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 allergic to cephalosporins (cross-hypersensitivity may occur).
    • May cause:
      • nausea, vomiting (the infusion rate may be slowed down in case of nausea), diarrhoea;
      • neurotoxicity: 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: avoid unless the benefits outweigh the risks.

    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)