Expiration date: 11/2025

Composition 

1 FL. contains the event trihydrate 1.14 g, which corresponds to the content of the event 1 g, 

auxiliary substances: sodium carbonate.

Packaging

1 bottle.

Pharmacological action

Antibiotics group carbapenems. More stable relative to dehydropeptidase I than imipenem. Meropenem has a bactericidal effect by violating the synthesis of the cell wall of bacteria. Has an affinity for proteins binding penicillin (PBPs). Active against most aerobic and anaerobic gram-positive and gram-negative bacteria. The event is resistant Xanthomonas maltophilia, Enterococcus faecium, methicillin-resistant strains of Staphylococcus spp. Resistant to ?-lactamase.

Indications

Infectious-inflammatory diseases caused by susceptible to malaria infections, including polymicrobial infections (as monotherapy or in combination with other antibacterial, antiviral and antifungal drugs):

• infections of the lower respiratory tract (including pneumonia, including hospital),
  
• intra-abdominal infections (including complicated appendicitis, peritonitis, pelvioperitonit),
  
• infections of the urinary system (including pyelonephritis, pyelitis),
  
• infections of the skin and soft tissues (including erysipelas, impetigo, secondary infected dermatoses),
  
• infections of the pelvic organs (including endometritis),
  
• bacterial meningitis,
  
• septicaemia.
  

Empirical treatment (in the form of monotherapy or in combination with antiviral or antifungal drugs in suspected infection in adult patients with febrile episodes with neutropenia.

Contraindications

• hypersensitivity to any of the components of the drug Meropenem,
  
• children under 3 months of age (no data on efficacy and portability).
  

Application during pregnancy and breast-feeding

During pregnancy, it is possible if the intended benefit to the mother exceeds the potential risk to the fetus. Category effects on the fetus by FDA — B. At the time of treatment should stop breastfeeding.

Method of application and doses

Meropenem is introduced in / V. dosing Regimen is set individually depending on the type and severity of the infection and the patient's condition. Adults 500 mg every 8 h, with nosocomial infections - 1 g 3 times a day, with meningitis - 2 g every 8 h. with creatinine clearance from 26 to 50 ml/min — at a dose of 0, 5-2 g every 12 h, from 10 to 25 ml/min — 1/2 recommended dose every 12 h, less than 10 ml / min — 1/2 regular dose once a day. Children: from 3 months to 12 years-10-12 mg/kg every 8 hours, with meningitis — 40 mg / kg 3 times a day.

B / C can be entered in the form of bolus.

Side effect

From the nervous system and sensory organs: headache, dizziness, paresthesia, agitation, disturbance of consciousness, epileptiform seizures.

From the cardiovascular system and blood (hematopoiesis, hemostasis): thrombocytosis, eosinophilia, thrombocytopenia, leukopenia and neutropenia (including rare cases of agranulocytosis), reduction of hemoglobin, hematocrit, leukopenia, shortening of PV and partial thromboplastin time.

From the digestive tract: pain in the epigastric region, nausea, vomiting, diarrhea, constipation, anorexia, jaundice, hyperbilirubinemia, increased ALT, AST, schf, LDH, rarely — candidiasis of the oral mucosa, very rarely — pseudomembranous colitis.

From the genitourinary system: dysuria, edema, impaired renal function (hypercreatininemia, increased urea concentration in plasma), hematuria, vaginal candidiasis.

Allergic reactions: itching, rash, urticaria, multiform exudative erythema, Stevens-Johnson syndrome, toxic epidermal necrolysis, angioedema, anaphylactic shock.

Other: hypokalemia, hypervolemia, positive direct or indirect samples of Coombs, local reactions-inflammation, phlebitis, thrombophlebitis, soreness, swelling at the injection site.

A causal link with Meropenem reception is not installed: rarely, fainting, hallucinations, depression, anxiety, irritability, insomnia, cholestatic hepatitis, heart failure, cardiac arrest, tachycardia, bradycardia, myocardial infarction, reduced or increased blood pressure, pulmonary embolism, shortness of breath.

Special instruction

Patients who have a history of hypersensitivity to carbapenems, penicillins or other beta-lactam antibiotics may be hypersensitive to the event. Treatment of patients with liver diseases should be carried out under the control of liver transaminases and bilirubin concentration. In the process of treatment, the development of resistance of pathogens is possible, in connection with which long-term treatment is carried out under constant control of the spread of resistant strains. In patients with gastrointestinal diseases, especially colitis, it is necessary to take into account the possibility of the development of pseudomembranous colitis (toxin produced by Clostridium difficult, is one of the main causes of colitis associated with antibiotics), the first symptom of which may be the development of diarrhea during treatment. With monotherapy established or suspected infection of the lower respiratory tract severe, caused by Pseudomonas aeruginosa, it is recommended to regularly determine the sensitivity of the pathogen. Experience of using Meropenem in children with neutropenia, with primary or secondary immunodeficiency is absent.

Drug interaction

Probenecid slows down the excretion, increases the concentration in the blood plasma. Meropenem reduces the plasma concentration of valproic acid, which can lead to a decrease in the anticonvulsant effect.

Overdose

Symptoms: increased severity of side effects.

Treatment: symptomatic therapy. Normal is a rapid elimination of the drug by the kidneys. Hemodialysis is effective in patients with impaired renal function.

Storage conditions

The drug should be stored in a dry, dark place, at a temperature not exceeding 30°C in places inaccessible to children.

Shelf life

2 years.