Merrem (Meropenem) - Intravenous

What Is Merrem?

Merrem (Meropenem) is an antibiotic medication administered intravenously (IV; into a vein) and delivered by a trained healthcare provider. Merrem is used to treat complicated skin and skin structure infections, complicated intra-abdominal infections, and bacterial meningitis in adults and children 3 months and older. Merrem belongs to a class of drugs called carbapenems.

Carbapenems are antibiotics (medicines that fight bacterial infections in people and animals) used to treat complicated bacterial infections. A carbapenem is commonly combined with an antibiotic that targets Gram-positive bacteria.

Moreover, carbapenems are members of the beta-lactam class of antibiotics, which kill bacteria by binding to proteins. Carbapenems are usually unaffected by antibiotic resistance.

In this case, Merrem works by killing bacteria that cause infection.

While available generically, this article will focus on the IV use of meropenem, referred to as Merrem, a corresponding branded version of meropenem.

Drug Facts

Generic Name: Meropenem
Brand Name: Merrem
Drug Availability: Prescription
Administration Route: IV
Therapeutic Classification: Antibiotic
Available Generically: Yes
Controlled Substance: N/A
Active Ingredient: Meropenem
Dosage Form(s): IV injection

What Is Merrem Used For?

Merrem is Food and Drug Administration (FDA)-approved as a prescription antibiotic used to treat complicated skin and skin structure, complicated intra-abdominal infections, and bacterial meningitis.

For context, bacterial infections are diseases that can affect your skin, lungs, brain, blood, and other parts of your body.

In this case, Merrem may be used alone or in conjunction with other antibiotics. However, Merrem does not work on colds, flu, or viral infections.

Specific bacterial infections Merrem treats include the following infections for adults and children 3 months and older:

  • Bacteroides fragilis
  • Enterococcus faecalis (vancomycin-susceptible isolates only)
  • Escherichia coli
  • Peptostreptococcus species
  • Proteus mirabilis
  • Pseudomonas aeruginosa
  • Staphylococcus aureus (methicillin-susceptible isolates only) 
  • Streptococcus agalactiae
  • Streptococcus pyogenes
  • Viridans group streptococci

Specific intra-abdominal infections for adults and children 3 months and older treated by Merrem include:

  • B. thetaiotaomicron
  • Bacteroides fragilis
  • Escherichia coli
  • Klebsiella pneumoniae
  • Peptostreptococcus species
  • Pseudomonas aeruginosa

Specific bacterial meningitis infections for children 3 months and older treated by Merrem include:

  • Haemophilus influenzae
  • Neisseria meningitidis
  • Streptococcus pneumoniae

How to Take Merrem

It’s important to talk to your healthcare provider about any drug-related allergies prior to taking Merrem. Merrem is typically administered via IV infusion in a hospital setting. However, on some occasions, it may be given at home by a trained licensed healthcare provider.

Merrem comes as a white to pale yellow crystalline powder and must be mixed into a liquid to be administered intravenously. It must be prepared with sterile water; each vial is single-use only. Typically, the medication is administered every eight hours.

If the dosage ordered is less than a typical vial of Merrem, then the hospital pharmacy may mix the medication and deliver it for administration.

You should begin to feel better during the first few days of treatment with meropenem injection. If your symptoms do not improve or if they get worse, call your healthcare provider.

Use Merrem until you finish the prescription, even if you feel better. If you stop using the injection too soon or skip doses, your infection may not be completely treated, and the bacteria may become resistant to antibiotics.

Storage

If you receive your Merrem injections at home, follow these instructions for proper storage:

  • Do not use expired medication.
  • Keep away from areas with significant moisture, such as the bathroom.
  • Protect from light, extreme heat, and extreme cold.
  • Store in the airtight original container until ready for administration.
  • Once a vial has been reconstituted, you must use it immediately.

Off-Label Uses

Sometimes Merrem is used off-label for indications that are not FDA-approved.

Off-label uses of meropenem can include:

How Long Does Merrem Take to Work?

Clinical research has shown that Merrem can work in 12 to 24 hours on specific bacteria; however, how fast the medication works is specific to what disease process is being treated.

What Are the Side Effects of Merrem?

This is not a complete list of side effects, and others may occur. A healthcare provider can advise you on side effects. If you experience other effects, contact your healthcare provider. You may report side effects to the FDA at fda.gov/medwatch or 1-800-FDA-1088.

Common Side Effects

As with all medications, there are possible side effects you may experience while taking Merrem.

Common and less severe side effects include:

Severe Side Effects

While serious side effects with Merrem are very rare, immediately call your healthcare provider if you experience any of the following:

Report Side Effects

Merrem may cause other side effects. Call your healthcare provider if you have any unusual problems while taking this medication.

If you experience a serious side effect, you or your healthcare provider may send a report to the FDA's MedWatch Adverse Event Reporting Program or by phone (800-332-1088).

Dosage: How Much Merrem Should I Take?

Merrem is typically administered via IV infusion in a hospital setting. It may also be given at home by a trained licensed healthcare provider. Your healthcare provider will determine the dosage of this medication.

Modifications

Due to the possible effects of this medication, there may be changes to how it is used.

Therefore, Merrem may require modifications for the following users:

  • Children: Merrem is not approved for people under 3 months of age. Therefore, speak with your healthcare provider to identify alternative treatments for your child or dependent.
  • Pregnant or breastfeeding people: There is insufficient data to determine whether there is a drug-associated risk of major birth defects or miscarriages associated with Merrem usage in pregnant people. Therefore, pregnant people, people who plan on becoming pregnant, or breastfeeding should talk to their healthcare provider before taking Merrem.
  • Adults 65 and older: Merrem is substantially expelled by the kidneys, and the risk of negative reactions to this drug may be greater in people with kidney failure. Because older adults are more likely to have decreased kidney function, care should be taken in dose selection.
  • People with liver problems: People with a history of liver problems that occurred with meropenem use should not take Merrem. Healthcare providers may or may not prescribe it for people with liver problems unrelated to Merrem usage. Nonetheless, these people may be able to use Merrem with heightened caution.
  • Driving or operating machinery: People should avoid driving or operating machinery until drug tolerability has been established by a healthcare provider.

Missed Dose

Because Merrem is given in the hospital setting, it is highly unlikely for a dose to be missed. However, it is possible for Merrem to be given at home. In this case, your dose would still be administered by a healthcare provider.

Nonetheless, users should still strive to be proactive in their treatment, especially if they are tasked with storing Merem.

Overdose: What Happens If I Take Too Much Merrem?

The chance of a Merrem overdose is extremely unlikely as the medication is administered by a trained healthcare provider.

However, it is possible for an accidental overdose to occur if the person has impaired kidney function.

What Happens If I Overdose on Merrem?

If you think you or someone else may have overdosed on Merrem, call a healthcare provider or the Poison Control Center (800-222-1222).

If someone collapses or isn't breathing after taking Merrem, call 911 immediately.

Precautions

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It is very important that your doctor check you or your child's progress closely while you are receiving this medicine. This will allow your doctor to see if the medicine is working properly and to decide if you should continue to receive it.

Meropenem may cause serious allergic reactions, including anaphylaxis, which can be life-threatening and requires immediate medical attention. Tell your doctor or nurse right away if you or your child have itching, hives, hoarseness, trouble breathing, trouble swallowing, or any swelling of your hands, face, or mouth after receiving this medicine.

Serious skin reactions can occur with this medicine. Check with your doctor right away if you have blistering, peeling, or loosening of the skin, red skin lesions, severe acne or a skin rash, sores or ulcers on the skin, or fever or chills with this medicine.

Some patients may develop tremors or seizures while receiving this medicine. If you or your child already have a history of seizures and you are taking anticonvulsants, you should continue unless otherwise directed by your doctor. Tell your doctor if you are taking divalproex sodium (Depakote®) or valproic acid (Depakene®).

Meropenem may cause diarrhea, and in some cases it can be severe. It may occur 2 months or more after you stop using this medicine. Do not take any medicine to treat diarrhea without first checking with your doctor. Diarrhea medicines may make the diarrhea worse or make it last longer. If you have any questions about this or if mild diarrhea continues or gets worse, check with your doctor.

This medicine may cause seizures, confusion, headaches, numbness or tingling sensation. Do not drive or do anything else that could be dangerous until you know how this medicine affects you.

Do not take other medicines unless thy have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.

What Are Reasons I Shouldn’t Take Merrem?

Merrem is not for everyone. Potential users should be aware of the following before beginning Merrem:

  • Alert your healthcare provider if you are allergic to meropenem, other carbapenem antibiotics, cephalosporin antibiotics, or other beta-lactam antibiotics.
  • Tell your healthcare provider if you are pregnant, plan on becoming pregnant, or are currently breastfeeding. 
  • Discuss with your healthcare provider if you have or have ever had seizures, brain lesions, or kidney disease.
  • Inform your healthcare provider about other prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you currently take.

What Other Medications Interact With Merrem?

Individuals taking Merrem should avoid the following:

  • Oral contraceptives (OCs): The use of OCs with Merrem may impact their effectiveness. Therefore, alert your healthcare provider if you currently take an OC, as they may recommend alternative or additional contraceptives to counteract any impact from using them alongside antibiotics.
  • Probenecid: A prescription drug used to treat the symptoms associated with gout, probenecid, when used alongside Merrem, may hinder the expulsion of the drug from the kidneys.
  • Valproic acid, divalproex sodium: Drugs used to treat the symptoms associated with seizures, the use of these and other epilepsy medications alongside carbapenems may decrease their ability to prevent and lessen the severity of seizures.
  • Warfarin: A commonly prescribed blood thinner used to prevent and treat blood clots, its use alongside Merrem may result in an increased INR time, a measurement used to determine how long it takes for blood to clot inside the body, therefore potentially increasing the chance of internal bleeding.

What Medications Are Similar?

Merrem belongs to a class of antibiotics called carbapenems.

Other commonly used carbapenems include:

  • Invanz (ertapenem)
  • Primaxin (imipenem; cilastatin)
  • Recarbrio (relebactam)
  • Vabomere (meropenem)

Frequently Asked Questions

  • What is Merrem used for?

    Merrem is used to treat intra-abdominal infections, bacterial meningitis, and complicated skin and skin structure infections. 

  • When should I stop taking Merrem?

    Merrem should not be stopped abruptly without guidance and approval from a healthcare provider.

  • What are the side effects of Merrem?

    The most common side effects associated with the use of Merrem include inflammation, pain, and edema at the injection site. Other common side effects include nausea, vomiting, and skin rash.

  • How does Merrem work?

    Merrem is a carbapenem antibiotic that inhibits cell wall synthesis. In this case, Merrem works by killing bacteria that cause infection.

  • How is Merrem administered?

    Merrem is only administered via IV injection given by a trained healthcare provider. Do not attempt to administer by yourself.

How Can I Stay Healthy While Taking Merrem?

Merrem, a carbapenem antibiotic, can be safely used to treat various infections including, intra-abdominal infections, bacterial meningitis, and complicated skin and skin structure infections.

Before taking Merrem, discuss all existing health conditions and your medical history with your healthcare provider. Tell them about all your medications, including prescription and over-the-counter (OTC) drugs and vitamins or herbal supplements.

Medical Disclaimer

Verywell Health's drug information is meant for educational purposes only and is not intended as a replacement for medical advice, diagnosis, or treatment from a healthcare provider. Consult your healthcare provider before taking any new medication(s). IBM Watson Micromedex provides some of the drug content, as indicated on the page.

7 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Food and Drug Administration. Merrem IV- meropenem injection prescribing information.

  2. Merck Manual. Carbapenems.

  3. ScienceDirect. Carbapenem antibiotics.

  4. MedlinePlus. Bacterial infections.

  5. MedlinePlus. Meropenem injection.

  6. Prescribers' Digital Reference. Meropenem - drug summary.

  7. Papp-Wallace KM, Endimiani A, Taracila MA, Bonomo RA. Carbapenems: past, present, and futureAntimicrob Agents Chemother. 2011;55(11):4943-4960. doi:10.1128/AAC.00296-11

By Kathleen Gaines, MSN, RN, CBC
Kathleen Gaines, MSN, RN, CBC, is a nurse and health journalist, as well as an adjunct clinical faculty member at hospitals in the Philadelphia area.