Probenecid Meropenem

Mercaptopurine [6-MP] (Purinethol) [Antineoplastic/ Antimeta lite] Uses Acute leukemias, 2nd-line Rx of CML NHL, maint ALL in children, immunosuppressant w/ autoimmune Dzs (Crohn Dz) Action Antimetabolite, mimics hypoxanthine Dose Adults. 80-100 mg/mVd or 2.5-5 mg/kg/d maint 1.5-2.5 mg/kg/d Peds. Per protocol X w/ renal/hepatic insuff on empty stomach Caution [D, ] Contra Severe hepatic Dz, BM suppression, PRG Disp Tabs SE Mild hematotox, mucositis, stomatitis, D rash, fever, eosinophilia, jaundice. Hep Interactions T Effects W/ allopurinol T risk of BM suppression W/ trimethoprim-sulfamethoxazole X effects OF warfarin EMS May falsely T glucose OD May cause NA and liver necrosis symptomatic and supportive Meropenem (Merrem) [Antibiotic/Carbapenem] Uses lntra-abd Infxns, bacterial meningitis Action Carbapenem X cell wall synth, a [3-lactam Dose Adults. 1 to 2 g IV q8h Peds. >3 mo, <50 kg 10-40 mg/kg IV q 8h in renal insuff Caution [B, ] Contra [3-Lactam sensitivity Disp Inj 500 mg, 1 g SE Less Sz potential than imipenem D, thrombocytopenia Interactions T Effects W/ probenecid EMS Monitor for signs of electrolyte disturbances and... 

PROBENECID MEROPENEM t meropenem levels Uncertain Manufacturers recommend avoiding co-administration... 

Probenecid increases the serum levels of meropenem, but does not appear to interact with ertapenem to a clinically relevant extent. 

In 6 healthy subjects probenecid (1 g given orally 2 hours before meropenem and 500 mg given orally 1.5 hours after meropenem) increased the AUC of meropenem 500 mg by 43%. Another study in 6 healthy subjects found that probenecid (1.5 g in divided doses the day before and 500 mg one hour before meropenem) increased the AUC of meropenem 1 g by up to 55% and increased its half-life by 33% (from 0.98 to 1.3 hours). In both studies the serum levels of meropenem were modestly increased. This is possibly because meropenem and probenecid compete for active kidney tubular secretion. The manufacturers say that because the potency and duration of meropenem are adequate without probenecid, they do not recommend concurrent use. ... 

Ishida Y, Matsumoto F, Sakai O, Yoshida M, Shiba K. The pharmacokinetic study of meropenem effect of probenecid and hemodialysis. JC/2emt r(1993)5(Suppl 1), 124-6. 

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