Patient was educated on contraindications for using Merrem as follows:
- Significant share of Merrem given IV is primarily excreted unchanged in the urine. Individuals with compromised renal function tend to retain the drug in the circulation longer, thus resulting in toxicity. Merrem should be avoided or used with extreme caution in such individuals.
- Merrem intake can increase the risk for skin rash, ranging from mild to severe exfoliating rash and blisters. Individuals with history of extreme skin rashes and taking Merrem should be aware of this response and observe a close watch on the same.
- Merrem should be administered cautiously in individuals taking Probenecid, a medication used for gout, as Probenecid inhibits the metabolism of Merrem in the liver. Inhibition of metabolism of Merrem leads to increased blood levels of Merrem for longer duration, leading to toxicity.
- Some forms of Merrem have sodium content in them, which can result in fluid retention and unusual weight gain in individuals taking them. This can be dangerous in individuals with heart failure, as fluid retention and increased volume can be detrimental in an already failing heart.
