From the FDA Drug Label
Hepatic:increased alanine transaminase (ALT), aspartate transaminase (AST), alkaline phosphatase, lactate dehydrogenase (LDH), and bilirubin
- Elevated liver enzymes have been reported in patients taking Merrem (Meropenem), including increased alanine transaminase (ALT) and aspartate transaminase (AST).
- The drug label also mentions that the meropenem group had a statistically higher number of patients with transient elevation of liver enzymes in pediatric patients.
- These findings suggest that Merrem (Meropenem) may cause hepatocellular injury or hypertransaminasemia in some patients 1.
From the Research
Meropenem (Merrem) has been associated with elevated liver enzymes, specifically hepatocellular injury or hypertransaminasemia, in some patients, as evidenced by a recent study published in 2024 2.
Key Findings
- The study found that meropenem can cause liver injury, particularly in male patients, those with a longer administration period, and those with pre-existing elevated alanine aminotransferase levels.
- Another study published in 2018 3 reported a case of meropenem-induced liver injury with a mixed hepatocellular/cholestatic pattern, highlighting the potential for severe liver damage.
- However, it is essential to note that the incidence of liver enzyme elevation with Merrem is relatively low, and serious hepatotoxicity is rare.
Clinical Implications
- Healthcare providers should monitor liver function tests in patients receiving prolonged courses of Merrem, particularly those with pre-existing liver disease or who are taking other potentially hepatotoxic medications.
- The mechanism behind Merrem-induced liver enzyme elevation is not fully understood but may involve direct hepatocellular injury or an immune-mediated response.
- Despite these potential effects on liver enzymes, Merrem remains an important option for treating serious bacterial infections, especially those caused by resistant organisms.
Recommendations
- Monitor liver function tests regularly in patients receiving Merrem, especially those with risk factors for liver injury.
- Be aware of the potential for severe liver damage and discontinue Merrem if liver injury is suspected.
- Consider alternative antibiotics if patients have a history of liver disease or are taking other hepatotoxic medications.