Patient was educated on precautions to be exercised while taking Merrem as follows:
- Check with your doctor regarding safety upon receiving any live vaccinations, as Merrem by eliminating natural bacterial flora, could lower the body’s resistance. Live vaccinations could turn virulent in such individuals, precipitating new infections.
- Merrem should be administered cautiously in individuals taking Probenecid, a medication used for gout, as Probenecid inhibits the enzymes responsible for 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. So, individuals with congestive heart failure must be watchful about signs and symptoms of fluid retention, such as, edema, sudden weight gain, increased shortness of breath and report to the physician at the earliest notice of such findings.
- Merrem undergoes minimal metabolism in the liver and the metabolites along with the of the unchanged drug is excreted in the urine. Individuals with history of liver and kidney disease cannot metabolize and excrete Merrem normally and tend to retain the drug in the body longer, thus resulting in toxicity. Merrem should be avoided or used with extreme caution in such individuals.
