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Also known as: 96036-03-2, Merrem, Meropenem anhydrous, Meropenemum, Antibiotic sm 7338, Meronem
Molecular Formula
C17H25N3O5S
Molecular Weight
383.5  g/mol
InChI Key
DMJNNHOOLUXYBV-PQTSNVLCSA-N
FDA UNII
YOP6PX0BAO

Meropenem
A thienamycin derivative antibacterial agent that is more stable to renal dehydropeptidase I than IMIPENEM, but does not need to be given with an enzyme inhibitor such as CILASTATIN. It is used in the treatment of bacterial infections, including infections in immunocompromised patients.
Meropenem anhydrous is a Penem Antibacterial.
1 2D Structure

Meropenem

2 Identification
2.1 Computed Descriptors
2.1.1 IUPAC Name
(4R,5S,6S)-3-[(3S,5S)-5-(dimethylcarbamoyl)pyrrolidin-3-yl]sulfanyl-6-[(1R)-1-hydroxyethyl]-4-methyl-7-oxo-1-azabicyclo[3.2.0]hept-2-ene-2-carboxylic acid
2.1.2 InChI
InChI=1S/C17H25N3O5S/c1-7-12-11(8(2)21)16(23)20(12)13(17(24)25)14(7)26-9-5-10(18-6-9)15(22)19(3)4/h7-12,18,21H,5-6H2,1-4H3,(H,24,25)/t7-,8-,9+,10+,11-,12-/m1/s1
2.1.3 InChI Key
DMJNNHOOLUXYBV-PQTSNVLCSA-N
2.1.4 Canonical SMILES
CC1C2C(C(=O)N2C(=C1SC3CC(NC3)C(=O)N(C)C)C(=O)O)C(C)O
2.1.5 Isomeric SMILES
C[C@@H]1[C@@H]2[C@H](C(=O)N2C(=C1S[C@H]3C[C@H](NC3)C(=O)N(C)C)C(=O)O)[C@@H](C)O
2.2 Other Identifiers
2.2.1 UNII
YOP6PX0BAO
2.3 Synonyms
2.3.1 MeSH Synonyms

1. 3-(5-dimethylcarbamoylpyrrolidin-3-ylthio)-6-(1-hydroxyethyl)-4-methyl-7-oxo-1-azabicyclo(3.2.0)hept-2-ene-2-carboxylic Acid

2. Merrem

3. Penem

4. Ronem

5. Sm 7338

6. Sm-7338

7. Sm7338

2.3.2 Depositor-Supplied Synonyms

1. 96036-03-2

2. Merrem

3. Meropenem Anhydrous

4. Meropenemum

5. Antibiotic Sm 7338

6. Meronem

7. Meropenem [inn]

8. 119478-56-7

9. Mepm

10. Sm 7338

11. Chebi:43968

12. Sm-7338

13. Meropenemum [inn-latin]

14. Merrem I.v.

15. Meropenem (inn)

16. Meropenem, Anhydrous

17. (4r,5s,6s)-3-{[(3s,5s)-5-(dimethylcarbamoyl)pyrrolidin-3-yl]sulfanyl}-6-[(1r)-1-hydroxyethyl]-4-methyl-7-oxo-1-azabicyclo[3.2.0]hept-2-ene-2-carboxylic Acid

18. Meropenem Hydrate

19. Yop6px0bao

20. (4r,5s,6s)-3-[(3s,5s)-5-(dimethylcarbamoyl)pyrrolidin-3-yl]sulfanyl-6-[(1r)-1-hydroxyethyl]-4-methyl-7-oxo-1-azabicyclo[3.2.0]hept-2-ene-2-carboxylic Acid

21. Ici-194660

22. (4r,5s,6s)-3-{[(3s,5s)-5-(dimethylcarbamoyl)pyrrolidin-3-yl]thio}-6-[(1r)-1-hydroxyethyl]-4-methyl-7-oxo-1-azabicyclo[3.2.0]hept-2-ene-2-carboxylic Acid

23. Ncgc00016962-01

24. Ici 194660

25. Dsstox_cid_25526

26. Dsstox_rid_80930

27. Dsstox_gsid_45526

28. Ici 194,660

29. Meropenem (as Trihydrate)

30. Meropen

31. (1r,5s,6s)-2-[(3s,5s)-5-dimethylaminocarbonylpyrrolidin-3-ylthio]-6-[(r)-1-hydroxyethyl]-1-methylcarbapen-2-em-3-carboxylic Acid

32. (4r,5s,6s)-3-(((3s,5s)-5-(dimethylcarbamoyl)pyrrolidin-3-yl)thio)-6-((r)-1-hydroxyethyl)-4-methyl-7-oxo-1-azabicyclo[3.2.0]hept-2-ene-2-carboxylic Acid

33. (4r,5s,6s)-3-[[(3s,5s)-5-[(dimethylamino)carbonyl]-3-pyrrolidinyl]thio]-6-[(1r)-1-hydroxyethyl]-4-methyl-7-oxo-1-azabicyclo[3.2.0]hept-2-ene-2-carboxylic Acid

34. Meronem (tn)

35. Cas-96036-03-2

36. Nsc-759621

37. Merrem I.v. (tn)

38. Sr-01000762894

39. Unii-yop6px0bao

40. Hsdb 8019

41. Merrem Iv

42. Meropenem,(s)

43. M2279

44. Brn 6940582

45. Meropenem (closed Form)

46. Meropenem [mi]

47. Prestwick0_001106

48. Prestwick1_001106

49. Prestwick2_001106

50. Prestwick3_001106

51. Chembl127

52. Epitope Id:195064

53. Meropenem [who-dd]

54. Schembl34442

55. Bspbio_001212

56. Mls001401437

57. Bidd:gt0851

58. 4-methyl-7-oxo-1-azabicyclo

59. Spbio_003086

60. Bpbio1_001334

61. Meropenem With Sodium Carbonate

62. Dtxsid7045526

63. Gtpl10829

64. Hms1571m14

65. Hms2051g08

66. Hms2090c05

67. Hms2098m14

68. Hms3715m14

69. Meropenem Aslo Known As Meropenemum

70. (4r,5s,6s)-3-[(3s,5s)-5-(dimethylcarbamoyl)pyrrolidin-3-yl]sulfanyl-6-[(1s)-1-hydroxyethyl]-4-methyl-7-oxo-1-azabicyclo[3.2.0]hept-2-ene-2-carboxylic Acid

71. 1-azabicyclo(3.2.0)hept-2-ene-2-carboxylic Acid, 3-(((3s,5s)-5-((dimethylamino)carbonyl)-3-pyrrolidinyl)thio)-6-((1r)-1-hydroxyethyl)-4-methyl-7-oxo-, (4r,5s,6s)-

72. Amy22192

73. Zinc3808779

74. Tox21_110715

75. Tox21_113794

76. Bdbm50129062

77. Mfcd00864966

78. Akos015920140

79. Tox21_110715_1

80. Ccg-100850

81. Cs-1865

82. Db00760

83. Ks-5224

84. Nc00100

85. [3.2.0]hept-2-ene-2-carboxylic Acid

86. Ncgc00179259-01

87. Ncgc00179259-06

88. Ncgc00179259-17

89. Ncgc00253670-01

90. Ncgc00262579-02

91. (6s)-2-{[(3s,5s)-5-(dimethylcarbamoyl)pyrrolidin-3-yl]sulfanyl}-6-[(1r)-1-hydroxyethyl]-1beta-methyl-2,3-didehydro-1-carbapenam-3-carboxylic Acid

92. Hy-13678

93. Smr000469184

94. Ab00514051

95. D08185

96. M-2780

97. M05727

98. Ab00514051-02

99. Ab00698370-05

100. Pyrrolidin-3-ylthio)-6-((r)-1-hydroxyethyl)-

101. 036m032

102. Q421670

103. (4r,5s,6s)-3-((3s,5s)-5-(dimethylcarbamoyl)

104. Sr-01000762894-3

105. Sr-01000762894-4

106. Meropenem Trihydrate, Antibiotic For Culture Media Use Only

107. (1r,5s,6s)-2-[(3s,5s)-5-(dimethylaminocarbonyl)pyrrolidin-3-ylthio]-6-[(r)-1-hydroxyethyl]-1-methylcarbapen-2-em-3-carboxylic Acid

108. (4r,5s,6s)-3-(((3s,5s)-5-(dimethylcarbamoyl)-3-pyrrolidinyl)thio)-6-((1r)-1-hydroxyethyl)-4-methyl-7-oxo-1-azabicyclo(3.2.0)hept-2-ene-2-carboxylic Acid

109. (4r,5s,6s)-3-(((3s,5s)-5-(dimethylcarbamoyl)pyrrolidin-3-yl)thio)-6-((r)-1-hydroxyethyl)-4-methyl-7-oxo-1-azabicyclo[3.2.0]hept-2-ene-2-carboxylicacid

110. (4r,5s,6s)-3-((3s,5s)-5-(dimethylcarbamoyl)pyrrolidin-3-ylthio)-6-((r)-1-hydroxyethyl)-4-methyl-7-oxo-1-azabicyclo[3.2.0]hept-2-ene-2-carboxylic Acid

111. (4r,5s,6s)-3-[[(3s,5s)-5-(dimethylaminocarbonyl)-3-pyrrolidinyl]thio]-6-[(1r)-1-hydroxyethyl]-4-methyl-7-oxo-1-azabicyclo[3.2.0]hept-2-ene-2-carboxylic Acid

112. (4r,6s)-3-((3s,5s)-5-(dimethylcarbamoyl)pyrrolidin-3-ylthio)-6-((r)-1-hydroxyethyl)-4-methyl-7-oxo-1-azabicyclo[3.2.0]hept-2-ene-2-carboxylic Acid

113. 1-azabicyclo(3.2.0)hept-2-ene-2-carboxylic Acid, 3-((5-((dimethylamino)carbonyl)-3-pyrrolidinyl)thio)-6-(1-hydroxyethyl)-4-methyl-7-oxo-, (4r-(3(s*,5s*),4-alpha,5-beta,6-beta(r*)))-

2.4 Create Date
2005-06-24
3 Chemical and Physical Properties
Molecular Weight 383.5 g/mol
Molecular Formula C17H25N3O5S
XLogP3-2.4
Hydrogen Bond Donor Count3
Hydrogen Bond Acceptor Count7
Rotatable Bond Count5
Exact Mass383.15149208 g/mol
Monoisotopic Mass383.15149208 g/mol
Topological Polar Surface Area136 Ų
Heavy Atom Count26
Formal Charge0
Complexity679
Isotope Atom Count0
Defined Atom Stereocenter Count6
Undefined Atom Stereocenter Count0
Defined Bond Stereocenter Count0
Undefined Bond Stereocenter Count0
Covalently Bonded Unit Count1
4 Drug and Medication Information
4.1 Drug Information
1 of 4  
Drug NameMeropenem
PubMed HealthMeropenem (Injection)
Drug ClassesAntibiotic
Drug LabelMeropenem for Injection, USP (I.V.) is a sterile, pyrogen-free, synthetic, broad-spectrum, carbapenem antibiotic for intravenous administration. It is (4R,5S,6S)-3-[[(3S,5S)-5-(Dimethylcarbamoyl)-3-pyrrolidinyl]thio]-6-[(1R)-1-hydroxyethyl]-4-methyl-...
Active IngredientMeropenem
Dosage FormInjectable
RouteInjection
Strength500mg/vial; 1gm/vial
Market StatusPrescription
CompanyHospira; Sandoz; Acs Dobfar

2 of 4  
Drug NameMerrem
PubMed HealthMeropenem (Injection)
Drug ClassesAntibiotic
Drug LabelMERREM I.V. (meropenem for injection) is a sterile, pyrogen-free, synthetic, broad-spectrum, carbapenem antibiotic for intravenous administration. It is (4R,5S,6S)-3- [[(3S,5S)-5-(Dimethylcarbamoyl)-3-pyrrolidinyl]thio]-6- [(1R)-1-hydroxyethyl]-4-m...
Active IngredientMeropenem
Dosage FormInjectable
RouteInjection
Strength500mg/vial; 1gm/vial
Market StatusPrescription
CompanyAstrazeneca

3 of 4  
Drug NameMeropenem
PubMed HealthMeropenem (Injection)
Drug ClassesAntibiotic
Drug LabelMeropenem for Injection, USP (I.V.) is a sterile, pyrogen-free, synthetic, broad-spectrum, carbapenem antibiotic for intravenous administration. It is (4R,5S,6S)-3-[[(3S,5S)-5-(Dimethylcarbamoyl)-3-pyrrolidinyl]thio]-6-[(1R)-1-hydroxyethyl]-4-methyl-...
Active IngredientMeropenem
Dosage FormInjectable
RouteInjection
Strength500mg/vial; 1gm/vial
Market StatusPrescription
CompanyHospira; Sandoz; Acs Dobfar

4 of 4  
Drug NameMerrem
PubMed HealthMeropenem (Injection)
Drug ClassesAntibiotic
Drug LabelMERREM I.V. (meropenem for injection) is a sterile, pyrogen-free, synthetic, broad-spectrum, carbapenem antibiotic for intravenous administration. It is (4R,5S,6S)-3- [[(3S,5S)-5-(Dimethylcarbamoyl)-3-pyrrolidinyl]thio]-6- [(1R)-1-hydroxyethyl]-4-m...
Active IngredientMeropenem
Dosage FormInjectable
RouteInjection
Strength500mg/vial; 1gm/vial
Market StatusPrescription
CompanyAstrazeneca

4.2 Therapeutic Uses

Anti-Bacterial Agents

National Library of Medicine's Medical Subject Headings online file (MeSH, 2012)


Meropenem is used for the treatment of intra-abdominal infections, including complicated appendicitis and peritonitis, caused by susceptible bacteria. The drug may be used as monotherapy for the treatment of intra-abdominal infections caused by susceptible viridans streptococci, Escherichia coli, Klebsiella pneumonia, Pseudomonas aeruginosa, Bacteroides fragilis, B. thetaiotaomicron, or Peptostreptococcus. Because meropenem has a broad spectrum of antibacterial activity, the drug may be used empirically to treat intra-abdominal infections before identification of the causative organism. /Included in US product labeling/

American Society of Health-System Pharmacists 2011; Drug Information 2011. Bethesda, MD. 2011, p. 186


Meropenem is used for the treatment of bacterial meningitis caused by susceptible Streptococcus pneumoniae, Haemophilus influenzae (including beta-lactamase-producing strains), or Neisseria meningitidis in children 3 months of age and older. /Included in US product labeling/

American Society of Health-System Pharmacists 2011; Drug Information 2011. Bethesda, MD. 2011, p. 187


The drug also is used in the treatment of meningitis in adults. /NOT included in US product labeling/

American Society of Health-System Pharmacists 2011; Drug Information 2011. Bethesda, MD. 2011, p. 187


For more Therapeutic Uses (Complete) data for Meropenem (20 total), please visit the HSDB record page.


4.3 Drug Warning

Serious and occasionally fatal hypersensitivity reactions (e.g., anaphylaxis) reported with beta-lactams. If hypersensitivity occurs, discontinue meropenem and institute appropriate therapy as indicated (e.g., epinephrine, corticosteroids, and maintenance of an adequate airway and oxygen).

American Society of Health-System Pharmacists 2011; Drug Information 2011. Bethesda, MD. 2011, p. 189


Adverse effects reported in 1% or more of patients receiving meropenem including GI effects (diarrhea, nausea, vomiting, constipation), local reactions (pain and inflammation at injection site, phlebitis/thrombophlebitis), headache, anemia, rash, pruritus, sepsis, apnea, shock, glossitis, and oral candidiasis.

American Society of Health-System Pharmacists 2011; Drug Information 2011. Bethesda, MD. 2011, p. 190


Seizures and other adverse CNS effects reported during meropenem therapy, especially in those with underlying CNS disorders (e.g., brain lesions, history of seizures), bacterial meningitis, or compromised renal function. Do not exceed recommended dosage, especially in those with known factors that predispose to seizures. Anticonvulsant therapy should be continued in those with known seizure disorders. If focal tremors, myoclonus, or seizures occur, evaluate the patient neurologically, initiate anticonvulsant therapy if necessary, and determine whether meropenem dosage should be decreased or the drug discontinued.

American Society of Health-System Pharmacists 2011; Drug Information 2011. Bethesda, MD. 2011, p. 189


Partial cross-allergenicity among beta-lactam antibiotics, including penicillins, cephalosporins, and other beta-lactams. Prior to initiation of meropenem therapy, make careful inquiry concerning previous hypersensitivity reactions to meropenem, cephalosporins, penicillins, or other drugs.

American Society of Health-System Pharmacists 2011; Drug Information 2011. Bethesda, MD. 2011, p. 189


For more Drug Warnings (Complete) data for Meropenem (8 total), please visit the HSDB record page.


4.4 Drug Indication

For use as single agent therapy for the treatment of the following infections when caused by susceptible isolates of the designated microorganisms: complicated skin and skin structure infections due to Staphylococcus aureus (b-lactamase and non-b-lactamase producing, methicillin-susceptible isolates only), Streptococcus pyogenes, Streptococcus agalactiae, viridans group streptococci, Enterococcus faecalis (excluding vancomycin-resistant isolates), Pseudomonas aeruginosa, Escherichia coli, Proteus mirabilis, Bacteroides fragilis and Peptostreptococcus species; complicated appendicitis and peritonitis caused by viridans group streptococci, Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa, Bacteroides fragilis, B. thetaiotaomicron, and Peptostreptococcus species. Also for use in the treatment of bacterial meningitis caused by Streptococcus pneumoniae, Haemophilus influenzae (b-lactamase and non-b-lactamase-producing isolates), and Neisseria meningitidis.


FDA Label


Treatment of bacterial sepsis, Treatment of bacterial meningitis


5 Pharmacology and Biochemistry
5.1 Pharmacology

Meropenem is a broad-spectrum carbapenem antibiotic. It is active against Gram-positive and Gram-negative bacteria. Meropenem exerts its action by penetrating bacterial cells readily and interfering with the synthesis of vital cell wall components, which leads to cell death.


5.2 MeSH Pharmacological Classification

Anti-Bacterial Agents

Substances that inhibit the growth or reproduction of BACTERIA. (See all compounds classified as Anti-Bacterial Agents.)


5.3 FDA Pharmacological Classification
5.3.1 Active Moiety
MEROPENEM ANHYDROUS
5.3.2 FDA UNII
YOP6PX0BAO
5.3.3 Pharmacological Classes
Penem Antibacterial [EPC]; Carbapenems [CS]
5.4 ATC Code

J01DH02

S76 | LUXPHARMA | Pharmaceuticals Marketed in Luxembourg | Pharmaceuticals marketed in Luxembourg, as published by d'Gesondheetskeess (CNS, la caisse nationale de sante, www.cns.lu), mapped by name to structures using CompTox by R. Singh et al. (in prep.). List downloaded from https://cns.public.lu/en/legislations/textes-coordonnes/liste-med-comm.html. Dataset DOI:10.5281/zenodo.4587355


J - Antiinfectives for systemic use

J01 - Antibacterials for systemic use

J01D - Other beta-lactam antibacterials

J01DH - Carbapenems

J01DH02 - Meropenem


5.5 Absorption, Distribution and Excretion

Route of Elimination

Approximately 70% of the intravenously administered dose is recovered as unchanged meropenem in the urine over 12 hours, after which little further urinary excretion is detectable.


Approximately 70% of the intravenously administered dose is recovered as unchanged meropenem in the urine over 12 hours, after which little further urinary excretion is detectable. Urinary concentrations of meropenem in excess of 10 ug/mL are maintained for up to 5 hours after a 500 mg dose.

US Natl Inst Health; DailyMed. Current Medication Information for MEROPENEM injection, powder, for solution (October 2011). Available from, as of February 8, 2012: https://dailymed.nlm.nih.gov/dailymed/search.cfm?startswith=meropenem


Meropenem is distributed into most body tissues and fluids, including bronchial mucosa, lung, bile, gynecologic tissue (endometrium, myometrium, ovary, cervix, fallopian tube), muscle, heart valves, skin, interstitial and peritoneal fluid, and CSF. Plasma protein binding is approximately 2%. The drug is partially metabolized to at least one microbiologically inactive metabolite. About 70% of an IV dose is eliminated in urine as unchanged drug by tubular secretion and glomerular filtration.

American Society of Health-System Pharmacists 2011; Drug Information 2011. Bethesda, MD. 2011, p. 190


At the end of a 30 minute intravenous infusion of a single dose of Meropenem for injection (IV) in healthy volunteers, mean peak plasma concentrations of meropenem are approximately 23 ug/mL (range 14-26) for the 500 mg dose and 49 ug/mL (range 39-58) for the 1 g dose. A 5-minute intravenous bolus injection of Meropenem for injection (IV) in healthy volunteers results in mean peak plasma concentrations of approximately 45 ug/mL (range 18-65) for the 500 mg dose and 112 ug/mL (range 83-140) for the 1 g dose. Following intravenous doses of 500 mg, mean plasma concentrations of meropenem usually decline to approximately 1 ug/mL at 6 hours after administration. No accumulation of meropenem in plasma was observed with regimens using 500 mg administered every 8 hours or 1 g administered every 6 hours in healthy volunteers with normal renal function.

US Natl Inst Health; DailyMed. Current Medication Information for MEROPENEM injection, powder, for solution (October 2011).


5.6 Metabolism/Metabolites

Primarily excreted unchanged. There is one metabolite which is microbiologically inactive.


There is one metabolite of meropenem that is microbiologically inactive.

US Natl Inst Health; DailyMed. Current Medication Information for MEROPENEM injection, powder, for solution (October 2011). Available from, as of February 8, 2012: https://dailymed.nlm.nih.gov/dailymed/search.cfm?startswith=meropenem


5.7 Biological Half-Life

Approximately 1 hour in adults and children 2 years of age and older with normal renal function. Approximately 1.5 hours in children 3 months to 2 years of age.


The plasma half-life of meropenem is approximately 1 hour in adults with normal renal function and 1.5 hours in children 3 months to 2 years of age. Plasma half-life is increased and clearance of the drug is decreased in patients with renal impairment.

American Society of Health-System Pharmacists 2011; Drug Information 2011. Bethesda, MD. 2011, p. 190


5.8 Mechanism of Action

The bactericidal activity of meropenem results from the inhibition of cell wall synthesis. Meropenem readily penetrates the cell wall of most Gram-positive and Gram-negative bacteria to reach penicillin-binding- protein (PBP) targets. Its strongest affinities are toward PBPs 2, 3 and 4 of Escherichia coli and Pseudomonas aeruginosa; and PBPs 1, 2 and 4 of Staphylococcus aureus.


The bactericidal activity of meropenem results from the inhibition of cell wall synthesis. Meropenem readily penetrates the cell wall of most Gram-positive and Gram-negative bacteria to reach penicillin-binding-protein (PBP) targets. Its strongest affinities are toward PBPs 2, 3 and 4 of Escherichia coli and Pseudomonas aeruginosa; and PBPs 1, 2, and 4 of Staphylococcus aureus. Bactericidal concentrations (defined as a 3 log10 reduction in cell counts within 12 to 24 hours) are typically 1-2 times the bacteriostatic concentrations of meropenem, with the exception of Listeria monocytogenes, against which lethal activity is not observed.

US Natl Inst Health; DailyMed. Current Medication Information for MEROPENEM injection, powder, for solution (October 2011). Available from, as of February 8, 2012: https://dailymed.nlm.nih.gov/dailymed/search.cfm?startswith=meropenem


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01-Jan-2021
26-Aug-2024
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