MEROPENEM
Please note meropenem is not licensed for the treatment of tuberculosis in the UK.
Meropenem is not usually recommended for the treatment of MDRTB. When it is used, it should be counted as half a drug in a treatment regimen.
DOSAGE
Adults:
Maximum dose: 6000mg/ day
In renal failure dose reduction may be necessary. Please discuss with a pharmacist.
PREPARATIONS
Parenteral: 500mg, 1g powder for solution for injection or infusion.
DRUG LEVEL MONITORING
ADVERSE EFFECTS
COMMON:
Dermatological: Rash, pruritis, injection site inflammation (2%).
Gastrointestinal: Abdominal pain, diarrhoea (3-7%), nausea & vomiting (3%).
Haematological: Thrombocythaemia.
Hepatic: Transient increases in LFTs.
Neurological: Headache (2-8%).
SERIOUS:
Dermatological: Erythema multiforme, Stevens-Johnson syndrome, toxic epidermal necrolysis.
Haematological: Eosinophilia, thrombocytopaenia, leucopaenia, neutropaenia.
Immunological: Anaphylaxis, angioedema.
Infective: Clostridium difficile-associated diarrhoea and colitis.
Neurological: Seizures.
ADVERSE EFFECTS: MONITORING
Routine tests as per generic MDR-TB treatment monitoring guidelines.
INTERACTONS
Valproate: Reduced serum concentrations of valproate. Avoid concomitant use.
Please discuss with a pharmacist.
CONTRA-INDICATIONS & CAUTIONS
Contraindications:
Hypersensitivity: To carbapenems.
Hypersensitivity: Severe hypersensitivity to penicillins or cephalosporins.
Pregnancy
Cautions:
Breast-feeding.
Liver disease: Monitor LFTs (hepatic dysfunction with cholestasis and cytolysis).
LABORATORY INFORMATION
Please find up to date information at www.assayfinder.com regarding individual providers of drug level monitoring tests. Click on the provider to discover contact details. Turnaround time varies depending on the test and whether it is run locally or sent to an external lab. By contacting laboratories in advance, turnaround time can significantly be reduced.
Meropenem is not usually recommended for the treatment of MDRTB. When it is used, it should be counted as half a drug in a treatment regimen.
DOSAGE
Adults:
- 1g three times a day (intravenous).
- NB. Should be used in combination with clavulanate in the form of a combination of co-amoxiclav 625mg (500 mg/125 mg) three times a day.
- Adult dose in weights over 50Kg.
- 1 month–14 years: 20–40 mg/kg every 8 hours (intravenous).
Maximum dose: 6000mg/ day
In renal failure dose reduction may be necessary. Please discuss with a pharmacist.
PREPARATIONS
Parenteral: 500mg, 1g powder for solution for injection or infusion.
DRUG LEVEL MONITORING
- Drug levels need not be routinely measured.
ADVERSE EFFECTS
COMMON:
Dermatological: Rash, pruritis, injection site inflammation (2%).
Gastrointestinal: Abdominal pain, diarrhoea (3-7%), nausea & vomiting (3%).
Haematological: Thrombocythaemia.
Hepatic: Transient increases in LFTs.
Neurological: Headache (2-8%).
SERIOUS:
Dermatological: Erythema multiforme, Stevens-Johnson syndrome, toxic epidermal necrolysis.
Haematological: Eosinophilia, thrombocytopaenia, leucopaenia, neutropaenia.
Immunological: Anaphylaxis, angioedema.
Infective: Clostridium difficile-associated diarrhoea and colitis.
Neurological: Seizures.
ADVERSE EFFECTS: MONITORING
Routine tests as per generic MDR-TB treatment monitoring guidelines.
INTERACTONS
Valproate: Reduced serum concentrations of valproate. Avoid concomitant use.
Please discuss with a pharmacist.
CONTRA-INDICATIONS & CAUTIONS
Contraindications:
Hypersensitivity: To carbapenems.
Hypersensitivity: Severe hypersensitivity to penicillins or cephalosporins.
Pregnancy
Cautions:
Breast-feeding.
Liver disease: Monitor LFTs (hepatic dysfunction with cholestasis and cytolysis).
LABORATORY INFORMATION
Please find up to date information at www.assayfinder.com regarding individual providers of drug level monitoring tests. Click on the provider to discover contact details. Turnaround time varies depending on the test and whether it is run locally or sent to an external lab. By contacting laboratories in advance, turnaround time can significantly be reduced.