Meropenem
- Atc Codes:J01DH02
- CAS Codes:119478-56-7#96036-03-2
- PHARMGKB ID:119478-56-7#96036-03-2
Table of contents
- Brand Names
- Chemistry
- Pharmacologic Category
- Mechanism of Action
- Therapeutic Use
- Unlabeled Use
- Pregnancy and Lactation Implications
- Contraindications
- Warnings and Precautions
- Adverse Reactions
- Genes that may be involved
- Drug Interactions
- Dosage
- Pharmacokinetics and Pharmacodynamics
- Special Considerations
Brand Names
Europe
Austria: Merinfec, Optinem; Belgium: Meronem; Bulgaria: Meronem; Cyprus: Meronem; Czech Republic: Meronem; Denmark: Meronem; Estonia: Meronem; Finland: Meronem; France: Meronem; Germany: Meronem; Greece: Carbenem, Merobact, Meronem, Meropenem, Merovia, Merozan, Nemerop, Santamer; Hungary: Meronem; Ireland: Meronem; Italy: Merrem; Latvia: Meronem; Lithuania: Meronem; Luxembourg: Meronem; Malta: Meronem;Netherlands: Meronem; Poland: Meronem, Meropenem; Portugal: Meronem; Romania: Meronem; Slovakia: Meronem; Slovenia: Meronem; Spain: Meronem; Sweden: Meronem; UK: Meronem.
North America
Canada: Merrem; USA: Merrem.
Latin America
Argentina: Meroefectil, Meropenem, Merotenk, Merozen, Merpem; Brazil: Meronem, Meropenem; Mexico: Lusantem, Merrem.
Asia
Japan: Meropen.
Drug combinations
Chemistry
Meropenem: C~17~H~25~N~3~O~5~S 3H~2~O. Mw: 437.51. (1) 1-Azabicyclo[3.2.0]hept-2-ene-2-carboxylic acid, 3-[[5-[(dimethylamino)carbonyl]-3-pyrrolidinyl]thio]-6-(1-hydroxyethyl)-4-methyl-7-oxo-, trihydrate, [4R-[3(3S*,5S*),4a,5b,6b(R*)]]-; (2)(4R,5S,6S)-3-[[(3S,5S)-5-(Dimethylcarbamoyl)-3-pyrrolidinyl]thio]-6-[(1R)-1-hydroxyethyl]-4-methyl-7-oxo-1-azabicyclo[3.2.0]hept-2-ene-2-carboxylic acid, trihydrate. CAS-119478-56-7; CAS-96036-03-2 (anhydrous)(1992).
Pharmacologic Category
Antibacterials; Miscellaneous β-Lactams; Carbapenems. (ATC-Code: J01DH02).
Mechanism of action
Inhibits bacterial cell wall synthesis by binding to several penicillin-binding proteins, which in turn inhibit final transpeptidation step of peptidoglycan synthesis in bacterial cell walls, thus inhibiting cell wall biosynthesis.
Therapeutic use
Treatment of intra-abdominal infections (complicated appendicitis and peritonitis). Treatment of bacterial meningitis in pediatric patients ≥3 months of age caused by S. pneumoniae, H. influenzae, and N. meningitides. Treatment of complicated skin and skin structure infections caused by susceptible organisms.
Pregnancy and lactiation implications
No evidence of impaired fertility or fetal harm found in animals. Unknown whether meropenem can cause fetal harm. Caution when administering to breast-feeding women.
Unlabeled use
Burkholderia pseudomallei (melioidosis), febrile neutropenia, liver abscess, meningitis (adults), otitis externa, pneumonia, urinary tract infections.
Contraindications
Hypersensitivity to meropenem, any component of the formulation, or other carbapenems (e.g. imipenem). Patients who have experienced anaphylactic reactions to other β-lactams.
Warnings and precautions
Anaphylaxis and hypersensitivity reactions reported (some without history of previous allergic reactions to β-lactams). Use caution with CNS disorders (e.g. brain lesions, history of seizures, or renal impairment). Prolonged use may result in fungal or bacterial superinfection, including C. difficile-associated diarrhea and pseudomembranous colitis. Use with caution in renal impairment (increased seizure risk and thrombocytopenia). Lower doses (based upon renal function) often required in the elderly.