Parenteral Manual

Meropenem

Disclaimer: Official controlled document is the CHEO online copy. It is the responsibility of user to ensure that any paper copy version is the same as the online version before use.

Alternate Name(s): 
Merrem
Classification: 
Carbapenem antibiotic
Original Date: 
August 2005
Revised Date: 
October 2021
Indications: 
  • Treatment of infections caused by susceptible bacteria.

** Prescribing is restricted to Infectious Disease **

Reconstitution and Stability: 

VIAL  SIZE

0.9%  SODIUM CHLORIDE REQUIRED

FINAL CONCENTRATION

500 mg

10 mL

50 mg/mL

1,000 mg

20 mL

50 mg/mL
  • Shake to dissolve and let stand until clear.
  • Reconstituted solutions stable 3 hours room temperature, 24 hours refrigerated.
  • Solution ranges in color from colorless to pale yellow.
Compatibility: 
  • Solutions Compatible: D5W, 0.9%NS, D5NS, ringer's solution, ringer's lactate
  • Additives/Above Cassette Compatible: no information
  • Y-site Compatible: aminophylline, dexamethasone, digoxin, diphenhydramine, fluconazole,​ furosemide, metoclopramide, morphine, norepinephrine, potassium (up to 40 mmol/L) vancomycin, TPN (amino acids/dextrose)

Incompatible: acyclovir, amphotericin B, diazepam, doxycycline, metronidazole, ondansetron, zidovudine.

 

 

Administration: 

(For approved routes of administration by nursing personnel, refer to Policy for the Administration of Intravenous Medications.)

SC NO
IM NO
IV Direct

NO
IV Intermittent Infusion

YES
Usual dilution: 20 mg/mL
Infusion time: 30 minutes
IV Continuous Infusion NO

 

Dosage: 

(For neonatal dosages, refer to Neonatal IV Drug Manual.)

Pediatric: (>3 months)
- Infection: 60 mg/kg/day IV ÷ Q  6 - 8 hours (Maximum: 3 g/day)

- Meningitis/Cystic Fibrosis patients with LRTI:  120 mg/kg/day IV ÷ Q 6 - 8 hours  (Maximum: 6 g/day)

Adult:
- Infection:   1.5-3 g/day IV ÷ Q 6 - 8 hours

- Meningitis: 6 g/day IV ÷ Q 8 hours

DOSING ADJUSTMENT IN RENAL IMPAIRMENT:

  • CrCl 26-50 mL/minute: full dose Q 12 hours
  • CrCl 10-25 mL/minute: ½ dose Q 12 hours
  • CrCl <10 mL/minute: ½ dose Q 24 hours
  • Meropenem is removed by hemodialysis; therefore, administer dose at completion of hemodialysis procedure
Potential hazards of parenteral administration: 
  • Thrombophlebitis, phlebitis, inflammation at injection site
  • Headache, diarrhea, pseudomembranous colitis, nausea, vomiting
  • Transient increase in liver enzymes, liver function tests and bilirubin
  • Elevated BUN and serum creatinine
  • Rash, pruritus, urticaria
  • Increases in platelets occur more frequently in pediatric patients
  • Seizures (rare)
Notes: 
  • Use with caution in patients with a history of seizures, CNS disease, CNS infection,
  • May exhibit cross-allergy with penicillins or cephalosporins
  • Monitor CBC with differential, serum creatinine and BUN, periodic hepatic function tests
  • 1 gram of meropenem provides 90.2 mg (or 3.92 mmol) of sodium

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