Merosap (Meropenem Anhydrous)

• Meropenem is a carbapenem antibiotic used to treat serious bacterial infections.
• Complicated intra‑abdominal infections: provides broad‑spectrum coverage to eradicate mixed aerobic and anaerobic pathogens.
• Complicated urinary tract infections: eliminates resistant Gram‑negative organisms causing severe UTIs.
• Hospital‑acquired pneumonia: penetrates lung tissue to treat multidrug‑resistant respiratory pathogens.
• Severe sepsis and septic shock: offers rapid bactericidal activity essential for critically ill patients.

• Meropenem binds to penicillin‑binding proteins (PBPs) on bacterial cell walls, inhibiting the final transpeptidation step of peptidoglycan synthesis. This disruption weakens the cell wall, leading to osmotic instability, cell lysis, and bacterial death. Its broad affinity for multiple PBPs accounts for activity against a wide range of Gram‑positive, Gram‑negative, and anaerobic organisms.

Adverse reactions may occur with meropenem therapy.

Common Side Effects

• Nausea or vomiting
• Diarrhea, including mild Clostridioides difficile colonisation
• Headache
• Rash or mild skin erythema
• Elevated liver enzymes
• Infusion site erythema or phlebitis

Serious or Rare Side Effects

• Seizures, especially in patients with renal impairment or CNS disorders
• Severe Clostridioides difficile‑associated colitis
• Anaphylactic or anaphylactoid reactions
• Acute renal toxicity
• Neutropenia or agranulocytosis
• Thrombocytopenia or other hematologic abnormalities

• Key safety considerations should be observed before and during meropenem therapy.
• Renal function: adjust dose in patients with impaired renal clearance.
• Allergy: avoid in individuals with known carbapenem hypersensitivity.
• Seizure risk: monitor patients with a history of CNS disorders or epilepsy.
• Pregnancy and lactation: use only if potential benefit justifies potential risk.
• Drug interactions: review concomitant medications for possible pharmacodynamic or pharmacokinetic effects.
• Store at 2-8°C: keep refrigerated, protect from light, do not freeze.

Meropenem may interact with several co‑administered drugs.

Major Interactions (Avoid)

• Valproic acid: may reduce plasma levels of valproate, risking seizure breakthrough.
• Probenecid: decreases renal clearance of meropenem, increasing toxicity risk.
• High‑dose aminoglycosides: additive nephrotoxicity.

Moderate Interactions (Monitor Closely)

• Loop diuretics: may exacerbate renal impairment.
• NSAIDs: increase risk of renal dysfunction.
• Warfarin: monitor INR as meropenem can alter anticoagulant effect.