Merolev Dosage/Direction for Use

Dosage/Direction for Use: Adults: The dosage range is 1.5 g to 6 g daily in three divided doses.
Usual dose: 500 mg to 1 g by intravenous administration every 8 hours depending on the type and severity of infection, the known or expected susceptibility of the pathogen(s), and the condition of the patient.
Exceptions: Febrile episodes in neutropenic patients: the dose should be 1 g every 8 hours.
Meningitis/Cystic Fibrosis: the dose should be 2 g every 8 hours.
When treating infections known or suspected to be caused by Pseudomonas aeruginosa, a dose of at least 1 g every 8 hours in adults (the maximum approved dose is 6 g daily given in 3 divided doses) and a dose of at least 20 mg/kg every 8 hours in children (the maximum approved dose is 120 mg/kg daily given in 3 divided doses) are recommended.
Regular sensitivity testing is recommended when treating Pseudomonas aeruginosa infections.
Meropenem (MEROLEV) IV should be given as an intravenous bolus injection over approximately 5 minutes or by intravenous infusion over approximately 15 to 30 minutes. There is limited safety data available to support the administration of a 2 g bolus dose.
Dosage Schedule for Adults with Impaired Renal Function: Dosage should be reduced in patients with creatinine clearance less than 51 mL/min, as scheduled as follows. (See Table 2.)

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Meropenem (MEROLEV) IV is cleared by haemodialysis and hemofiltration; if continued treatment with Meropenem (MEROLEV) IV is necessary, the unit dose is based on the infection type and severity is recommended at the completion of the haemodialysis procedure to re-institute effective treatment.
There is no experience with peritoneal dialysis.
Use in Adults with Hepatic Insufficiency: No dosage adjustment is necessary for patients with hepatic impairment.
Elderly: No dosage adjustment is required for the elderly with normal renal function or creatinine clearance values above 50 mL/min.
Children: For infants and children over 3 months and up to 12 years of age the IV dose is 10 to 40 mg/kg every 8 hours depending on the type and severity of infection, the known or suspected susceptibility of the pathogen(s), and the condition of the patient. In children over 50 kg in weight, an adult dosage should be used.
Exceptions: Febrile episodes in neutropenic patients: the dose should be 20 mg/kg every 8 hours.
Meningitis/Cystic Fibrosis: the dose should be 40 mg/kg every 8 hours.
Meropenem (MEROLEV) IV should be given as an IV bolus over approximately 5 min or by intravenous infusion over approximately 15 to 30 minutes (see Directions for Reconstitution under Cautions for Usage for the reconstitution details). There is limited safety data available to support the administration of a 40 mg/kg bolus dose.
There is no experience in children with renal impairment.
Direction For Reconstitution: Add 20 mL of Sterile Water for Injection into the vial containing 1 g of Meropenem. The vial should be shaken until dissolution occurs and allowed to stand until the solution is clear. The reconstituted solution should be used immediately.