RiteMED Meropenem Trihydrate Drug Interactions

Aminoglycosides: Concomitant administration with aminoglycosides may result in synergistic antibacterial effects against Pseudomonas aeruginosa.
Oral Anticoagulants: Simultaneous administration of antibiotics with warfarin may augment its anticoagulant effects. The risk may vary with the underlying infection, age and general status of the patients so that the contribution of the antibiotic to the increase in international normalized ratio (INR) is difficult to assess. It is recommended to frequently monitor the INR during and shortly after concomitant administration.
Probenecid: Probenecid competes with meropenem for active tubular secretion, resulting in increased plasma concentrations of meropenem. Concomitant use is not recommended.
Valproic acid: There have been case reports that concomitant administration of carbapenems, including meropenem, to patients on valproic acid or divalproex sodium results in a reduction (60 to 100%) in valproic acid concentrations. The valproic acid concentrations may drop below the therapeutic range, therefore increasing the risk of breakthrough seizures. Increasing the dose of valproic acid or divalproex sodium may not be sufficient to overcome this interaction.
Although the mechanism of this interaction is unknown, data from in vitro and animal studies suggest that carbapenems may inhibit the hydrolysis of valproic acid's glucuronide metabolite (VPA-g) back to valproic acid, thus decreasing the serum concentrations of valproic acid.
Interference with Laboratory Tests: A positive or indirect Coombs' test may develop.