Merostat
Generic Name
Meropenem
Manufacturer
Incepta Pharmaceuticals Ltd.
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| merostat 1 gm injection | ৳ 1,275.00 | N/A |
Description
Overview of the medicine
Merostat 1 gm Injection contains Meropenem, a broad-spectrum carbapenem antibiotic effective against a wide range of gram-positive and gram-negative bacteria. It is used to treat serious bacterial infections in various parts of the body.
Uses & Indications
Dosage
Adults
Typical dosage is 500 mg to 1 gm IV every 8 hours, depending on the type and severity of infection. For meningitis or severe infections, 2 gm IV every 8 hours. Administered over 15-30 minutes as an IV infusion.
Elderly
Dosage adjustment may be necessary based on renal function. Close monitoring of renal parameters is advised.
Renal_impairment
Dosage must be reduced in patients with creatinine clearance less than 50 mL/min. For CrCl 26-50 mL/min: 1 adult unit dose every 12 hours. For CrCl 10-25 mL/min: 1 adult unit dose every 24 hours. For CrCl <10 mL/min: 1 adult unit dose every 24 hours (half the usual dose).
How to Take
Merostat 1 gm Injection is administered intravenously. It can be given as an intravenous bolus injection over 3-5 minutes (for doses up to 1 gm) or as an intravenous infusion over 15-30 minutes. It must be reconstituted with sterile water for injection or other compatible diluents as per manufacturer's instructions.
Mechanism of Action
Meropenem exerts its bactericidal activity by inhibiting bacterial cell wall synthesis. It binds to essential penicillin-binding proteins (PBPs) within the bacterial cell, leading to disruption of cell wall integrity and ultimately bacterial cell lysis and death.
Pharmacokinetics
Onset
Rapid (within minutes of IV administration)
Excretion
Primarily excreted unchanged in the urine (approximately 70% as unchanged drug and 30% as metabolite).
Half life
Approximately 1 hour in adults with normal renal function.
Absorption
Rapid and complete absorption after intravenous administration.
Metabolism
Minimal hepatic metabolism; primarily hydrolyzed to an inactive metabolite by dehydropeptidase-I (DHP-I) in the kidneys.
Side Effects
Contraindications
- Hypersensitivity to meropenem, any other carbapenem antibiotic, or any component of the formulation.
- History of severe hypersensitivity (e.g., anaphylactic reaction) to any beta-lactam antibiotic (e.g., penicillins, cephalosporins).
Drug Interactions
Probenecid
Probenecid competitively inhibits renal tubular secretion of meropenem, thereby increasing meropenem plasma concentrations and prolonging its half-life. Co-administration is not recommended.
Valproic Acid/Sodium Valproate
Meropenem may reduce plasma levels of valproic acid, potentially leading to a loss of seizure control. Co-administration is generally not recommended.
Oral Anticoagulants (e.g., Warfarin)
Concomitant use with antibiotics, including meropenem, may increase the anticoagulant effect. INR should be monitored.
Storage
Store intact vials below 25°C (77°F) in a dry place, protected from light. Do not freeze. Reconstituted solutions should be used immediately or within specified periods (e.g., 6 hours at room temperature, 24 hours under refrigeration) as per manufacturer's guidelines.
Overdose
In the event of an overdose, symptomatic and supportive treatment should be initiated. Meropenem can be removed by hemodialysis. There is no specific antidote.
Pregnancy & Lactation
Meropenem should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus. It is excreted in human milk; therefore, caution should be exercised when administered to a nursing mother. A decision should be made whether to discontinue nursing or to discontinue the drug.
Side Effects
Contraindications
- Hypersensitivity to meropenem, any other carbapenem antibiotic, or any component of the formulation.
- History of severe hypersensitivity (e.g., anaphylactic reaction) to any beta-lactam antibiotic (e.g., penicillins, cephalosporins).
Drug Interactions
Probenecid
Probenecid competitively inhibits renal tubular secretion of meropenem, thereby increasing meropenem plasma concentrations and prolonging its half-life. Co-administration is not recommended.
Valproic Acid/Sodium Valproate
Meropenem may reduce plasma levels of valproic acid, potentially leading to a loss of seizure control. Co-administration is generally not recommended.
Oral Anticoagulants (e.g., Warfarin)
Concomitant use with antibiotics, including meropenem, may increase the anticoagulant effect. INR should be monitored.
Storage
Store intact vials below 25°C (77°F) in a dry place, protected from light. Do not freeze. Reconstituted solutions should be used immediately or within specified periods (e.g., 6 hours at room temperature, 24 hours under refrigeration) as per manufacturer's guidelines.
Overdose
In the event of an overdose, symptomatic and supportive treatment should be initiated. Meropenem can be removed by hemodialysis. There is no specific antidote.
Pregnancy & Lactation
Meropenem should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus. It is excreted in human milk; therefore, caution should be exercised when administered to a nursing mother. A decision should be made whether to discontinue nursing or to discontinue the drug.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
Typically 2-3 years when stored as recommended. Refer to the specific product label for precise shelf life.
Availability
Pharmacies, hospitals, clinics
Approval Status
Approved
Patent Status
Expired for generic Meropenem
WHO Essential Medicine
YesClinical Trials
Meropenem has undergone extensive clinical trials demonstrating its efficacy and safety in treating a wide range of severe bacterial infections across various patient populations, including pediatric and adult patients.
Lab Monitoring
- Renal function (creatinine clearance, BUN)
- Liver function tests (ALT, AST, ALP)
- Complete blood count (CBC) with differential, especially with prolonged therapy or in immunocompromised patients
- Coagulation parameters (INR) if co-administered with anticoagulants
Doctor Notes
- Ensure proper renal function assessment before initiating and during meropenem therapy, particularly in elderly and renally impaired patients, and adjust dosage accordingly.
- Be vigilant for signs of hypersensitivity reactions, including anaphylaxis, and be prepared for immediate intervention.
- Consider the potential for drug interactions, especially with valproic acid, and advise patients accordingly.
- Monitor for superinfections and C. difficile-associated diarrhea, especially with prolonged use.
Patient Guidelines
- It is crucial to complete the entire course of meropenem treatment, even if symptoms improve, to prevent the development of antibiotic resistance.
- Report any new or worsening symptoms, especially severe diarrhea, rash, or signs of allergic reaction, to your healthcare provider immediately.
- Inform your doctor about all other medications, herbal products, and supplements you are taking to avoid potential drug interactions.
- Stay well-hydrated during the treatment period.
Missed Dose Advice
If a dose is missed, it should be administered as soon as remembered. If it is almost time for the next scheduled dose, skip the missed dose and continue with the regular dosing schedule. Do not double the dose to catch up.
Driving Precautions
Meropenem may cause side effects such as dizziness or seizures in some individuals. Patients should be advised to exercise caution when driving or operating machinery until they know how the medication affects them.
Lifestyle Advice
- Maintain good hygiene to prevent further infections.
- Follow a balanced diet and ensure adequate rest to support recovery.
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