Merostat
Generic Name
Meropenem
Manufacturer
A leading pharmaceutical company
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| merostat 500 mg injection | ৳ 675.00 | N/A |
Description
Overview of the medicine
Meropenem is a carbapenem antibiotic used to treat various severe bacterial infections. It is a broad-spectrum antibiotic effective against a wide range of Gram-positive and Gram-negative bacteria, including anaerobes.
Uses & Indications
Dosage
Adults
500 mg to 2 g intravenously (IV) every 8 hours, depending on the type and severity of infection. For bacterial meningitis, 2 g IV every 8 hours.
Elderly
Dosage adjustments may be necessary based on renal function, similar to adults with renal impairment.
Renal_impairment
Dosage must be reduced based on creatinine clearance (CrCl): CrCl 26-50 mL/min: 1 dose unit every 12 hours; CrCl 10-25 mL/min: 1/2 dose unit every 12 hours; CrCl <10 mL/min: 1/2 dose unit every 24 hours.
How to Take
Meropenem for injection can be administered as an intravenous bolus over approximately 3 to 5 minutes or as an intravenous infusion over 15 to 30 minutes. It should be reconstituted with sterile water for injection or other compatible diluents as directed by the manufacturer.
Mechanism of Action
Meropenem exerts its bactericidal effect by interfering with bacterial cell wall synthesis. It penetrates the bacterial cell wall and binds to penicillin-binding proteins (PBPs), leading to inhibition of peptidoglycan synthesis, which ultimately results in cell lysis and bacterial death.
Pharmacokinetics
Onset
Rapid onset of action, typically within minutes of IV administration.
Excretion
Mainly excreted by the kidneys (approximately 70% as unchanged drug and 30% as the inactive metabolite within 12 hours).
Half life
Approximately 1 hour in adults with normal renal function.
Absorption
Rapid and complete absorption after intravenous administration.
Metabolism
Primarily metabolized by hydrolysis of the beta-lactam ring to an inactive metabolite (BRL 42715) by dehydropeptidase-I, though it is relatively stable to this enzyme.
Side Effects
Contraindications
- Hypersensitivity to meropenem or any component of the formulation.
- Patients with a history of severe hypersensitivity (e.g., anaphylactic reaction, severe skin reaction) to any other carbapenem antibiotic or to beta-lactam antibiotics (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 is not recommended.
Valproic acid/Divalproex
Meropenem can significantly decrease serum concentrations of valproic acid, leading to loss of seizure control. Co-administration should generally be avoided.
Oral Anticoagulants (e.g., Warfarin)
Concomitant use with antibiotics may increase the anticoagulant effect. International Normalized Ratio (INR) should be monitored carefully.
Storage
Store unopened vials below 25°C (77°F). Protect from light. Do not freeze. Reconstituted solutions should be used immediately or stored as per manufacturer's instructions, typically for a limited time in a refrigerator.
Overdose
In the event of an overdose, meropenem can be removed by hemodialysis. Treatment should be symptomatic and supportive.
Pregnancy & Lactation
Pregnancy Category B. Studies in animals have shown no evidence of harm to the fetus. However, 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 milk; use with caution in breastfeeding mothers.
Side Effects
Contraindications
- Hypersensitivity to meropenem or any component of the formulation.
- Patients with a history of severe hypersensitivity (e.g., anaphylactic reaction, severe skin reaction) to any other carbapenem antibiotic or to beta-lactam antibiotics (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 is not recommended.
Valproic acid/Divalproex
Meropenem can significantly decrease serum concentrations of valproic acid, leading to loss of seizure control. Co-administration should generally be avoided.
Oral Anticoagulants (e.g., Warfarin)
Concomitant use with antibiotics may increase the anticoagulant effect. International Normalized Ratio (INR) should be monitored carefully.
Storage
Store unopened vials below 25°C (77°F). Protect from light. Do not freeze. Reconstituted solutions should be used immediately or stored as per manufacturer's instructions, typically for a limited time in a refrigerator.
Overdose
In the event of an overdose, meropenem can be removed by hemodialysis. Treatment should be symptomatic and supportive.
Pregnancy & Lactation
Pregnancy Category B. Studies in animals have shown no evidence of harm to the fetus. However, 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 milk; use with caution in breastfeeding mothers.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
Typically 2 to 3 years for unopened vials when stored as recommended. Reconstituted solution has limited stability and should be used promptly.
Availability
Hospitals, Clinics, Retail Pharmacies
Approval Status
Approved by regulatory authorities worldwide
Patent Status
Off-patent for generic meropenem, brand patents may vary by region
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 (creatinine, BUN) should be monitored regularly, especially in patients with pre-existing renal impairment.
- Liver function tests (ALT, AST, ALP) periodically.
- Complete blood count (CBC) during prolonged therapy.
- International Normalized Ratio (INR) if co-administered with anticoagulants.
Doctor Notes
- Meropenem is a critical carbapenem antibiotic reserved for serious infections, particularly those caused by multi-drug resistant organisms.
- Careful dosage adjustment is essential in patients with renal impairment to prevent accumulation and potential CNS toxicity.
- Monitor for signs of hypersensitivity reactions, C. difficile infection, and seizures.
- Avoid concomitant use with valproic acid due to risk of seizure recurrence.
Patient Guidelines
- Complete the entire course of treatment, even if symptoms improve, to prevent the development of antibiotic resistance.
- Report any unusual or severe side effects, especially diarrhea that is watery or bloody, or new onset seizures.
- Inform your healthcare provider about all your medical conditions and other medications you are taking.
- Do not share this medication with others.
Missed Dose Advice
If a dose is missed, administer it as soon as you remember. If it is almost time for the next dose, skip the missed dose and continue with your regular dosing schedule. Do not double the dose to catch up.
Driving Precautions
Meropenem may cause adverse effects like headache, dizziness, or seizures in some patients, which could impair the ability to drive or operate machinery. Patients should be advised to exercise caution until they know how the medication affects them.
Lifestyle Advice
- Maintain good hydration during treatment.
- Avoid self-medication.
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