Merom
Generic Name
Meropenem
Manufacturer
General Pharmaceutical Company
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| merom 500 mg injection | ৳ 600.00 | N/A |
Description
Overview of the medicine
Meropenem is a carbapenem antibiotic used to treat a wide range of bacterial infections, including severe and hospital-acquired infections. It is effective against both Gram-positive and Gram-negative bacteria, including anaerobic strains.
Uses & Indications
Dosage
Adults
Dosage varies based on infection type and severity, typically 500 mg to 2 g intravenously every 8 hours. For severe infections, 1 g every 8 hours is common.
Elderly
Dose adjustment may be necessary based on renal function.
Renal_impairment
Dose reduction is required based on creatinine clearance. For example, CrCl 26-50 mL/min: 1 g every 12 hours; CrCl 10-25 mL/min: 500 mg every 12 hours; CrCl <10 mL/min: 500 mg every 24 hours.
How to Take
Meropenem is administered intravenously either as a bolus injection (3-5 minutes) or as an infusion (15-30 minutes). The powder must be reconstituted with an appropriate solvent (e.g., Sterile Water for Injection, 0.9% Sodium Chloride) prior to administration.
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 prevents the cross-linking of peptidoglycan polymers, leading to cell lysis and bacterial death.
Pharmacokinetics
Onset
Rapid, typically within minutes of IV administration.
Excretion
Primarily excreted unchanged in the urine (approximately 70% as unchanged drug) by glomerular filtration and tubular secretion.
Half life
Approximately 1 hour in adults with normal renal function.
Absorption
After intravenous administration, meropenem is 100% bioavailable.
Metabolism
Partially metabolized by hydrolysis of the beta-lactam ring to an inactive metabolite.
Side Effects
Contraindications
- Known hypersensitivity to meropenem or any other carbapenem antibiotics.
- Known hypersensitivity to any component of the formulation.
- Severe hypersensitivity (e.g., anaphylactic reaction, severe skin reaction) to any other beta-lactam antibacterial agents (e.g., penicillins or cephalosporins).
Drug Interactions
Probenecid
Probenecid competes with meropenem for active tubular secretion, leading to increased plasma concentrations and prolonged half-life of meropenem. Co-administration is generally not recommended unless benefits outweigh risks.
Valproic acid/Divalproex
Concomitant use with meropenem may decrease valproic acid plasma concentrations, potentially leading to subtherapeutic levels and increased risk of seizures. Monitoring of valproic acid levels is recommended.
Oral anticoagulants (e.g., Warfarin)
Concurrent administration with antibiotics, including carbapenems, may enhance the anticoagulant effect. Close monitoring of INR is advised.
Storage
Store dry powder vials below 30°C (86°F) and protect from light. Reconstituted solution should be used immediately or stored as per manufacturer's instructions, typically for a limited time (e.g., up to 12 hours at room temperature or 48 hours under refrigeration).
Overdose
Limited experience with meropenem overdose. In the event of an overdose, symptomatic and supportive treatment should be initiated. Meropenem can be removed by hemodialysis.
Pregnancy & Lactation
Pregnancy Category B: Animal studies have not shown evidence of fetal harm, but there are no adequate and well-controlled studies in pregnant women. Meropenem should be used during pregnancy only if clearly needed and the potential benefit justifies the potential risk to the fetus. Lactation: Meropenem is excreted in human milk in very low concentrations. Caution should be exercised when meropenem is administered to a nursing woman. The benefits of breastfeeding should be weighed against the potential risks to the infant.
Side Effects
Contraindications
- Known hypersensitivity to meropenem or any other carbapenem antibiotics.
- Known hypersensitivity to any component of the formulation.
- Severe hypersensitivity (e.g., anaphylactic reaction, severe skin reaction) to any other beta-lactam antibacterial agents (e.g., penicillins or cephalosporins).
Drug Interactions
Probenecid
Probenecid competes with meropenem for active tubular secretion, leading to increased plasma concentrations and prolonged half-life of meropenem. Co-administration is generally not recommended unless benefits outweigh risks.
Valproic acid/Divalproex
Concomitant use with meropenem may decrease valproic acid plasma concentrations, potentially leading to subtherapeutic levels and increased risk of seizures. Monitoring of valproic acid levels is recommended.
Oral anticoagulants (e.g., Warfarin)
Concurrent administration with antibiotics, including carbapenems, may enhance the anticoagulant effect. Close monitoring of INR is advised.
Storage
Store dry powder vials below 30°C (86°F) and protect from light. Reconstituted solution should be used immediately or stored as per manufacturer's instructions, typically for a limited time (e.g., up to 12 hours at room temperature or 48 hours under refrigeration).
Overdose
Limited experience with meropenem overdose. In the event of an overdose, symptomatic and supportive treatment should be initiated. Meropenem can be removed by hemodialysis.
Pregnancy & Lactation
Pregnancy Category B: Animal studies have not shown evidence of fetal harm, but there are no adequate and well-controlled studies in pregnant women. Meropenem should be used during pregnancy only if clearly needed and the potential benefit justifies the potential risk to the fetus. Lactation: Meropenem is excreted in human milk in very low concentrations. Caution should be exercised when meropenem is administered to a nursing woman. The benefits of breastfeeding should be weighed against the potential risks to the infant.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
Typically 24-36 months from the date of manufacture, as per manufacturer's label.
Availability
Hospitals, clinics, retail pharmacies
Approval Status
Approved by major regulatory authorities (e.g., FDA, DGDA)
Patent Status
Off-patent, widely available as generics
WHO Essential Medicine
YesClinical Trials
Meropenem has undergone extensive clinical trials demonstrating its efficacy and safety in various bacterial infections compared to other broad-spectrum antibiotics. Post-marketing surveillance continues to monitor its long-term effects.
Lab Monitoring
- Renal function (creatinine, BUN) in patients with pre-existing renal impairment or during prolonged treatment.
- Liver function tests (ALT, AST, alkaline phosphatase).
- Complete blood count (CBC) to monitor for blood dyscrasias.
- Therapeutic drug monitoring may be considered in critically ill patients or those with difficult-to-treat infections.
Doctor Notes
- Meropenem should be reserved for serious infections where its broad spectrum of activity is clinically justified.
- Adjust dose carefully in patients with renal impairment to prevent accumulation and reduce the risk of adverse events, particularly seizures.
- Monitor for signs of superinfection and C. difficile infection.
- Counsel patients on potential interactions, especially with valproic acid.
Patient Guidelines
- Complete the full course of treatment as prescribed, even if symptoms improve.
- Report any severe side effects immediately to your doctor.
- Inform your doctor about all other medications, supplements, and herbal products you are taking.
- Avoid self-medication with other antibiotics.
Missed Dose Advice
If a dose is missed, administer it as soon as remembered. 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.
Driving Precautions
Meropenem may cause side effects such as headache, dizziness, or seizures, which could impair the ability to drive or operate machinery. Patients should be advised to exercise caution until they know how the medicine affects them.
Lifestyle Advice
- Maintain good personal hygiene to prevent further infections.
- Ensure adequate rest and hydration to support recovery.
- Follow a balanced diet.
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