Injection vials (500 mg and 1 gram) may be directly re-constituted with a compatible infusion fluid. Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances. Detailed Meropenem dosage information for adults and children. -Renal: Renal organ system functions (periodically during prolonged therapy); renal function in elderly patients -Infants less than 32 weeks gestational age (GA) and postnatal age (PNA) less than 2 weeks: 20 mg/kg IV every 12 hours When treating complicated skin and skin structure infections caused by P. aeruginosa, a dose of 1 gram every 8 hours is recommended. Solutions prepared for infusion (MERREM IV concentrations ranging from 1 mg/mL to 20 mg/mL) re-constituted with Dextrose Injection 5% should be used immediately. -Solution for IV infusion when constituted with Sodium Chloride Injection 0.9%: If unable to use freshly prepared solution immediately, may store for 1 hour at up to 25C (77F) or 15 hours at up to 5C (41F) TDM-monograph Meropenem October 2015, CONCEPT version Page 4 of 5 meropenem 500 mg every 8 hours, or 1 gram every 6 hours in patients with normal renal function. Comments: For pediatric patients weighing over 50 kg administer MERREM IV at a dose of 500 mg every 8 hours for cSSSI, 1 gram every 8 hours for cIAI and 2 grams every 8 hours for meningitis. This material is provided for educational purposes only and is not intended for medical advice, diagnosis or treatment. Synopsis: Comparison of 2 meropenem dosing regimens, 500 mg q 6 h and 1000 mg q 8h, found that the resultant pharmacokinetics and pharmacodynamics were equivalent. Use half normal dose every 24 hours if eGFR less than 10 mL/minute/1.73 m 2. -Compatibility with other drugs not established; this drug should not be mixed with or physically added to solutions containing other drugs. No dose adjustment is necessary in patients with hepatic impairment (see section 4.4). Meropenem Merrem ® - Renal dosing. Typhoid Fever (Off-label) 15-20 mg/kg/day PO divided q12hr for 7-14 days. CrCl less than 10 mL/min: One-half recommended dose every 24 hours Shake to dissolve and let stand until clear. Alternatively, an injection vial may be re-constituted, then the resulting solution added to an intravenous container and further diluted with an appropriate infusion fluid. Uses: As a single agent therapy for the treatment of complicated intraabdominal infections (including appendicitis and peritonitis) due to viridans group streptococci, E coli, Klebsiella pneumoniae, P aeruginosa, B fragilis, B thetaiotaomicron, Peptostreptococcus species, Infectious Diseases Society of America (IDSA) recommendations: 2 g IV every 8 hours for 7 to 21 days Complicated skin and skin structure infections, Infants less than 32 weeks GA and PNA less than 2 weeks, Infants less than 32 weeks GA and PNA 2 weeks and older, Infants 32 weeks and older GA and PNA less than 2 weeks, Infants 32 weeks and older GA and PNA 2 weeks and older, For pediatric patients 3 months of age and older, the MERREM IV dose is 10 mg/kg, 20 mg/kg or 40 mg/kg every 8 hours (maximum dose is 2 grams every 8 hours), depending on the type of infection (cSSSI, cIAI, intra-abdominal infection or meningitis). It is given by injection into a vein.. Common side effects include nausea, diarrhea, constipation, headache, rash, and pain at the site of injection. -Recommended as an alternative therapy. There are no established dose recommendations for patients receiving peritoneal dialysis. -Solution for IV infusion when constituted with Dextrose Injection 5%: Freshly prepared solution should be used immediately. Authoritative and practical information on the selection and clinical use of medicines. The easiest way to lookup drug information, identify pills, check interactions and set up your own personal medication records. -Avoid missing doses and complete the entire course of therapy. -Recommended as an alternative therapy, Adults: amoxicillin, Keflex, doxycycline, triamcinolone, metronidazole, azithromycin, ciprofloxacin, clindamycin, Augmentin, Flagyl. -Compatible for IV bolus: Sterile Water for Injection Storage requirements: Greater than 50 mL/min: Recommended dose every 8 hours Source: Kuti JL, et al. -Hematologic: Hematopoietic organ system functions (periodically during prolonged therapy) 3 months or older: 10 mg/kg IV every 8 hours A 20 mg/kg dose of meropenem results in peak serum concentrations of about 50 μg/mL. Comments: MERREM IV should not be mixed with or physically added to solutions containing other drugs. Meropenem is cleared by haemodialysis and haemofiltration. Uses: As a single agent therapy for the treatment of bacterial meningitis due to S pneumoniae, Haemophilus influenzae, Neisseria meningitidis -Shortening the duration of therapy may reduce the risk of superinfections with resistant organisms. NDA 50-706/S-022 Page 4 concentrations of meropenem in excess of … Hemodialysis, peritoneal dialysis: Data not available. -Constituted solution for IV bolus: If unable to use freshly prepared solution immediately, may store up to 3 hours at up to 25C (77F) or for 13 hours at up to 5C (41F) Pediatric Patients 3 Months of Age and Older, Pediatric Patients Less Than 3 Months of Age. Page 1 of 3 King Edward Memorial Hospital & Perth Children’s Hospital Neonatology Meropenem - Neonatal NEONATAL MEROPENEM This document should be read in conjunction with this DISCLAIMER Restricted: Requires Microbiologist review within 24 hours of initiation Presentation Vial: 500mg Classification Bactericidal carbapenem antibiotic. • If seizures occur during meropenem therapy, decrease dosage or discontinue meropenem. Maximum dose: 500 mg/dose [35489] [63245] One trial of 47 patients with a mean age of 2 years (range, 4 days to 20 years) examined meropenem 20 mg/kg/dose (or up to 40 mg/kg/dose for CNS or critical infections) IV every 8 hours for a variety of infections. Meropenem exhibits dose-proportional linear PK properties with dosages of meropenem from 10 to 40 mg/kg. Dosage should be reduced in patients with creatinine clearance of 50 mL/min or less. Consult WARNINGS section for dosing related precautions. Should you take probiotics with antibiotics. Reference(s) National Institutes of Health, U.S. National Library of Medicine, DailyMed Database. -Infants 32 weeks or older GA and PNA less than 2 weeks: 20 mg/kg IV every 8 hours Applies to the following strengths: 500 mg; 1000 mg; 500 mg/ 50 mL-NaCl 0.9%; 1000 mg/ 50 mL-NaCl 0.9%, 500 mg IV every 8 hours Chris is an Intensivist and ECMO specialist at the Alfred ICU in Melbourne. IV compatibility: British National Formulary - BNF (Add filter) 15 October 2020 Indications, dose, contra-indications, side-effects, interactions, cautions, warnings and other safety information for MEROPENEM WITH VABORBACTAM. Directions for administration For continuous intravenous infusion , manufacturer advises reconstitute each 1 g (as meropenem) vial to produce a 0.05 g (as meropenem)/mL solution with 20 mL Sodium Chloride 0.9%. Faropenem is an orally active beta-lactam antibiotic belonging to the penem group. Meropenem / vaborbactam is also indicated for the treatment of infections due to aerobic Gram-negative organisms in adults with limited treatment options. Administer MERREM IV as an intravenous infusion over approximately 15 minutes to 30 minutes or as an intravenous bolus injection (5 mL to 20 mL) over approximately 3 minutes to 5 minutes. No dose adjustment is necessary in patients with hepatic impairment (see section 4.4). We comply with the HONcode standard for trustworthy health information -. -For IV infusion: May constitute infusion vials directly with compatible infusion fluid; alternatively, may constitute an injection vial, add the resulting solution to an IV container, then further dilute with an appropriate infusion fluid Pediatric patients: Data not available. Subscribe to Drugs.com newsletters for the latest medication news, new drug approvals, alerts and updates. MERREM IV injection vials re-constituted with sterile Water for Injection for bolus administration (up to 50 mg/mL of MERREM IV) may be stored for up to 3 hours at up to 25°C (77°F) or for 13 hours at up to 5°C (41°F). Approximately 70% of the intravenously administered dose is recovered as unchanged meropenem in the urine over 12 hours, after which little further urinary excretion is detectable. Meropenem readily penetrates the cell wall of most Gram-positive and Gram-negative bacteria to reach penicillin-binding- protein (PBP) targets. Meropenem, sold under the brandname Merrem among others, is a broad-spectrum antibiotic used to treat a variety of bacterial infections. Urinary . However, re-constituted solutions of MERREM IV maintain satisfactory potency under the conditions described below. The easiest way to lookup drug information, identify pills, check interactions and set up your own personal medication records. Maximum dose: 2 g/dose -Compatible for IV infusion: Sodium Chloride Injection 0.9%, Dextrose Injection 5% -Complicated infections due to P aeruginosa: 20 mg/kg IV every 8 hours General: • For I.V. Available for Android and iOS devices. All the information, content and live chat provided on the site is intended to be for informational purposes only, and not a substitute for professional or medical advice. Data sources include IBM Watson Micromedex (updated 2 Nov 2020), Cerner Multum™ (updated 2 Nov 2020), ASHP (updated 23 Oct 2020) and others. Freshly prepared solutions of MERREM IV should be used. Once-daily administration of gentamicin is safe and effective for most patients. <10 one-half unit dose every 24 hours Meropenem is cleared by haemodialysis. -Concentration of solution for IV infusion: Ranges from 1 to 20 mg/mL Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances. Meropenem dose bnf Usage of meropenem Download Here Free HealthCareMagic App to Ask a Doctor. Weight (kg) × (140 - age) Publishers of the British National Formulary. IDSA recommendations: MERREM IV should be administered by intravenous infusion over approximately 15 minutes to 30 minutes. Dosing Modifications Renal impairment. -This drug is useful as presumptive therapy in the indicated condition before causative organism is identified due to broad spectrum of bactericidal activity. 3 months or older: 20 mg/kg IV every 8 hours Economic benefit of a meropenem dosage strategy based on pharmacodynamic concepts. Use half normal dose every 12 hours if eGFR 10–25 mL/minute/1.73 m 2. -Do not use flexible container in series connections. Adult: In cases of severe pneumonia, complicated UTI, complicated intra-abdominal infections, complicated skin and skin structure infections, gynaecological infections: 0.5-1 g 8 hourly via infusion over approx 15-30 minutes or via bolus inj over approx 3-5 minutes. Table 1: Recommended MERREM IV Dosage Schedule for Adult Patients with Renal Impairment, Table 2: Recommended MERREM IV Dosage Schedule for Pediatric Patients 3 Months of Age and Older with Normal Renal Function, Table 3: Recommended MERREM IV Dosage Schedule for Pediatric Patients Less than 3 Months of Age with Complicated Intra-abdominal Infections and Normal Renal Function, Table 4: Volume of Sterile Water for Injection for Reconstitution of Injection Vials, We comply with the HONcode standard for trustworthy health information -, Recommended dose (500 mg cSSSI and 1 gram Intra-abdominal). Comments: The recommended dose of MERREM IV is 500 mg given every 8 hours for skin and skin structure infections and 1 gram given every 8 hours for intra-abdominal infections. Generic name: MEROPENEM 1g in 30mLDosage form: injection. Infants and children: 40 mg/kg IV every 8 hours -Complicated infections due to Pseudomonas aeruginosa: 1 g IV every 8 hours Meropenem undergoes both filtration and tubular secretion. There is limited safety data available to support the administration of a 40 mg/kg (up to a maximum of 2 grams) bolus dose. Consider IVIg. Drugs.com provides accurate and independent information on more than 24,000 prescription drugs, over-the-counter medicines and natural products. Date last published: ... under 50kg; 40mg/kg q8h (max dose 2g/dose q8h) over 50kg; dose as for child 12 - 18 years : Child 12 years - 18 years ... . 72 × serum creatinine (mg/dL). Re-constitute injection vials (500 mg and 1 gram) with sterile Water for Injection (see table 4 below). Hepatic impairment. CrCl 10 to 25 mL/min: One-half recommended dose every 12 hours Last updated on Jul 26, 2019. -Dry powder: Store at controlled room temperature 20C to 25C (68F to 77F) -Effective in eliminating concurrent bacteremia associated with bacterial meningitis. Doses of 1 gram may also be administered as an intravenous bolus injection (5 mL to 20 mL) over approximately 3 minutes to 5 minutes. 400 mg/day PO in single daily dose or divided q12hr. There is inadequate information regarding the use of MERREM IV in patients on hemodialysis or peritoneal dialysis. See dosing table 3 below. It is available for oral use. -Concentration of solution for IV bolus: Up to 50 mg/mL He is also the Innovation Lead for the Australian Centre for Health Innovation at Alfred Health and Clinical Adjunct Associate Professor at Monash University.. • For I.V. Applying Pharmacokinetic and Pharmacodynamic Principles to Meropenem . -Pediatric patients 3 months or older: Administer as IV infusion over about 15 to 30 minutes or as an IV bolus injection over about 3 to 5 minutes; limited safety data available to support use of a 40 mg/kg (maximum of 2 g) bolus dose. Duration of therapy: As short as 7 days recommended (reducing from traditional 14 to 21 days) if causative organism is not P aeruginosa and patient has good clinical response Solutions prepared for infusion (MERREM IV concentrations ranging from 1 mg/mL to 20 mg/mL) re-constituted with Sodium Chloride Injection 0.9% may be stored for 1 hour at up to 25°C (77°F) or 15 hours at up to 5°C (41°F). Use normal dose every 12 hours if estimated glomerular filtration rate 26–50 mL/minute/1.73 m 2.. Use half normal dose every 12 hours if estimated glomerular filtration rate 10–25 mL/minute/1.73 m 2.. Use half normal dose every 24 hours if estimated glomerular filtration rate less than 10 mL/minute/1.73 m 2. Antibiotics & Drinking Alcohol - Is it Safe? Compatibility of MERREM IV with other drugs has not been established. • For pediatric patients weighing over 50 kg administer MERREM IV at a dose of 500 mg every 8 hours for cSSSI, 1 gram every 8 hours for cIAI and 2 grams every 8 hours for meningitis. Drugs.com provides accurate and independent information on more than 24,000 prescription drugs, over-the-counter medicines and natural products. -Do not freeze IV solutions. Meropenem is cleared by haemodialysis and haemofiltration. Meropenem clearance increases with gestational age and chronologic age as the kidneys mature. See. Use normal dose every 12 hours if eGFR 26–50 mL/minute/1.73 m 2. For pediatric patients weighing over 50 kg administer MERREM IV at a dose of 500 mg every 8 hours for cSSSI, 1 gram every 8 hours for cIAI and 2 grams every 8 hours for meningitis. Dental abscess : ... Gentamicin once-daily dosing. Elimination half life (T 1/2): Table 3. Monitoring: Patient advice: -If multidrug-resistant organisms suspected, initial empiric treatment with broad-spectrum coverage (according to the hospital's and/or ICU's antibiogram) is recommended. Solutions of intravenous MERREM IV should not be frozen. Comments: Approximately 70% (50% to 75%) of a meropenem dose administered intravenously is recovered unchanged in the urine over 12 hours 1. If continued treatment with MEROPENEM RANBAXY for Injection is necessary, the unit dose (based on the type and severity of infection) is recommended at the completion of the haemodialysis … For pediatric patients (with normal renal function) less than 3 months of age, with complicated intra-abdominal infections, the MERREM IV dose is based on gestational age (GA) and postnatal age (PNA). -For IV bolus: Constitute injection vials with sterile Water for Injection; shake to dissolve then let stand until clear. American Thoracic Society, IDSA recommendations: 1 g IV every 8 hours Active ingredients Size Unit NHS indicative price Drug tariff Drug tariff price; Meropenem (as Meropenem trihydrate) 500 mg; 10: vial (POM) £103.14 (Hospital only) Part VIIIA Category C Approximately 70% (50% to 75%) of a meropenem dose administered intravenously is recovered unchanged in the urine over 12 hours 1. Includes dosages for Skin and Structure Infection, Intraabdominal Infection, Nosocomial Pneumonia and more; plus renal, liver and dialysis adjustments. Reconstitution/preparation techniques: -Do not operate machinery or motorized vehicles until it is reasonable well established that this drug is well tolerated. Manufacturer advises reduce dose to 0.5 g every 12 hours if creatinine clearance less than 10 mL/minute. -General: Organ system functions (periodically during prolonged therapy) Uses: As a single agent therapy for the treatment of complicated intraabdominal infections (including appendicitis and peritonitis) due to viridans group streptococci, E coli, K pneumoniae, P aeruginosa, B fragilis, B thetaiotaomicron, Peptostreptococcus species, 3 months or older: 40 mg/kg IV every 8 hours
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