Mephem 2 gram (Meropenem hydrate)

Adult administration

For meropenem hydrate, the daily dosage is 0.5 to 1 g (potency), administered as an intravenous infusion divided into 2 to 3 doses over at least 30 minutes. For suspected infections in pathogenic pneumonia, peritonitis, and neutropenic patients, administer 1 g (potency) as an intravenous infusion every 8 hours. For cystic fibrosis and meningitis, infuse 2 g (potency) every 8 hours.

Child administration

For children over 3 months with bacterial meningitis, the dosage should be given as a continuous intravenous infusion administering 40 mg per kg of body weight every 8 hours for at least 30 minutes, depending on the sensitivity of the pathogen and the patient’s condition.

This medication should not be used in patients who have experienced shock due to this drug in the past. Additionally, patients taking sodium valproate should not use this drug as it may lower valproate levels and lead to epileptic seizures. Patients who have had allergic reactions to this drug or its ingredients should also not receive it. Patients who have had serious allergic reactions to other carbapenem antibiotics or beta-lactam antibiotics (penicillins, cephalosporins, etc.) should refrain from using this drug. This drug should be administered with caution in patients with allergies or who easily exhibit allergic symptoms such as bronchial asthma or rash. Patients with impaired renal function may have prolonged drug retention leading to central nervous system symptoms like seizures or altered consciousness; thus, dosages should be reduced or intervals extended. Caution is also needed for patients with a history of epilepsy or central nervous system disorders due to the risk of seizures. Patients with severely compromised liver function should be monitored closely as their condition may worsen. Elderly patients, those in poor nutritional status, and infants under 3 months should also be given carefully. When using this drug, allergic reactions such as shock, rash, urticaria, and itching may occur, so treatment should be discontinued immediately if symptoms arise. Regular blood testing is necessary as there may be indications of leukopenia, anemia, thrombocytopenia, etc. Liver and kidney functions may deteriorate, so periodic monitoring is important. Gastrointestinal symptoms like severe diarrhea or abdominal pain should be reported immediately if they occur. If central nervous system symptoms, such as seizures or altered consciousness, show up, the medication should be stopped. Respiratory symptoms or severe skin reactions may also occur rarely, requiring careful observation. This drug should be administered only for the necessary duration after ensuring sensitivity, to prevent the development of resistant bacteria. If sensitivity has not been verified, it can be reassessed and switched to another medication within 3 days. Prior to administration, it is mandatory to check the patient's history of beta-lactam drug allergies. During administration, symptoms such as headaches, mental confusion, and dizziness may occur, necessitating caution while driving or operating machinery. If symptoms like myalgia, muscle weakness, or dark urine indicative of rhabdomyolysis occur, treatment should be stopped immediately. This drug can interact with other medications, so patients must inform their physicians about any other medications they are taking. Special caution should be exercised to avoid concurrent use with probenecid, valproate, antiepileptic drugs, and hormonal contraceptives. Women who are pregnant or may become pregnant should only use this drug if absolutely necessary and nursing mothers are advised to avoid its use. Safety and efficacy in children, especially infants under 3 months, have not been established, hence caution is warranted. In elderly patients, drug side effects may manifest more easily, and a bleeding tendency due to vitamin K deficiency may arise, necessitating careful dosing and monitoring. This drug is administered only by intravenous injection and should be used promptly after reconstitution. Storage should be within the prescribed period, and any slight discoloration does not affect its efficacy.

Serious side effects

Shock, anaphylaxis, urticaria, severe swelling (edema), chest tightness, difficulty breathing, cold sweat, pallor, high fever with severe rash, blisters, skin peeling, oral/ocular mucosal pain, severe skin reactions (toxic epidermal necrolysis, Stevens-Johnson syndrome, DRESS syndrome), difficulty breathing or shortness of breath, asthma attacks, respiratory abnormalities accompanied by cough and fever, jaundice of the skin or eyes.

Mild side effects

• Oral dyskinesia
• dizziness
• changes in stool
• tinnitus
• sweating
• fever
• redness
• flushing
• angioedema
• pancytopenia

This medication should be stored in a sealed container to prevent exposure to air, and maintained at room temperature between 1°C and 30°C for safety. Proper storage preserves the drug's efficacy and prevents degradation.

Appearance

A white to light yellow crystalline powder in a colorless and transparent vial for injection.

Package unit

10 vials/box (2,416 mg/vial)