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Why it's used

Meropenem is used to treat certain infections including complicated skin and soft tissue infection, complicated stomach cavity infection, infection during or following childbirth, urinary tract infection, and lower respiratory tract infection in patients with damaged lungs and digestive system. Meropenem also treats pneumonia and inflammation of the brain and spinal cord membranes. This medicine works by killing bacteria causing serious infections. Meropenem is also used to treat patients with the presence of bacteria in the bloodstream that occurs in association with any of these infections, and for the management of patients with low level of neutrophils and fever due to bacterial infection.
When not to use
Meropenem cannot be used to treat viral infections (common cold).
Antibacterial
Meropenem is a prescription medicine that belongs to a class of medicines called Antibacterial. Antibacterial.

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How to use

Follow directions on the product label, information guide, and provided by your doctor before using Meropenem. Inject this medicine as per your doctor's instructions.

Typical Dosage

The typical adult dose of Meropenem is up to 2000 mg three times every day. The typical dose for children is up to 40 mg/kg (18.2 mg/lb) three times every day. The maximum dose for adults of Meropenem is 2000 mg three times daily per day. Meropenem is typically used at the same time every day.
You should continue to use this medicine as directed by the doctor even if you feel well.
The injection form of the medicine may be used on the large vein. Meropenem intended for intravenous use only. Meropenem injection through the veins (intravenous) should be given with sterile water (5 ml/250 mg of Meropenem). For intravenous infusion, Meropenem vials may be given with 5% glucose solutions or 0.9% sodium chloride. A vial which is used once already, it should not be repeated for the second time. The gap between the start of mixing of drug with liquid and the completion of infusion or intravenous injection should not be more than one hour. It is advised not to freeze the mixed solution. yes

Talk to Your Doctor

Tell your doctor if your condition does not improve. Talk to your doctor if watery and bloody stools. If you have any kidney disease, adjustment of the dose should be done in kidney patients with creatinine clearance 50 mL/min or less. Consult with your doctor before stopping the use of Meropenem.
To see the impact of Meropenem on the body, your doctor may recommend a lower initial dose. Please follow your doctor's instructions carefully.

Use in Children

If you are giving Meropenem to a child, be sure to use a product that is meant for use in children. Before giving this medicine, use the child's weight or age to find the right dose from the leaflet or product package. You can also read the dosage section of this page to know the correct dose for your child. Else, consult with your doctor and follow their recommendation.

Lab Tests

Your doctor may require that certain tests be performed before using Meropenem. The doctor may ask you to have Antibiotic Susceptibility test. This test helps the doctor in selection antimicrobial dose for the treatment.

Storage

Store Meropenem dry powder at controlled room temperature 20º- 25ºC (68º-77ºF). Keep this medicine away from children and pets.
Medicines may be given for uses other than those listed in the medicine guide. Do not use Meropenem for symptoms for which it was not prescribed. Do not give Meropenem to others who may have similar symptoms as you. Self-medication can cause harm.

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How to take Meropenem

Your dose and how often you take Meropenem will depend on the following factors:
  • age
  • weight
  • patient's health
  • the health of the patient's liver

Meropenem Dosage

Dosage for complicated skin and soft tissue infection

Adult
  • Recommended: 500 mg every 8 hours for skin and soft tissue infections or 1000 mg after every 8 hours for complicated skin and soft tissue infections
Children (3 months of age and older)
  • Recommended: 10 mg/kg (4.54 mg/lb) after every 8 hours
  • Maximum: 500 mg after 8 hours of interval

Dosage for complicated infections within the stomach cavity

Adult
  • Recommended: 1000 mg after every 8 hours
Children (3 months of age and older)
  • Recommended: 20 mg/kg (9.09 mg/lb) after every 8 hours
  • Maximum: 1000 mg after 8 hours of interval
Children (infants having less than 32 weeks gestational age (GA) and postnatal age (PNA) less than 2 weeks)
  • Recommended: 20 mg/kg (9.09 mg/lb) after every 12 hours
Children (infants having less than 32 weeks of GA and PNA of 2 weeks and older)
  • Recommended: 20 mg/kg (9.09 mg/lb) after every 8 hours
Children (infants having 32 weeks and older GA and PNA less than 2 weeks)
  • Recommended: 20 mg/kg (9.09 mg/lb) after every 8 hours
Children (infants having 32 weeks and older GA and PNA 2 weeks and older)
  • Recommended: 30 mg/kg (13.6 mg/lb) after 8 hours of interval

Dosage for brain and spinal cord membranes inflammation

Adult
  • Recommended: 2000 mg after every 8 hours
Children (3 months - 11 years and body weight up to 50 kg (110 lb))
  • Recommended: 40 mg/kg (18.2 mg/lb) after every 8 hours
  • Maximum: 2000 mg after every 8 hours

Dosage for severe infection of the lungs

Adult
  • Recommended: 500 mg or 1000 mg every 8 hours
Children (3 months - 11 years and body weight up to 50 kg (110 lb))
  • Recommended: 10 mg/kg (4.54 mg/lb) or 20 mg/kg (9.09 mg/lb) after every 8 hours

Dosage for lower respiratory tract infection

Adult
  • Recommended: 2000 mg after every 8 hours
Children (3 months - 11 years of children and body weight up to 50 kg (110 lb))
  • Recommended: 40 mg/kg (18.2 mg/lb) after every 8 hours

Dosage for complicated urinary tract infections

Adult
  • Recommended: 500 mg or 1000 mg after every 8 hours
Children (3 months - 11 years of children and body weight up to 50 kg (110 lb))
  • Recommended: 10 mg/kg (4.54 mg/lb) or 20 mg/kg (9.09 mg/lb) after every 8 hours

Dosage for fever with low white blood cells

Adult
  • Recommended: 1000 mg after every 8 hours
Children (3 months - 11 years of children and body weight up to 50 kg (110 lb))
  • Recommended: 20 mg/kg (9.09 mg/lb) after every 8 hours

Dosage for infection during or following childbirth

Adult
  • Recommended: 500 mg or 1000 mg every 8 hours

Minimum Age

3 months

Dosage calculation for children

To calculate the dosage for children please use the weight based dose calculator to calculate the appropriate dosage as per the weight of your child.

Forms

Injection
Strength: 500 mg/20 ml,1000 mg/30ml
Powder, for solution
Strength: 500 mg, 1000 mg
Injection, powder, for solution
Strength: 500 mg, 500 mg/10 ml, 500 mg/20 ml, 1000 mg/20ml, 1000 mg/30ml, 1000 mg

Special Instructions

Creatinine clearance with 26-50 ml/min
Patients with creatinine clearance of 26-50 ml/min, the dose should be one unit dose (500 mg, 1000 mg or 2000 mg) after every 12 hours.
Creatinine clearance with 10-25 ml/min
Patients with creatinine clearance of 10-25 ml/min, the dose should be half of one unit dose (one unit dose is equal to 500 mg, 1000 mg or 2000 mg) after every 12 hours.
Creatinine clearance of less than 10 ml/min
Patients with creatinine clearance of less than 10 ml/min, the dose should be half of one unit dose (one unit dose is equal to 500 mg, 1000 mg or 2000 mg) after every 24 hours.

Missed Dose

The missed injection should be taken as soon as you remember it. However, if it is almost time for your next dose, the missed injection should be skipped, and the regular dosing schedule should be continued. A double dose (two injections at a time) should not be taken to make up for a missed dose.

Overdose

What to do if you overdose on Meropenem?
In the case of overdose, Meropenem and its metabolite will get effectively removed by purifying the blood (hemodialysis).
Symptoms of an overdose of Meropenem
If you use too much of this medicine, it could lead to dangerous levels of the medicine in your body. In such cases, symptoms of an overdose may include:
  • rapid kidney elimination
If you think you have overdosed on Meropenem, call a poison control center immediately. You can look up the poison control center information from the Poison Center Finder at TabletWise.com.

Precautions while using Meropenem

Before you use Meropenem, tell your doctor of your medical and health history including the following:
  • allergic reaction
  • brain disorder
  • diarrhea
  • kidney disorder
  • liver disease
This medicine may increase the level of liver enzymes.
Before you use Meropenem, discuss with your doctor if you are allergic to it or its ingredients. Your doctor may prescribe an alternative medicine and update your medical records to record this information. Tell your doctor if you are allergic any of the following substances: carbapenems, penicillins, or other beta-lactam antibiotics.
The use of Meropenem may change blood creatinine. Meropenem may increase the blood creatinine level.
The use of this medicine may change liver enzyme. This medicine may increase the level of liver enzymes.

Seizures

Meropenem can make you feel sleepy. Be careful when using any machinery, driving a vehicle, or doing any other activity that needs you to be fully alert. The consumption of alcohol with Meropenem can worsen the sleepiness. Meropenem may cause rarely seizures in some people. If you perform any activities where a loss of consciousness may cause harm to you (or others), you should discuss with your doctor.

Use in Pregnancy

Consult with your doctor on the use of Meropenem during pregnancy, or if you are planning to become pregnant. There is no or limited data available for Meropenem use in pregnant women. Before using Meropenem in pregnant women, it is advised to consult the doctor.

Use while Breastfeeding

Consult with your doctor on the use of Meropenem during breastfeeding. It has been reported that while using Meropenem in breastfeeding women, a minimal amount of this medicine is excreted in human milk. Breastfeeding women should not use Meropenem unless the possible benefit for the mother explains the possible risk to the baby. Before using Meropenem in breastfeeding women, it is advised to consult the doctor.

Increased Risks

This medicine may cause bleeding in the stomach. Regular use of tobacco or alcohol while using this medicine can increase your risk. Discuss with your doctor if you smoke and drink alcohol regularly.

Side-effects in Older Patients

Meropenem may cause increased incidence of side-effects in older patients. Elderly patients may see an increased risk of decreased functioning of kidneys.

Side-effects in Children

Meropenem may cause an increased risk of side-effects in children. Children using this medicine may see an increased risk of diarrhea, rash, nausea, vomiting, a fungal infection of the mouth and throat, inflammation of the tongue, and increased level of bilirubin in the blood.

Long-term Use

Long term use of Meropenem may result in overgrowth of non-sensitive organisms.

Meropenem Side-effects

The following side-effects may commonly occur when using Meropenem. If any of these side-effects worsen or last for a long time, you should consult with your doctor:
  • constipation
  • deficiency of red blood cells
  • diarrhea
  • headache
  • increased blood alkaline phosphatase
  • increased blood lactate dehydrogenase
  • increased transaminases
  • inflammation
  • inflammation of the tongue
  • nausea
  • pain
  • rash
  • severe itching
  • stomach pain
  • vomiting
  • yeast infection of the mouth and throat
The following side-effects may commonly occur in children when using Meropenem. Discuss with your doctor if any of these side-effects last for a long time or are severe:
  • bilirubin in the blood
  • convulsion
  • diarrhea
  • inflammation of the tongue
  • rash
  • vomiting
  • yeast infection of the throat and mouth
Rarely, the use of Meropenem may cause the following side-effects:
The following severe side-effects may also occur when using Meropenem:
  • Heart disorders
    Symptoms: heart failure, heart arrest, increased heartbeat, high blood pressure, heart attack, blood clot in the lungs, decreased heartbeat low blood pressure
  • Hemic/Lymphatic disorders
    Symptoms: deficiency of red blood cells, paler red blood cells excess water in the body
  • Nervous system disorders
    Symptoms: agitation, disturbance in mental abilities (delirium), confusion, seizure, hallucinations, drowsiness, anxiety depression
  • Skin and appendages disorders
    Symptoms: skin ulcer
  • Liver disorders
    Symptoms: increased alanine transaminase, increased aspartate transaminase, increased alkaline phosphatase, increased lactate dehydrogenase increased bilirubin level
  • Body as a whole
    Symptoms: fever
    If fever occurs, patients should reach out to their doctor as soon as possible.
  • Digestive system disorders
    Symptoms: abnormally low body weight (anorexia), a decrease in bile flow (cholestatic jaundice), lack of movement in the intestine (ileus), liver failure, intestinal blockage yeast infection of the mouth and throat (oral moniliasis)
  • Metabolic/Nutritional disorders
    Symptoms: decreased level of oxygen swelling in the arms and legs
  • Symptoms: shortness of breath (dyspnea), fluid around the lungs (pleural effusion), lung swelling asthma
  • Urogenital system disorder
    Symptoms: pain while urinating, kidney failure yeast infection of the vagina
Your doctor has prescribed Meropenem because they judge that the benefit is greater than the risk posed by side-effects. Many people using this medicine do not have serious side-effects. This page does not list all possible side-effects of Meropenem.
If you experience side-effects or notice other side-effects not listed above, contact your doctor for medical advice. You may also report side-effects to your local food and drug administration authority. You can look up the drug authority contact information from the Drug Authority Finder at TabletWise.com.

Warnings

Meropenem Containing Sodium

Patients are on a controlled sodium diet are at an increased risk while taking Meropenem. Meropenem powder of 1000 mg for a solution for infusion or injection contains about 4.0 mEq of sodium/vial which should be considered by patients who are on a controlled sodium diet.

Possibility of Neuromotor Abnormality

It should be advised to patients not to operate motorized or machinery vehicles unless it is reported that Meropenem is well tolerated. Patients should be aware of the side effects such as seizures, mental confusion, headache or abnormal sensation in the body. These side effects could interfere with mental alertness or disorders of the nervous system.

Low Levels of Thrombocytes

Patients with kidney abnormality are at an increased risk while using this medicine. In patients with kidney abnormality, low levels of thrombocytes have been observed. There have been no reports of clinical bleeding.

Overgrowth of Non-Sensitive Organisms

Long term use of Meropenem may result in excess of non-sensitive organisms. Repeated evaluation of the patient is required. If superinfection occurs during treatment, proper measures should be taken.

Development of Drug-Resistant Bacteria

Giving Meropenem in the absence of suspected bacterial infection or a preventive indication does not give an advantage to the patient. This enhances the risk of the growth of drug-resistant bacteria.

Hospital-Acquired Infection

Clostridium difficile-associated diarrhea has been observed over two months of the use of Meropenem and may vary in severity from moderate diarrhea to life-threatening inflammation of the colon. Treatment with Meropenem changes the normal flora of the colon leading to overgrowth of C. difficile, contributing to hospital-acquired diarrhea. These can cause an increased fatality and disease rate. Patients with such condition may require the removal of the colon. If CDAD is doubted or confirmed, the use of Meropenem against C. difficile needs to be discontinued. Suitable fluid and electrolyte use, protein supplementation, antibacterial therapy of C. difficile, and operational evaluation should be started as indicated.

Risk of Breakthrough Seizures

Patients taking Meropenem in combination with valproic acid are at an increased risk. It is shown that combined use of these drugs results in a decrease in valproic acid levels. As a result of this interaction, valproic acid levels may fall below the therapeutic range, therefore increases the risk of sudden seizure attack (breakthrough seizures). The combined use of Meropenem and divalproex sodium or valproic acid is generally not advised. If the use of Meropenem is required, consider additive anticonvulsant therapy. Use of antibacterial drugs other than Meropenem should be considered to treat the infections in patients whose seizures are well-controlled when being on divalproex sodium or valproic acid.

Seizure Possibility

Patients with brain disorders (e.g. history of seizures or brain lesions) or with inflammation of the brain and spinal cord membranes and improper functioning of the kidneys are at an increased risk when using this medicine. Seizures and other central nervous system side effects have been seen during treatment with Meropenem. It is recommended to adjust the dose in old and adult patients with lowered creatinine clearance. Patients with seizure disorders should continue with anticonvulsant therapy. If seizures occur, assess neurologically, start taking anticonvulsant therapy if not previously begun. Also, re-examine the dosage of Meropenem to learn whether it should be lowered or discontinued.

Severe Allergic Reactions

Patients with a history of sensitivity to cephalosporins, other beta-lactams, penicillins and various allergens are at an increased risk when using Meropenem. Serious and infrequently fatal allergic reactions have been seen in patients with beta-lactams use. Before starting treatment with Meropenem, it is important to examine previous allergic reactions to cephalosporins, penicillins, other beta-lactams, and another allergen. Discontinue the medicine immediately, if an allergic reaction to Meropenem occurs.

Interactions with Meropenem

When two or more medicines are taken together, it can change how the medicines work and increase the risk of side-effects. In medical terms, this is called as a Drug Interaction.
This page does not contain all the possible interactions of Meropenem. Share a list of all medicines that you use with your doctor and pharmacist. Do not start, stop, or change the dose of any medicines without the approval of your doctor.

Oral Anticoagulants

Meropenem interacts with oral anti-coagulants, which prevent or reduce the coagulation of blood. The combined use of Meropenem with warfarin may increase its blood clotting effect. The risk may vary with the severity of infection, age and the overall status of the patient. This is because the contribution of Meropenem to the increase in an international normalized ratio (INR) should remain hard to assess. It is advised that the international normalized ratio should be observed regularly during and shortly after combined use of Meropenem with an oral anticoagulant agent.

Anticonvulsant

There may be an interaction of Meropenem with an anticonvulsant (valproic acid), which is used to treat various types of seizure disorders. The combined use of Meropenem with divalproex sodium or valproic acid results in a reduction in valproic acid levels. The valproic acid levels may fall below the therapeutic range as a result of this interaction, therefore raises the chance of sudden seizure attacks. If the use of Meropenem is necessary, then additive anticonvulsant treatment should be taken into consideration.

Uricosurics

Meropenem may interact with uricosurics (probenecid), which is used in treating severe pain, redness, or tenderness in joints and excess of uric acid. Probenecid competes with Meropenem for the transfer of materials from blood vessels to the kidney, resulting in increased blood levels of Meropenem. The combined use of probenecid with Meropenem is not recommended.

Traveling With Medication

  • Ensure that you carry enough doses of each of your prescription medicines to last the entire trip. The best place to store your medicines is in the carry on baggage. However, while flying, if carrying liquid medicines, make sure you do not go over the limits imposed for carry-on liquids.
  • While traveling overseas, make sure that you can carry each of your prescription medicines legally to your destination country. One way to ensure this is by checking with your destination country's embassy or website.
  • Make sure that you carry each of your medicines in their original packaging, which should typically include your name and address, and the details of the prescribing doctor.
  • If your travel involves crossing time zones, and you are required to take your medicine as per a fixed schedule, make sure that you adjust for the change in time.

Expired Medication

Taking a single dose of expired Meropenem is unlikely to cause a side-effect. However, please discuss with your doctor or pharmacist, if you feel unwell or sick. An expired medicine may become ineffective in treating your prescribed conditions. To be on the safe side, it is important not to use an expired drug. You are much safer by always keeping a fresh supply of unexpired medicines.

Safe Disposal of Medication

  • If there are disposal instructions on the package, please follow the instructions.
  • If there are medicine take-back programs in your country, you should contact the respective authority to arrange for the disposal of the medicine. For example, in the USA, the Drug Enforcement Administration regularly hosts National Prescription Drug Take-Back events.
  • If there are no take-back programs, mix the medicine with dirt and place them in a sealed plastic bag. Throw the plastic bag in your household trash. Separately, remove all personal information including the prescription label from the medicine packaging and then dispose off the container.
  • If specifically indicated on the medicine package that it needs to be flushed down the toilet when no longer needed, perform the required step.
This page provides information for Meropenem .
Bacterial Infections
Skin Infections
Urinary Tract Infections
Infectious Diseases

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