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.

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:

• Acute pulmonary exacerbation
• Anthrax disease
• Bite wound infections
• Bloodstream infection (e.g., gram-negative bacteremia)
• Cystic fibrosis (CF)
• Diabetic foot infection
• Intracranial (brain) abscess
• Melioidosis
• Neutropenic enterocolitis
• Neutropenic fever
• Osteomyelitis
• Pneumonia
• Sepsis and septic shock
• Urinary tract infection (UTI)

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:

• Back pain
• Constipation
• Diarrhea
• Fever
• Headache
• Nausea
• Redness, pain, and swelling at the injection site
• Sweating
• Urticaria (hives)
• Vomiting

Severe Side Effects

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

• Angioedema
• Dysphagia (difficulty swallowing or breathing)
• Heart failure
• Hypertension
• Phlebitis
• Thrombophlebitis
• Shortness of breath
• Syncope
• Tachycardia

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.

Precautions

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)

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.