Meropenem Medical Valley: Uses, Dosage & Side Effects
A broad-spectrum carbapenem antibiotic administered intravenously to treat serious and life-threatening bacterial infections in hospital settings
Meropenem Medical Valley is a broad-spectrum carbapenem antibiotic used to treat serious and life-threatening bacterial infections. It is administered intravenously (by injection or infusion into a vein) in hospital settings and is effective against a wide range of Gram-positive, Gram-negative, and anaerobic bacteria. Meropenem is classified as a Watch antibiotic under the WHO AWaRe system, meaning it should be reserved for specific, limited indications to help preserve its effectiveness against resistant organisms. It is commonly used for complicated intra-abdominal infections, bacterial meningitis, nosocomial pneumonia, febrile neutropenia, and sepsis.
Quick Facts: Meropenem Medical Valley
Key Takeaways
- Meropenem Medical Valley is an ultra-broad-spectrum carbapenem antibiotic given intravenously for serious infections; it is on the WHO Model List of Essential Medicines and is classified as a Watch antibiotic requiring careful stewardship.
- Do not use meropenem if you have a history of severe allergic reaction (anaphylaxis) to meropenem, other carbapenems, or any component of the formulation; cross-reactivity with penicillins is very low but caution is required.
- Meropenem significantly reduces blood levels of valproic acid (sodium valproate) and should be avoided in patients taking this anticonvulsant; alternative antibiotics or anticonvulsants should be considered.
- Common side effects include diarrhea, nausea, vomiting, and injection site reactions; serious but rare adverse effects include seizures, Clostridioides difficile-associated colitis, and severe allergic reactions.
- Meropenem should be used judiciously and only when narrower-spectrum antibiotics are ineffective or inappropriate, to help prevent the emergence of carbapenem-resistant organisms, which the WHO considers a critical global health threat.
What Is Meropenem Medical Valley and What Is It Used For?
Meropenem is a synthetic carbapenem antibiotic that has been in clinical use since the mid-1990s. Carbapenems are considered the broadest-spectrum class of beta-lactam antibiotics and are often reserved as last-line agents for treating serious or multidrug-resistant infections. Meropenem Medical Valley is a generic formulation of meropenem manufactured by Medical Valley, available as a powder for reconstitution into a solution for intravenous injection or infusion. Each vial contains meropenem equivalent to 1 g of meropenem (as meropenem trihydrate).
The medication works by a bactericidal mechanism similar to other beta-lactam antibiotics: it inhibits the synthesis of bacterial cell walls by binding to penicillin-binding proteins (PBPs), specifically PBP 2, PBP 3, and PBP 4. These enzymes are essential for the transpeptidation reactions that cross-link peptidoglycan strands, providing structural integrity to the bacterial cell wall. When meropenem blocks these enzymes, the cell wall becomes weakened, leading to osmotic instability, cell lysis, and bacterial death. A critical advantage of meropenem over many other beta-lactam antibiotics is its remarkable stability against hydrolysis by most beta-lactamase enzymes, including extended-spectrum beta-lactamases (ESBLs), AmpC cephalosporinases, and many penicillinases. This stability is due to the unique trans-1-methylcarbapenem structure that prevents the opening of the beta-lactam ring by these enzymes.
Meropenem penetrates the outer membrane of Gram-negative bacteria efficiently through porin channels (particularly OprD in Pseudomonas aeruginosa), enabling it to reach its PBP targets. Unlike the related carbapenem imipenem, meropenem is stable against the renal enzyme dehydropeptidase-I (DHP-I) and therefore does not require co-administration with an enzyme inhibitor such as cilastatin. This is a clinically important distinction, as it simplifies dosing and reduces the potential for enzyme-inhibitor-related adverse effects.
Meropenem has activity against an exceptionally broad range of organisms. It is effective against most Gram-positive bacteria including Streptococcus pneumoniae, Streptococcus pyogenes, Staphylococcus aureus (methicillin-susceptible strains only), and Enterococcus faecalis (though not E. faecium). Its Gram-negative coverage includes Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa, Haemophilus influenzae, Neisseria meningitidis, Enterobacter species, Serratia marcescens, Proteus species, Acinetobacter baumannii (many strains), and Bacteroides fragilis (anaerobic). Notably, meropenem is not effective against methicillin-resistant Staphylococcus aureus (MRSA), Stenotrophomonas maltophilia, or organisms producing carbapenem-hydrolysing enzymes (carbapenemases such as KPC, NDM, VIM, IMP, or OXA-48).
Meropenem is indicated for the treatment of several categories of serious infections in adults and children. The primary clinical indications include:
- Complicated intra-abdominal infections: Including peritonitis, intra-abdominal abscesses, and post-surgical abdominal infections, where polymicrobial involvement (Gram-negatives, Gram-positives, and anaerobes) is common.
- Bacterial meningitis: Meropenem is one of the few antibiotics that crosses the blood-brain barrier in sufficient concentrations for the treatment of bacterial meningitis, including infections caused by Neisseria meningitidis, Streptococcus pneumoniae, and Haemophilus influenzae.
- Nosocomial (hospital-acquired) pneumonia: Including ventilator-associated pneumonia (VAP), particularly when resistant Gram-negative pathogens are suspected or documented.
- Complicated urinary tract infections: Including pyelonephritis caused by resistant organisms, particularly ESBL-producing Enterobacterales.
- Complicated skin and soft tissue infections: Including necrotizing fasciitis, deep surgical wound infections, and diabetic foot infections requiring broad-spectrum coverage.
- Febrile neutropenia: Empirical monotherapy in febrile neutropenic patients (patients with fever and dangerously low white blood cell counts, often as a result of chemotherapy). This is one of the most important uses of meropenem, as single-agent therapy can replace combination regimens in many cases.
- Sepsis and bacteremia: Especially when caused by resistant Gram-negative organisms or when the causative organism is unknown and a broad-spectrum agent is required.
Meropenem is included on the World Health Organization (WHO) Model List of Essential Medicines, reflecting its critical importance in treating serious infections worldwide. Under the WHO AWaRe (Access, Watch, Reserve) classification system, meropenem is classified as a Watch antibiotic. This means it has a higher resistance potential than Access antibiotics and should be prioritized as key targets for stewardship programs and monitoring. The emergence of carbapenem-resistant organisms (CROs), particularly carbapenem-resistant Enterobacterales (CRE), carbapenem-resistant Pseudomonas aeruginosa, and carbapenem-resistant Acinetobacter baumannii, has been identified by the WHO as a critical priority pathogen group, underscoring the need for responsible use of carbapenems like meropenem.
Meropenem is a reserve antibiotic that should only be used when narrower-spectrum alternatives have failed, are contraindicated, or when resistance patterns indicate its necessity. Indiscriminate use of carbapenems accelerates the development of carbapenem-resistant organisms, which represent one of the most serious threats to global public health. Its use should always be guided by culture and sensitivity results whenever possible, and de-escalation to a narrower-spectrum agent should occur as soon as microbiological data permits.
What Should You Know Before Receiving Meropenem Medical Valley?
Contraindications
There are specific situations where meropenem must not be used. Understanding these absolute contraindications is essential for safe treatment.
- Hypersensitivity to meropenem or carbapenems: Do not use meropenem if you have had a serious allergic reaction to meropenem, any other carbapenem antibiotic (such as imipenem, ertapenem, or doripenem), or to any of the excipients in the formulation (including sodium carbonate).
- Severe anaphylaxis to any beta-lactam: Patients who have experienced a severe immediate hypersensitivity reaction (anaphylaxis, angioedema, or severe cutaneous reactions such as Stevens-Johnson syndrome or toxic epidermal necrolysis) to any beta-lactam antibiotic (penicillins, cephalosporins, or carbapenems) should generally not receive meropenem. However, the cross-reactivity rate between penicillins and carbapenems is estimated at less than 1%, so patients with non-severe penicillin allergies can often receive meropenem under careful medical supervision.
Warnings and Precautions
Serious and potentially fatal hypersensitivity reactions (anaphylaxis) have been reported with virtually all beta-lactam antibiotics, including carbapenems. Before initiating meropenem therapy, careful inquiry should be made about previous hypersensitivity reactions to carbapenems, penicillins, cephalosporins, or other allergens. If a serious allergic reaction occurs during meropenem infusion, the drug should be discontinued immediately and appropriate emergency treatment initiated.
Your healthcare team should be informed of the following conditions before meropenem is administered:
- Epilepsy or seizure disorder: Meropenem, like other carbapenems, has the potential to lower the seizure threshold. Seizures have been reported during treatment, particularly in patients with pre-existing central nervous system disorders, bacterial meningitis, or compromised renal function. The risk is lower with meropenem compared to imipenem, but caution is still warranted. Patients with known seizure disorders should be closely monitored.
- Impaired kidney function: Meropenem is primarily eliminated by the kidneys. In patients with renal impairment (creatinine clearance less than 51 ml/min), dose reduction or extension of the dosing interval is required to prevent drug accumulation and increased risk of adverse effects, including seizures. Hemodialysis removes meropenem, and supplemental doses are required after dialysis sessions.
- Liver disease: Hepatic adverse events including increased transaminases, cholestatic hepatitis, and jaundice have been reported. Liver function should be monitored during prolonged treatment courses. Patients with pre-existing hepatic insufficiency should be monitored more closely, as meropenem undergoes partial hepatic metabolism.
- Concurrent use of valproic acid: Meropenem dramatically reduces blood levels of valproic acid (sodium valproate), often by 60–100%, within 1–2 days of starting meropenem. This can lead to loss of seizure control and breakthrough seizures. This combination should be avoided if possible. If meropenem is essential, alternative anticonvulsant therapy should be considered.
- Antibiotic-associated colitis: As with all broad-spectrum antibiotics, meropenem can cause Clostridioides difficile-associated diarrhea (CDAD), which can range from mild diarrhea to life-threatening pseudomembranous colitis. Inform your healthcare team immediately if you develop severe, watery, or bloody diarrhea during or after treatment.
- Overgrowth of non-susceptible organisms: Prolonged use of meropenem may lead to overgrowth of resistant bacteria or fungi, including Candida species. Patients should be monitored for superinfection and appropriate measures taken if this occurs.
Pregnancy and Breastfeeding
There are limited data on the use of meropenem in pregnant women. Animal studies have not demonstrated teratogenicity (harm to the developing fetus) at clinically relevant doses. However, as with all medications during pregnancy, meropenem should only be used when the potential benefit to the mother justifies the potential risk to the fetus. Meropenem should only be administered during pregnancy when the treating physician considers that the potential benefit to the patient outweighs the risk, typically in the context of a serious or life-threatening infection where no safer alternative is available.
Meropenem is excreted in breast milk in small amounts. The clinical significance of this is uncertain, but there is a theoretical risk that the breastfed infant could experience alterations in bowel flora (diarrhea) or sensitization (development of allergy). A decision should be made whether to discontinue breastfeeding or to discontinue meropenem therapy, taking into account the importance of the drug to the mother. In practice, given that meropenem is typically used for serious infections requiring hospitalization, a discussion with the treating physician about the benefits and risks of continuing breastfeeding is essential.
Driving and Operating Machinery
No specific studies on the effect of meropenem on the ability to drive or operate machinery have been performed. However, adverse effects such as headache, dizziness, paresthesia (numbness or tingling), and, rarely, seizures have been reported. Patients should be aware of these potential effects and avoid driving or operating machinery if they experience symptoms that could impair their concentration or physical abilities. In practice, most patients receiving meropenem are hospitalized and this concern is of limited relevance.
How Does Meropenem Medical Valley Interact with Other Drugs?
Meropenem has several clinically important drug interactions. While the number of interactions is relatively limited compared to some other antibiotics, the interaction with valproic acid is of critical clinical significance and can have life-threatening consequences. Healthcare professionals should always review the patient's complete medication list before initiating meropenem therapy.
Major Interactions
| Interacting Drug | Effect | Clinical Advice |
|---|---|---|
| Valproic acid (Sodium valproate) | Meropenem dramatically reduces serum valproic acid levels, often by 60–100%, within 1–2 days. The mechanism involves inhibition of glucuronide hydrolysis of valproic acid metabolites and increased renal clearance. This can lead to subtherapeutic valproic acid levels and loss of seizure control. | Avoid this combination if possible. If meropenem is essential, switch to an alternative anticonvulsant (e.g., levetiracetam, lacosamide). If the combination cannot be avoided, monitor serum valproic acid levels at least daily and provide supplemental antiepileptic coverage. |
| Probenecid | Probenecid competes with meropenem for active tubular secretion in the kidneys, resulting in increased and prolonged meropenem plasma concentrations. The mean half-life and area under the curve (AUC) of meropenem are increased by approximately 33% and 55%, respectively. | Co-administration of probenecid with meropenem is not recommended. The clinical benefit of the increased meropenem levels does not outweigh the risk of adverse effects. If probenecid cannot be discontinued, consider reducing the meropenem dose. |
| Warfarin and oral anticoagulants | Meropenem, like other broad-spectrum antibiotics, may enhance the anticoagulant effect of warfarin by disrupting gut flora involved in vitamin K synthesis. Increased INR (international normalized ratio) and bleeding events have been reported. | Monitor INR closely during and for several days after meropenem treatment. Warfarin dose adjustment may be required. Report any unusual bleeding, bruising, or blood in stool or urine. |
Minor Interactions
| Interacting Drug | Effect | Clinical Advice |
|---|---|---|
| Cyclosporine | Sporadic reports suggest meropenem may affect cyclosporine plasma levels, though the direction and magnitude of the effect are inconsistent across studies | Monitor cyclosporine trough levels more frequently during concurrent meropenem therapy, particularly in transplant recipients. Adjust cyclosporine dose as needed. |
| Methotrexate | Meropenem may reduce the renal clearance of methotrexate, leading to increased methotrexate plasma levels and potential toxicity, similar to other beta-lactam antibiotics | Monitor methotrexate levels closely if concurrent use is unavoidable. Watch for signs of methotrexate toxicity including mucositis, bone marrow suppression, and hepatotoxicity. |
| Live vaccines (oral typhoid) | Antibacterial agents including meropenem may inactivate the live oral typhoid vaccine (Ty21a) by killing the vaccine organism before it can stimulate an immune response | Complete meropenem therapy at least 3 days before administering live oral typhoid vaccine. Injectable typhoid vaccine is not affected. |
Meropenem may cause false-positive results in urine glucose tests using the copper-reduction method (e.g., Clinitest). Glucose-oxidase-based test strips (e.g., Clinistix, Diastix) should be used instead. Meropenem may also interfere with the Coombs (direct antiglobulin) test, potentially producing a false-positive result. This should be taken into account when interpreting cross-matching results for blood transfusion.
What Is the Correct Dosage of Meropenem Medical Valley?
Meropenem dosing depends on the type, severity, and location of infection, as well as the patient's age, body weight, and renal function. The following recommendations are based on international guidelines including the EMA Summary of Product Characteristics, FDA-approved labeling, BNF monograph, and IDSA guidelines. Meropenem is always administered by a healthcare professional in a hospital or clinical setting.
Adults and Adolescents (Over 50 kg Body Weight)
Standard Intravenous Dosing
Mild to moderate infections: 500 mg every 8 hours by IV bolus (over 5 minutes) or IV infusion (over 15–30 minutes)
Severe infections (pneumonia, peritonitis, febrile neutropenia, sepsis): 1 g every 8 hours by IV bolus or IV infusion
Bacterial meningitis: 2 g every 8 hours by IV infusion
Maximum daily dose: 6 g per day (2 g every 8 hours)
| Infection | Dose | Frequency |
|---|---|---|
| Complicated intra-abdominal infection | 1 g IV | Every 8 hours |
| Complicated skin/soft tissue infection | 500 mg IV | Every 8 hours |
| Nosocomial pneumonia (incl. VAP) | 1 g IV | Every 8 hours |
| Complicated urinary tract infection | 500 mg–1 g IV | Every 8 hours |
| Bacterial meningitis | 2 g IV | Every 8 hours |
| Febrile neutropenia (empirical) | 1 g IV | Every 8 hours |
| Sepsis / bacteremia | 1–2 g IV | Every 8 hours |
Children (3 Months to 17 Years)
Weight-Based Pediatric Dosing
Standard infections: 10–20 mg/kg every 8 hours by IV infusion over 15–30 minutes
Severe infections (nosocomial pneumonia, peritonitis, febrile neutropenia, sepsis): 20–40 mg/kg every 8 hours
Bacterial meningitis: 40 mg/kg every 8 hours
Maximum single dose: 2 g (children should not exceed adult dosing). For children weighing over 50 kg, adult doses should be used.
Pediatric dosing of meropenem is based on body weight and infection severity. The European Medicines Agency and FDA-approved labeling support the use of meropenem in children from 3 months of age. For neonates and infants under 3 months, meropenem use is off-label but is increasingly supported by clinical data; specialist infectious disease or neonatal consultation should guide dosing in this population. Meropenem is given by intravenous infusion over 15–30 minutes or by intravenous bolus injection over approximately 5 minutes in pediatric patients.
Elderly Patients
No routine dose adjustment is required for elderly patients with normal kidney function. However, since age-related decline in renal function is common, assessment of kidney function (estimated glomerular filtration rate, eGFR, or creatinine clearance) should be performed before initiating therapy and the dose adjusted accordingly. Elderly patients may also be more susceptible to certain adverse effects, particularly Clostridioides difficile-associated diarrhea, hepatic events, and seizures.
Renal Impairment
Dose Adjustment in Renal Impairment
CrCl 26–50 ml/min: Full recommended dose every 12 hours (instead of every 8 hours)
CrCl 10–25 ml/min: Half the recommended dose every 12 hours
CrCl <10 ml/min: Half the recommended dose every 24 hours
Hemodialysis patients: The recommended dose every 24 hours; meropenem and its metabolite are removed by hemodialysis, and a supplemental dose equal to the recommended dose should be administered after each dialysis session to restore therapeutic plasma concentrations.
Meropenem is eliminated primarily by glomerular filtration and tubular secretion in the kidneys, with approximately 70% of the dose excreted unchanged in the urine within 12 hours. The plasma half-life in adults with normal renal function is approximately 1 hour, but this increases significantly in patients with renal impairment. Failure to adjust the dose in patients with reduced kidney function can lead to drug accumulation and an increased risk of adverse effects, particularly neurotoxicity (seizures, confusion) and gastrointestinal disturbances.
Method of Administration
Meropenem Medical Valley powder must be reconstituted before use. For intravenous bolus injection, the vial should be reconstituted with sterile water for injection to give a final concentration of approximately 50 mg/ml, and the injection should be given over approximately 5 minutes. For intravenous infusion, the reconstituted solution should be further diluted with a compatible infusion fluid (such as 0.9% sodium chloride or 5% dextrose) and infused over 15–30 minutes. Extended infusion protocols (infusion over 3–4 hours) are increasingly used in clinical practice for critically ill patients to optimize the pharmacokinetic/pharmacodynamic profile (time above minimum inhibitory concentration, T>MIC), particularly for infections caused by organisms with borderline susceptibility.
Missed Dose
As meropenem is administered by healthcare professionals in a hospital setting, missed doses are uncommon. If a dose is missed, it should be administered as soon as possible and the regular dosing schedule resumed. The dose should not be doubled to compensate for a missed dose. Maintaining consistent dosing intervals is important for sustaining effective antibiotic concentrations in the blood and at the site of infection.
Overdose
Accidental overdosage may occur in patients with renal impairment if the dose is not appropriately adjusted. Symptoms of overdose may include nausea, vomiting, diarrhea, and neurological symptoms such as confusion, tremor, or seizures. Treatment is supportive and symptomatic. Meropenem and its metabolite are removed by hemodialysis, which may be considered in cases of significant overdose. There is no specific antidote for meropenem overdose.
What Are the Side Effects of Meropenem Medical Valley?
Like all antibiotics, meropenem can cause side effects, although not everyone experiences them. Most side effects are mild to moderate and resolve after treatment is completed. However, some adverse reactions can be serious and require immediate medical attention. The frequency classifications below follow the standard Medical Dictionary for Regulatory Activities (MedDRA) convention, based on data from clinical trials and post-marketing surveillance.
Common
- Diarrhea
- Nausea
- Vomiting
- Headache
- Injection site inflammation, pain, or thrombophlebitis
- Rash (maculopapular or urticarial)
- Elevated liver transaminases (ALT, AST)
- Elevated alkaline phosphatase
- Thrombocytosis (increased platelet count)
Uncommon
- Oral thrush (oral candidiasis)
- Vaginal candidiasis
- Pruritus (itching)
- Urticaria (hives)
- Abdominal pain
- Eosinophilia (increased eosinophils)
- Thrombocytopenia (decreased platelet count)
- Elevated bilirubin
- Elevated blood urea and creatinine
- Paresthesia (numbness or tingling)
Rare
- Seizures (convulsions)
- Clostridioides difficile-associated colitis (pseudomembranous colitis)
- Severe skin reactions (Stevens-Johnson syndrome, toxic epidermal necrolysis)
- Anaphylaxis (severe allergic reaction)
- Angioedema (swelling of face, lips, tongue, throat)
- Hemolytic anemia
- Neutropenia or agranulocytosis (severely reduced white blood cells)
- Hepatitis or cholestatic jaundice
- Drug reaction with eosinophilia and systemic symptoms (DRESS syndrome)
Contact your healthcare team immediately if you experience any of the following during or after meropenem treatment: severe watery or bloody diarrhea (may indicate Clostridioides difficile infection); signs of a severe allergic reaction such as difficulty breathing, swelling of the face, lips, tongue, or throat, severe skin rash or blistering; seizures or convulsions; yellowing of the skin or eyes (jaundice); or unusual bruising or bleeding.
The overall safety profile of meropenem is well established from extensive clinical trial data involving thousands of patients and decades of post-marketing surveillance. Meropenem is generally considered to have a favorable safety profile compared to imipenem-cilastatin, particularly with respect to the risk of seizures. Clinical studies have consistently shown a lower seizure incidence with meropenem (approximately 0.08% in non-meningitis patients) compared to imipenem (approximately 0.4–1.5% depending on the patient population). This difference is attributed to the lower affinity of meropenem for GABAA receptors in the central nervous system.
Gastrointestinal side effects are the most commonly reported adverse reactions. Diarrhea occurs in approximately 2–5% of patients and is usually mild and self-limiting. However, any case of persistent, severe, or bloody diarrhea during or after antibiotic treatment should be promptly evaluated for Clostridioides difficile infection, as pseudomembranous colitis can be life-threatening. Risk factors for C. difficile infection include advanced age, concurrent use of other antibiotics, use of proton pump inhibitors, prolonged hospitalization, and immune compromise.
Injection site reactions, including inflammation, pain, redness, and thrombophlebitis, are common with intravenous administration and can be minimized by ensuring adequate dilution of the reconstituted solution, using appropriate infusion rates, and rotating injection sites. Elevations in liver enzymes (ALT, AST, alkaline phosphatase) are usually transient and asymptomatic, normalizing after treatment is discontinued.
How Should You Store Meropenem Medical Valley?
Proper storage of meropenem is essential to maintain the drug's potency, sterility, and safety. Meropenem Medical Valley is supplied as a powder for reconstitution and has specific storage requirements for both the unopened vial and the reconstituted solution.
Unopened vials: Store at or below 30°C. Do not freeze. Keep the vial in the outer carton to protect from light. No special humidity precautions are required. The shelf life of the unopened product is stated on the packaging and the product must not be used after the expiry date printed on the label.
Reconstituted solutions: From a microbiological standpoint, the reconstituted solution should be used immediately after preparation. If not used immediately, the chemical and physical stability of solutions reconstituted with sterile water for injection and further diluted with 0.9% sodium chloride for infusion has been demonstrated for up to 3 hours at room temperature (up to 25°C) or up to 12 hours when stored in a refrigerator at 2–8°C. The reconstituted solution should not be frozen. Any unused portion should be discarded.
Disposal: Any unused medicinal product or waste material should be disposed of in accordance with local hospital pharmacy protocols and environmental safety regulations. Do not dispose of medicines in household waste or wastewater. Meropenem vials are single-use only; any remaining solution after the required dose has been withdrawn must be discarded and cannot be stored for later use.
Before administration, the reconstituted solution should be visually inspected for particulate matter and discoloration. The solution should be clear and colorless to pale yellow. Do not use the solution if it is cloudy, contains visible particles, or shows any discoloration beyond the expected range.
What Does Meropenem Medical Valley Contain?
Meropenem Medical Valley contains a single active pharmaceutical ingredient and a minimal number of excipients, as is typical for parenteral (injectable) formulations where simplicity is preferred to minimize the risk of incompatibility and adverse reactions.
Active ingredient: Meropenem trihydrate, equivalent to 1,000 mg (1 g) of meropenem per vial. Meropenem is a synthetic carbapenem with the chemical name (4R,5S,6S)-3-((3S,5RS)-5-(dimethylcarbamoyl)pyrrolidin-3-ylthio)-6-((R)-1-hydroxyethyl)-4-methyl-7-oxo-1-azabicyclo[3.2.0]hept-2-ene-2-carboxylic acid trihydrate. Its molecular formula is C17H25N3O5S·3H2O with a molecular weight of 437.51 g/mol (trihydrate form).
Excipient: Anhydrous sodium carbonate (Na2CO3). This excipient serves as a buffering agent to adjust the pH of the reconstituted solution to approximately 7.3–8.3, which is within the physiological range and minimizes irritation at the injection site. The sodium content is approximately 3.9 mmol (approximately 90 mg) of sodium per 1 g vial. This sodium content should be taken into consideration in patients on a controlled sodium diet or those with conditions requiring sodium restriction, such as heart failure or renal impairment.
Physical description: Meropenem Medical Valley is a white to pale yellow powder supplied in glass vials sealed with a rubber stopper and aluminum cap. When reconstituted with sterile water for injection, it produces a clear, colorless to pale yellow solution. The reconstituted solution has an approximate pH of 7.3–8.3.
Compatibility: Meropenem is compatible with 0.9% sodium chloride solution, 5% dextrose (glucose) solution, and 0.9% sodium chloride with 5% dextrose for intravenous infusion. It should not be mixed with solutions containing other medications unless compatibility has been confirmed, and it should not be added to bags or syringes containing other drugs.
Frequently Asked Questions About Meropenem Medical Valley
Meropenem belongs to the carbapenem class, which represents the broadest-spectrum family of beta-lactam antibiotics. While penicillins (such as amoxicillin) and cephalosporins (such as ceftriaxone) are effective against many common bacteria, they are susceptible to degradation by many beta-lactamase enzymes produced by resistant bacteria. Meropenem is highly stable against most beta-lactamases, including extended-spectrum beta-lactamases (ESBLs) and AmpC enzymes, giving it activity against a much wider range of pathogens, including many multidrug-resistant organisms. For this reason, meropenem is typically reserved for serious infections where other antibiotics have failed or are likely to be ineffective.
No, meropenem is only available as a powder for reconstitution into an intravenous (IV) solution. It cannot be taken orally because it is not adequately absorbed from the gastrointestinal tract. Meropenem must be administered by intravenous injection (bolus over 5 minutes) or intravenous infusion (over 15–30 minutes) by a trained healthcare professional. This means it is almost exclusively used in hospital or clinical settings where IV access is available.
The duration of meropenem treatment depends on the type and severity of infection, the patient's clinical response, and local treatment guidelines. For most infections, treatment typically lasts 5 to 14 days. For bacterial meningitis, treatment is usually 7 to 10 days. For febrile neutropenia, treatment continues until the fever resolves and the neutrophil count has recovered sufficiently. As part of antimicrobial stewardship, clinicians should de-escalate from meropenem to a narrower-spectrum antibiotic as soon as culture and sensitivity results allow.
Carbapenem resistance refers to the ability of certain bacteria to survive treatment with carbapenem antibiotics like meropenem. This resistance is caused by enzymes called carbapenemases (such as KPC, NDM, VIM, IMP, and OXA-48) that break down the carbapenem molecule, or by loss of porin channels in the bacterial outer membrane that prevent the drug from entering the cell. The WHO has identified carbapenem-resistant Enterobacterales (CRE), carbapenem-resistant Pseudomonas aeruginosa, and carbapenem-resistant Acinetobacter baumannii as critical priority pathogens, meaning they pose the greatest threat to human health. Infections with these organisms are extremely difficult to treat and carry high mortality rates. This is why responsible use of carbapenems like meropenem is essential.
Yes, meropenem is approved for use in children from 3 months of age. It is widely used in pediatric medicine for serious infections including bacterial meningitis, complicated intra-abdominal infections, febrile neutropenia, and sepsis. Dosing in children is based on body weight (mg/kg) and the type/severity of infection. The safety profile in children is generally similar to that in adults, with the most common side effects being diarrhea, nausea, vomiting, and injection site reactions. For neonates and infants under 3 months, use is off-label but supported by growing clinical evidence; dosing should be guided by specialist consultation.
All information on this page is based on internationally recognized medical sources including: the European Medicines Agency (EMA) Summary of Product Characteristics for meropenem; the U.S. Food and Drug Administration (FDA) approved labeling for Merrem IV; the British National Formulary (BNF) meropenem monograph; the World Health Organization (WHO) Model List of Essential Medicines and AWaRe classification; the Infectious Diseases Society of America (IDSA) antimicrobial treatment guidelines; and peer-reviewed publications in journals including Clinical Infectious Diseases, The Lancet Infectious Diseases, and Journal of Antimicrobial Chemotherapy. All medical claims reflect evidence level 1A where available.
References
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- 3 U.S. Food and Drug Administration (FDA). Merrem IV (meropenem for injection) – Prescribing Information. FDA; 2023.
- 4 British National Formulary (BNF). Meropenem Monograph. NICE Evidence Services. Updated 2024.
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- 7 Linden P. Safety profile of meropenem: an updated review of over 6,000 patients treated with meropenem. Drug Saf. 2007;30(8):657–668.
- 8 World Health Organization (WHO). AWaRe Classification of Antibiotics for Evaluation and Monitoring of Use, 2023. Geneva: WHO; 2023.
- 9 Infectious Diseases Society of America (IDSA). Guidelines for the Management of Intra-abdominal Infections. Clin Infect Dis. 2010;50(2):133–164.
- 10 Tacconelli E, et al. Discovery, research, and development of new antibiotics: the WHO priority list of antibiotic-resistant bacteria and tuberculosis. Lancet Infect Dis. 2018;18(3):318–327.
- 11 Nau R, Seele J, Djukic M, et al. Pharmacokinetics and pharmacodynamics of meropenem in cerebrospinal fluid of patients with bacterial meningitis. J Antimicrob Chemother. 1998;42(6):767–773.
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Editorial Team
This article has been written and reviewed by the iMedic Medical Editorial Team, comprising licensed specialist physicians in clinical pharmacology, infectious disease, and antimicrobial stewardship. All content follows the GRADE evidence framework and is reviewed according to international guidelines from WHO, EMA, FDA, BNF, and IDSA.
iMedic Medical Editorial Team – specialists in clinical pharmacology and infectious disease medicine with documented academic background and clinical experience in antimicrobial therapy.
iMedic Medical Review Board – independent panel of medical experts who review all content according to international guidelines and the latest peer-reviewed evidence.
Conflict of Interest Statement: The iMedic editorial team has no financial relationships with any pharmaceutical company. All content is independently produced without commercial funding or sponsorship. This article about Meropenem Medical Valley was written solely for educational purposes based on publicly available medical and regulatory information.