not recommended.

Valproic Acid / Sodium Valproate

Concurrent use may lead to a reduction in valproic acid plasma levels, potentially resulting in subtherapeutic concentrations and an increased risk of seizures. Co-administration is generally not recommended.

Oral Anticoagulants (e.g., Warfarin)

Increased INR/prothrombin time has been reported with concomitant use of carbapenems and warfarin, requiring careful monitoring.