R-Penem

R-Penem1gm/vial

Type:Injection

Generic Name:Meropenem

Manufacturer:Julphar Bangladesh Ltd.

Price:1300.00

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Indication

Cystic fibrosis, Intra-abdominal infections, Meningitis, Skin and skin structure infections, Diabetic foot infection

Administration

IV Administration Administer IV infusion over 15-30 minutes; administer IV bolus over 3-5 minutes

Adult Dose

Intravenous Intra-abdominal infections Adult: 1 g 8 hrly via IV inj over approx 3-5 min or infused over approx 15-30 min. Skin and skin structure infections Adult: 500 mg 8 hrly via IV inj over approx 3-5 min or infused over approx 15-30 min. Cystic fibrosis, Meningitis Adult: 2 g 8 hrly infused over approx 15-30 min. Susceptible infections Adult: 0.5-1 g 8 hrly via IV inj over approx 3-5 min or infused over approx 15-30 min. Hepatic impairment: No dosage adjustment needed.

Child Dose

Children: IV 60 mg/kg/day, max 3 g/day q8h 120 mg/kg/day meningitis, max 6 g/day q8h Intravenous Intra-abdominal infections Child: >3mth ?50 kg: 20 mg/kg 8 hrly via IV inj over approx 3-5 min or infused over approx 15-30 min. Max: 1000 mg. Skin and skin structure infections Child: >3 mth ?50 kg: 10 mg/kg 8 hrly via IV inj over approx 3-5 min or infused over approx 15-30 min. Max: 500 mg. Cystic fibrosis, Meningitis Child: >3 mth ?50 kg: 40 mg/kg 8 hrly via IV inj over approx 3-5 min or infused over approx 15-30 min. Max: 2 g. Susceptible infections Child: >3 mth ?50 kg: 10 or 20 mg/kg 8 hrly via IV inj over approx 3-5 min or infused over approx 15-30 min.

Renal Dose

Renal impairment: CrCl (ml/min) 26-50 Usual dose 12 hrly. 10-25 Half the usual dose 12 hrly. <10 Half the usual dose 24 hrly.

Contraindication

Hypersensitivity to meropenem, other carbapenems. History of anaphylactic reaction to β-lactams (e.g. penicillins, cephalosporins).

Mode of Action

Meropenem is a synthetic carbapenem beta-lactam antibiotic that exerts its bactericidal activity by inhibiting bacterial cell wall synthesis in gm+ve and gm-ve bacteria through binding to several penicillin-binding proteins (PBPs).

Precaution

Patient w/ underlying CNS disorders (e.g. brain lesions, history of seizures. Not recommended for treatment of MRSA. Renal impairment. Childn. Pregnancy and lactation. Monitoring Parameters Monitor for signs of anaphylaxis during 1st dose. Periodically assess renal, hepatic, and haematopoietic functions during prolonged therapy. Lactation: Unknown whether drug is excreted in breast milk; use with caution

Side Effect

1-10% Constipation (1-7%),Diarrhea (4-5%),Nausea or vomiting (1-4%),Rash (2-3%; includes diaper-area moniliasis in pediatric patients),Headache (2%),Inflammation at injection site (2%),Sepsis (2%),Oral moniliasis (≤2% in pediatric patients),Bleeding (1.2%),Apnea (1%),Constipation (1%),Glossitis (1%),Injection-site reaction (1%),Phlebitis or thrombophlebitis (1%),Pruritus (1%),Septic shock (1%) <1% Agranulocytosis,Angioedema,Erythema multiforme,Hypersensitivity reaction,Hypokalemia,Leukopenia,Neutropenia,Pleural effusion,Stevens-Johnson syndrome,Toxic epidermal necrolysis disorders or renal impairment. Potentially Fatal: Anaphylaxis; pseudomembranous colitis; Stevens-Johnsons sydrome.

Interaction

Increased plasma concentration w/ probenecid. May decrease plasma levels of valproic acid thus, increasing the risk of seizures.

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