Oropem
Generic Name
Meropenem 1 gm injection
Manufacturer
Orion Pharma
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| oropem 1 gm injection | ৳ 1,300.00 | N/A |
Description
Overview of the medicine
Meropenem is a carbapenem antibiotic used to treat a wide variety of serious bacterial infections, including those resistant to other antibiotics. It is administered intravenously.
Uses & Indications
Dosage
Adults
Typically 500 mg to 1 gm IV every 8 hours, depending on infection severity and type. For meningitis or severe infections, 2 gm IV every 8 hours.
Elderly
Dosage adjustment may be required based on renal function, similar to adults with renal impairment.
Renal_impairment
Dosage reduction is necessary based on creatinine clearance (e.g., 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).
How to Take
Administered by intravenous infusion over 15-30 minutes or by intravenous bolus injection (500 mg-1 gm) over 3-5 minutes. Reconstitute with sterile water for injection or compatible diluents.
Mechanism of Action
Meropenem inhibits bacterial cell wall synthesis by binding to penicillin-binding proteins (PBPs), leading to bacterial cell lysis and death.
Pharmacokinetics
Onset
Rapid (within minutes of IV administration).
Excretion
Primarily excreted unchanged in urine (approximately 70% of dose within 12 hours).
Half life
Approximately 1 hour in adults with normal renal function.
Absorption
Rapidly absorbed after intravenous (IV) administration, 100% bioavailability.
Metabolism
Primarily metabolized by hydrolysis of the beta-lactam ring to an inactive metabolite, but to a limited extent (about 25%).
Side Effects
Contraindications
- Known hypersensitivity to meropenem or any other carbapenem antibiotics.
- Severe hypersensitivity (e.g., anaphylactic reaction, severe skin reaction) to any other beta-lactam antibacterial agent (e.g., penicillins, cephalosporins).
Drug Interactions
Probenecid
Probenecid competitively inhibits renal tubular secretion of meropenem, increasing its plasma concentrations and prolonging its half-life. Co-administration is not recommended.
Other antibiotics
Do not mix with or physically add to solutions containing other drugs.
Valproic acid/Sodium valproate
Meropenem can significantly reduce serum concentrations of valproic acid, leading to loss of seizure control. Concomitant use is generally not recommended.
Oral anticoagulants (e.g., Warfarin)
Concomitant administration may enhance the anticoagulant effect of warfarin, necessitating monitoring of INR.
Storage
Store dry powder for injection below 25°C (77°F), protect from light. Reconstituted solutions have specific stability periods depending on the diluent and temperature, typically 1-8 hours at room temperature or up to 24 hours refrigerated.
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. Use in pregnancy only if clearly needed and the potential benefits outweigh the potential risks to the fetus. Meropenem is excreted in breast milk in small amounts; use with caution during lactation.
Side Effects
Contraindications
- Known hypersensitivity to meropenem or any other carbapenem antibiotics.
- Severe hypersensitivity (e.g., anaphylactic reaction, severe skin reaction) to any other beta-lactam antibacterial agent (e.g., penicillins, cephalosporins).
Drug Interactions
Probenecid
Probenecid competitively inhibits renal tubular secretion of meropenem, increasing its plasma concentrations and prolonging its half-life. Co-administration is not recommended.
Other antibiotics
Do not mix with or physically add to solutions containing other drugs.
Valproic acid/Sodium valproate
Meropenem can significantly reduce serum concentrations of valproic acid, leading to loss of seizure control. Concomitant use is generally not recommended.
Oral anticoagulants (e.g., Warfarin)
Concomitant administration may enhance the anticoagulant effect of warfarin, necessitating monitoring of INR.
Storage
Store dry powder for injection below 25°C (77°F), protect from light. Reconstituted solutions have specific stability periods depending on the diluent and temperature, typically 1-8 hours at room temperature or up to 24 hours refrigerated.
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. Use in pregnancy only if clearly needed and the potential benefits outweigh the potential risks to the fetus. Meropenem is excreted in breast milk in small amounts; use with caution during lactation.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
Typically 2-3 years, as indicated on the packaging, when stored under recommended conditions.
Availability
Hospitals, pharmacies
Approval Status
Approved by major regulatory bodies
Patent Status
Generic available
WHO Essential Medicine
YesClinical Trials
Meropenem has been extensively studied in numerous clinical trials globally, demonstrating efficacy and safety across various severe bacterial infections in both adult and pediatric populations.
Lab Monitoring
- Renal function (creatinine clearance, serum creatinine) regularly, especially in patients with pre-existing renal impairment.
- Liver function tests (ALT, AST, alkaline phosphatase, bilirubin) periodically.
- Complete blood count (CBC) to monitor for blood dyscrasias.
- Therapeutic drug monitoring (TDM) may be considered in critically ill patients or those with altered pharmacokinetics.
Doctor Notes
- Crucial to adjust dosage in patients with renal impairment to prevent accumulation and potential central nervous system (CNS) adverse effects.
- Careful patient history is essential to identify prior hypersensitivity reactions to beta-lactam antibiotics.
- Monitor for signs of C. difficile-associated diarrhea during and after treatment.
- Avoid concomitant use with valproic acid due to reduced efficacy of valproate and increased risk of seizures.
Patient Guidelines
- Inform your healthcare provider about any known allergies, especially to antibiotics.
- Report any unusual or severe side effects immediately, such as severe diarrhea, rash, or seizures.
- Complete the entire prescribed course of treatment, even if symptoms improve, to prevent recurrence and development of antibiotic resistance.
- Inform your doctor about all other medications, including over-the-counter drugs and herbal supplements, you are currently taking.
Missed Dose Advice
If a dose is missed, administer it as soon as remembered, unless it is almost time for the next scheduled dose. In that case, skip the missed dose and continue with the regular dosing schedule. Do not double the dose.
Driving Precautions
Meropenem may cause dizziness or seizures, especially in susceptible 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 hydration and follow your doctor's dietary recommendations.
- Avoid alcohol consumption during treatment if it exacerbates side effects.
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