Update: January 2022
Forms, strengths and route of administration
- Powder for injection, in 500 mg vial, to be reconstituted with 10 ml of water for injection (50 mg meropenem/ml).
- Each dose is to be diluted in 5 ml/kg of 0.9% sodium chloride in children under 20 kg and in 100 ml of 0.9% sodium chloride in children 20 kg and over and adults and to be administered by IV infusion over 15 to 30 minutes.
- Use a deep line, preferably an implantable venous access device (Port-a-Cath).
Dosage
- Child under 30 kg: 20 to 40 mg/kg every 8 hours
- Child 30 kg and over and adult: 1500 to 2000 mg 2 times daily with 10 hours minimum between infusions
- Maximum dose: 6000 mg daily
- Renal insufficiency: 750 mg every 12 hours for CrCl 20-40 ml/minute; 500 mg every 12 hours for CrCl < 20 ml/minute
|
Weight |
Daily dose |
Daily dose (ml) – IV infusion |
|---|---|---|
|
5 |
300 |
2 ml in 25 ml of 0.9% NaCl x 3 |
|
6 |
300 |
2 ml in 30 ml of 0.9% NaCl x 3 |
|
7 |
600 |
4 ml in 35 ml of 0.9% NaCl x 3 |
|
8 |
600 |
4 ml in 40 ml of 0.9% NaCl x 3 |
|
9 |
600 |
4 ml in 45 ml of 0.9% NaCl x 3 |
|
10 |
900 |
6 ml in 50 ml of 0.9% NaCl x 3 |
|
11 |
900 |
6 ml in 55 ml of 0.9% NaCl x 3 |
|
12 |
900 |
6 ml in 60 ml of 0.9% NaCl x 3 |
|
13 |
900 |
6 ml in 65 ml of 0.9% NaCl x 3 |
|
14 |
900 |
6 ml in 70 ml of 0.9% NaCl x 3 |
|
15 |
900 |
6 ml in 75 ml of 0.9% NaCl x 3 |
|
16 |
1200 |
8 ml in 80 ml of 0.9% NaCl x 3 |
|
17 |
1200 |
8 ml in 85 ml of 0.9% NaCl x 3 |
|
18 |
1200 |
8 ml in 90 ml of 0.9% NaCl x 3 |
|
19 |
1200 |
8 ml in 95 ml of 0.9% NaCl x 3 |
|
20 |
1200 |
8 ml in 100 ml of 0.9% NaCl x 3 |
|
21 |
1200 |
8 ml in 100 ml of 0.9% NaCl x 3 |
|
22 |
1200 |
8 ml in 100 ml of 0.9% NaCl x 3 |
|
23 |
1200 |
8 ml in 100 ml of 0.9% NaCl x 3 |
|
24 |
1650 |
11 ml in 100 ml of 0.9% NaCl x 3 |
|
25 |
1650 |
11 ml in 100 ml of 0.9% NaCl x 3 |
|
26 |
1650 |
11 ml in 100 ml of 0.9% NaCl x 3 |
|
27 |
1650 |
11 ml in 100 ml of 0.9% NaCl x 3 |
|
28 |
1650 |
11 ml in 100 ml of 0.9% NaCl x 3 |
|
29 |
1650 |
11 ml in 100 ml of 0.9% NaCl x 3 |
|
|
||
|
30-33 |
3000 |
3 vials (30 ml) in 100 ml of 0.9% NaCl x 2 |
|
34-40 |
3000 |
3 vials (30 ml) in 100 ml of 0.9% NaCl x 2 |
|
41-45 |
3000 |
3 vials (30 ml) in 100 ml of 0.9% NaCl x 2 |
|
46-50 |
3000 |
3 vials (30 ml) in 100 ml of 0.9% NaCl x 2 |
|
51-70 |
4000 |
4 vials (40 ml) in 100 ml of 0.9% NaCl x 2 |
|
> 70 |
4000 |
4 vials (40 ml) in 100 ml of 0.9% NaCl x 2 |
Contra-indications, adverse effects, precautions
- Do not administer to patients with hypersensitivity to carbapenems.
- Administer with caution to patients with hypersensitivity to other betalactams (cross-hypersensitivity may occur).
- May cause:
- nausea, vomiting (the infusion rate may be slowed down in case of nausea), diarrhoea;
- nervous system disorders: confusional state, seizures (rarely compared to imipenem/cilastatin, most frequently in patients with history of seizures or renal impairment);
- hypersensitivity reactions;
- local reactions (phlebitis/thrombophlebitis).
- For the management of adverse effects, see Appendix 17.
- Avoid or monitor combination with valproic acid (decreased concentration of valproic acid and risk of seizures).
- Pregnancy and breastfeeding: use only if the benefits outweigh the risks (safety not established).
Monitoring
- Symptomatic monitoring.
Remarks
- Administer clavulanic acid 60 minutes before each dose of meropenem.
- Do not mix with other drugs in the infusion bag.
Storage
Once reconstituted, solution should be used immediately (within 1 hour of preparation).