Meropenem Dilution Guidelines
Meropenem should be diluted in either 0.9% sodium chloride (normal saline) or 5% dextrose (D5W) at concentrations ranging from 1 mg/mL to 20 mg/mL for intravenous infusion administration. 1
Recommended Dilution Concentrations
- For intravenous bolus administration, reconstitute meropenem vials with sterile water for injection to a concentration of up to 50 mg/mL 1
- For intravenous infusion, dilute reconstituted meropenem to concentrations ranging from 1 mg/mL to 20 mg/mL using compatible solutions 1
- Solutions prepared with sodium chloride 0.9% may be stored for up to 1 hour at room temperature (25°C/77°F) or up to 15 hours at refrigerated temperature (5°C/41°F) 1
- Solutions prepared with dextrose 5% should be used immediately 1
Compatible Diluents
- Sodium chloride 0.9% (normal saline) is the preferred diluent for meropenem infusions 1, 2
- Dextrose 5% (D5W) is also compatible but offers less stability than normal saline 1, 3
Stability Considerations
- Meropenem stability is concentration-dependent - lower concentrations generally offer better stability 2
- At 25°C (room temperature), meropenem at 10 mg/mL and 20 mg/mL concentrations in normal saline remain stable for up to 12 hours 2
- Higher concentrations (40 mg/mL) remain stable for a maximum of 8 hours at room temperature 2
- Different commercial brands of meropenem show equivalent stability when diluted in normal saline 2
Administration Guidelines
- Inspect reconstituted solutions visually for particulate matter and discoloration prior to administration 1
- Administer meropenem as an intravenous infusion over 30 minutes for optimal pharmacodynamic effect 1, 4
- For maximum efficacy, maintain free-drug concentrations above the minimum inhibitory concentration (MIC) for approximately 40% of the dosing interval 4
Important Precautions
- Do not use flexible containers in series connections 1
- Do not mix meropenem with or physically add it to solutions containing other drugs, as compatibility with other medications has not been fully established 1
- Freshly prepared solutions of meropenem should be used when possible 1
- Do not freeze solutions of intravenous meropenem 1
Y-Site Compatibility
- When administering with other medications via Y-site, ensure compatibility - meropenem is compatible with many antibiotics including aminoglycosides, colistin, fosfomycin, linezolid, and vancomycin 5
- Meropenem is physically incompatible via Y-site with several medications including albumin, amiodarone, anidulafungin, caspofungin, ciprofloxacin, and daptomycin 5
Following these dilution and administration guidelines will help ensure optimal efficacy and safety when administering meropenem to patients.