Meroject
Generic Name
Meropenem
Manufacturer
Incepta Pharmaceuticals Ltd.
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| meroject 250 mg injection | ৳ 450.00 | N/A |
Description
Overview of the medicine
Meroject 250 mg Injection contains Meropenem, a broad-spectrum carbapenem antibiotic used to treat a wide variety of severe bacterial infections, including those resistant to other antibiotics. It is administered intravenously.
Uses & Indications
Dosage
Adults
Dosage varies based on infection type and severity, typically 500 mg to 2 g IV every 8 hours. For 250 mg, it may be used for specific pediatric indications or dose adjustments. Consultation with a physician is essential.
Elderly
No specific dosage adjustment needed for elderly patients with normal renal function. Dosage should be adjusted based on creatinine clearance if renal impairment is present.
Renal_impairment
Dose reduction required based on creatinine clearance (CrCl). For CrCl 26-50 mL/min, reduce dose by 50%. For CrCl 10-25 mL/min, reduce dose by 75%. For CrCl <10 mL/min, reduce dose by 75% and administer every 24 hours.
How to Take
Meroject 250 mg is administered by intravenous (IV) infusion over 15-30 minutes, or by IV bolus over 3-5 minutes, as directed by a healthcare professional. It should be reconstituted with an appropriate sterile diluent before use.
Mechanism of Action
Meropenem works by inhibiting bacterial cell wall synthesis. It binds to penicillin-binding proteins (PBPs) located in the bacterial cell wall, which are essential for maintaining cell wall integrity, leading to bacterial cell lysis and death. It has a high stability against hydrolysis by most beta-lactamases, including extended-spectrum beta-lactamases (ESBLs) and AmpC enzymes.
Pharmacokinetics
Onset
Rapid, typically within minutes after intravenous administration.
Excretion
Primarily renal excretion (approximately 70% as unchanged drug) within 12 hours. Renal tubular secretion and glomerular filtration are involved.
Half life
Approximately 1 hour in adults with normal renal function.
Absorption
Rapid and complete absorption after intravenous (IV) administration. Peak plasma concentrations are achieved shortly after the end of the infusion.
Metabolism
Minimal hepatic metabolism; primarily metabolized by hydrolysis of the beta-lactam ring to an inactive metabolite. However, a significant portion is excreted unchanged.
Side Effects
Contraindications
- Hypersensitivity to meropenem or any other carbapenem antibiotics.
- History of severe hypersensitivity (e.g., anaphylactic reaction, severe skin reaction) to any other beta-lactam antibacterial agents (e.g., penicillins, cephalosporins).
Drug Interactions
Probenecid
Probenecid competes with meropenem for active tubular secretion, resulting in increased plasma concentrations and prolonged half-life of meropenem. Co-administration with probenecid is not recommended.
Valproic acid
Meropenem may significantly decrease valproic acid plasma concentrations, leading to a loss of seizure control. Co-administration is generally not recommended.
Oral anticoagulants (e.g., Warfarin)
Co-administration with antibiotics, including carbapenems, may potentiate the anticoagulant effects of warfarin and other oral anticoagulants, increasing the risk of bleeding. Monitor INR/PT carefully.
Storage
Store intact vials below 30°C, protected from light and moisture. Do not freeze. Reconstituted solution storage depends on diluent and temperature.
Overdose
In case of overdose, symptoms may include nausea, vomiting, diarrhea, and potentially seizures. Management should be symptomatic and supportive. Meropenem can be removed by hemodialysis.
Pregnancy & Lactation
Pregnancy Category B. Studies in animals have shown no evidence of harm to the fetus, but there are no adequate and well-controlled studies in pregnant women. Meropenem should be used during pregnancy only if clearly needed. Meropenem is excreted in small amounts in human breast milk; caution should be exercised when administered to a nursing woman.
Side Effects
Contraindications
- Hypersensitivity to meropenem or any other carbapenem antibiotics.
- History of severe hypersensitivity (e.g., anaphylactic reaction, severe skin reaction) to any other beta-lactam antibacterial agents (e.g., penicillins, cephalosporins).
Drug Interactions
Probenecid
Probenecid competes with meropenem for active tubular secretion, resulting in increased plasma concentrations and prolonged half-life of meropenem. Co-administration with probenecid is not recommended.
Valproic acid
Meropenem may significantly decrease valproic acid plasma concentrations, leading to a loss of seizure control. Co-administration is generally not recommended.
Oral anticoagulants (e.g., Warfarin)
Co-administration with antibiotics, including carbapenems, may potentiate the anticoagulant effects of warfarin and other oral anticoagulants, increasing the risk of bleeding. Monitor INR/PT carefully.
Storage
Store intact vials below 30°C, protected from light and moisture. Do not freeze. Reconstituted solution storage depends on diluent and temperature.
Overdose
In case of overdose, symptoms may include nausea, vomiting, diarrhea, and potentially seizures. Management should be symptomatic and supportive. Meropenem can be removed by hemodialysis.
Pregnancy & Lactation
Pregnancy Category B. Studies in animals have shown no evidence of harm to the fetus, but there are no adequate and well-controlled studies in pregnant women. Meropenem should be used during pregnancy only if clearly needed. Meropenem is excreted in small amounts in human breast milk; caution should be exercised when administered to a nursing woman.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
2-3 years from manufacturing date, as indicated on the packaging. Reconstituted solution must be used immediately or within specified stability period (e.g., 2-4 hours at room temperature).
Availability
Available in hospitals and pharmacies nationwide with prescription
Approval Status
Approved by DGDA
Patent Status
Generic available, original patent expired
WHO Essential Medicine
YesClinical Trials
Meropenem has undergone extensive clinical trials demonstrating its efficacy and safety in various severe bacterial infections across different patient populations, including pediatric and adult patients.
Lab Monitoring
- Renal function tests (creatinine, BUN)
- Liver function tests (ALT, AST, bilirubin)
- Complete Blood Count (CBC) with differential, especially during prolonged therapy
- Coagulation parameters (INR/PT) if co-administered with anticoagulants
Doctor Notes
- Consider meropenem for empiric therapy in severe, life-threatening infections, especially in immunocompromised patients or when multi-drug resistant pathogens are suspected.
- Always consider renal function when dosing meropenem; adjust dosage accordingly in renal impairment.
- Be vigilant for potential drug interactions, especially with valproic acid and oral anticoagulants.
- Monitor for seizure activity, particularly in patients with pre-existing CNS disorders or compromised renal function.
Patient Guidelines
- Complete the full course of treatment as prescribed, even if symptoms improve.
- Report any severe side effects immediately to your healthcare provider.
- Ensure proper hydration during treatment.
- Do not share this medicine with others.
Missed Dose Advice
If a dose of Meroject is missed, it should be administered as soon as remembered. However, if it is almost time for the next scheduled dose, skip the missed dose and resume the regular dosing schedule. Do not double the dose to make up for a missed one. Consult your doctor or nurse for guidance.
Driving Precautions
Meroject may cause dizziness, confusion, or seizures in some patients. Patients should be advised to exercise caution when driving or operating machinery until they know how Meroject affects them.
Lifestyle Advice
- Maintain good hygiene to prevent further infections.
- Avoid self-medication and only use antibiotics under medical supervision.
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