Meropenem (Mpm)

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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
(kg)

Daily dose
(mg)

Daily dose (ml) – IV infusion
(500 mg per vial)

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

 
–  Below 25 °C
Once reconstituted, solution should be used immediately (within 1 hour of preparation).