Generic Name: Pethidine/Meperidine hydrochloride Brand Name(s): Generics only. No brands available.

Uses

What is pethidine/meperidine hydrochloride used for?

Pethidine/meperidine hydrochloride is a narcotic analgesic. It works in the brain and nervous system to decrease pain.

Pethidine/meperidine hydrochloride is commonly used for short-term treatment of moderate to severe pain. It may also be used before or during surgery (e.g., to support anesthesia), for pain relief during labor and delivery, or for other conditions as determined by your doctor.

How should I take pethidine/meperidine hydrochloride?

Pethidine/meperidine hydrochloride is usually given as an injection at your doctor’s office, hospital, or clinic. If you will be using meperidine at home, a health care provider will teach you how to use it. Be sure you understand how to use meperidine. Follow the procedures you are taught when you use a dose. Contact your health care provider if you have any questions.

Tell your doctor if you still experience pain or if your pain gets worse while using meperidine.

Do not use pethidine/meperidine hydrochloride if it contains particles, is cloudy or discolored, or if the vial is cracked or damaged.

Keep this product, as well as syringes and needles, out of the reach of children and pets. Do not reuse needles, syringes, or other materials. Ask your health care provider how to dispose of these materials after use. Follow all local rules for disposal.

How do I store pethidine/meperidine hydrochloride?

Pethidine/meperidine hydrochloride is best stored at room temperature away from direct light and moisture. To prevent drug damage, you should not store pethidine/meperidine hydrochloride in the bathroom or the freezer. There may be different brands of pethidine/meperidine hydrochloride that may have different storage needs. It is important to always check the product package for instructions on storage, or ask your pharmacist. For safety, you should keep all medicines away from children and pets.

You should not flush pethidine/meperidine hydrochloride down the toilet or pour them into a drain unless instructed to do so. It is important to properly discard this product when it is expired or no longer needed. Consult your pharmacist for more details about how to safely discard your product.

Precautions & warnings

What should I know before using pethidine/meperidine hydrochloride?

Before using pethidine/meperidine hydrochloride, tell your doctor if:

  • You are allergic to any ingredient in pethidine/meperidine hydrochloride.
  • You have severely slow or difficult breathing.
  • You have taken a monoamine oxidase inhibitor (MAOI) (e.g., phenelzine) within the last 14 days.
  • You are taking ritonavir, sibutramine, or sodium oxybate (GHB).
  • You are pregnant, planning to become pregnant, or are breastfeeding.
  • You are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement.
  • You have allergies to medicines, foods, or other substances.
  • You have had an allergic reaction to any codeine- or morphine-related medicine (e.g., hydrocodone, oxycodone, dihydrocodeine, hydromorphone).
  • You drink alcohol; are going through withdrawal from alcohol or other substances.

Pethidine/meperidine hydrochloride may cause dizziness, light-headedness, or fainting; alcohol, hot weather, exercise, or fever can increase these effects. To prevent them, sit up or stand slowly, especially in the morning. Sit or lie down at the first sign of any of these effects.

Use pethidine/meperidine hydrochloride with caution. Do not drive or perform other possibly unsafe tasks until you know how you react to it.

Pethidine/meperidine hydrochloride may cause constipation. Talk with your doctor or pharmacist about using a stool softener or laxative to prevent constipation. It is also important to maintain a diet adequate in fiber, drink plenty or water, and exercise to prevent constipation. If you become constipated while taking meperidine, talk with your doctor or pharmacist.

Do not take more than the recommended dose or use for longer than prescribed without checking with your doctor. Prolonged use of meperidine may increase the risk of toxicity, including seizures.

Do not suddenly stop taking pethidine/meperidine hydrochloride without first checking with your doctor. If you have been taking pethidine/meperidine hydrochloride for more than a few weeks and your doctor tells you to stop taking it, your dose may need to be gradually lowered as directed by your doctor to avoid side effects.

Tell your doctor or dentist that you take pethidine/meperidine hydrochloride before you receive any medical or dental care, emergency care, or surgery.

Use pethidine/meperidine hydrochloride with caution in the elderly; they may be more sensitive to its effects.

Use meperidine with extreme caution in children; they may be more sensitive to its effects, especially slowed or difficult breathing.

When used for long periods of time or at high doses, meperidine may not work as well and may require higher doses to obtain the same effect as when originally taken. This is known as tolerance. Talk with your doctor if pethidine/meperidine hydrochloride stops working well. Do not take more than prescribed.

When used for long periods of time or at high doses, some people develop a need to continue taking pethidine/meperidine hydrochloride. This is known as dependence or addiction.

If you suddenly stop taking meperidine, you may experience withdrawal symptoms, including anxiety; appetite loss; backache; chills; diarrhea; enlarged pupils; fast heartbeat or breathing rate; increased tears; irritability; muscle or joint pain; nausea; restlessness; runny nose; severe or persistent dizziness; sleeplessness; stomach cramps; sweating; vomiting; weakness; and yawning.

Is it safe during pregnancy or breastfeeding?

There are no adequate studies in women for determining risk when using pethidine/meperidine hydrochloride during pregnancy or while breastfeeding. Please always consult with your doctor to weigh the potential benefits and risks before taking pethidine/meperidine hydrochloride. Pethidine/meperidine hydrochloride is pregnancy risk category C, according to the US Food and Drug Administration (FDA).

FDA pregnancy risk category reference below:

  • A=No risk
  • B=No risk in some studies
  • C=There may be some risk
  • D=Positive evidence of risk
  • X=Contraindicated
  • N=Unknown

Side effects

What side effects can occur from pethidine/meperidine hydrochloride?

All medicines may cause side effects, but many people have no, or minor, side effects. Check with your doctor if any of these most common side effects persist or become bothersome:

  • Constipation
  • Dizziness
  • Drowsiness
  • Flushing
  • Light-headedness
  • Loss of appetite
  • Nausea
  • Sweating
  • Vomiting

Seek medical attention right away if any of these severe side effects occur:

  • Rash
  • Hives
  • Itching
  • Difficulty breathing
  • Tightness in the chest
  • Swelling of the mouth, face, lips, or tongue
  • Chest pain
  • Confusion
  • Difficulty urinating
  • Fainting
  • Fast, slow, or irregular heartbeat
  • Hallucinations
  • Mental or mood changes
  • Numbness of an arm or a leg
  • Seizure
  • Severe or persistent constipation or stomach pain
  • Severe or persistent dizziness or light-headedness
  • Severe or persistent drowsiness
  • Slowed, shallow, or difficult breathing
  • Sudden severe headache, nausea, or vomiting
  • Tremor
  • Uncontrolled muscle movements
  • Vision changes

Not everyone experiences these side effects. There may be some side effects not listed above. If you have any concerns about a side-effect, please consult your doctor or pharmacist.

Interactions

What drugs may interact with pethidine/meperidine hydrochloride?

Pethidine/meperidine hydrochloride may interact with other drugs that you are currently taking, which can change how your drug works or increase your risk for serious side effects. To avoid any potential drug interactions, you should keep a list of all the drugs you are using (including prescription drugs, nonprescription drugs, and herbal products) and share it with your doctor and pharmacist. For your safety, do not start, stop, or change the dosage of any drugs without your doctor’s approval.

Products may interact with this drug, including:

  • Mixed narcotic agonist/antagonists (e.g., butorphanol, pentazocine), naltrexone, or rifamycins (e.g., rifampin) because they may decrease meperidine’s effectiveness.
  • Furazolidone or MAOIs (e.g., phenelzine) because the risk of serious side effects, including coma, difficulty breathing, low blood pressure, seizures, and irregular heartbeat, may be increased.
  • Selective serotonin reuptake inhibitors (SSRIs) (e.g., fluoxetine) or sibutramine because the risk of side effects, including increased body temperature, mental or mood changes, muscle twitching, or severe drowsiness, may be increased.
  • Acyclovir, cimetidine, phenothiazines (e.g., chlorpromazine), phenytoin, or ritonavir because the risk of side effects of meperidine may be increased.
  • Muscle relaxers (e.g., cyclobenzaprine) or sodium oxybate (GHB) because actions and side effects may be increased by meperidine.

Does food or alcohol interact with pethidine/meperidine hydrochloride?

Pethidine/meperidine hydrochloride may interact with food or alcohol by altering the way the drug works or increase the risk for serious side effects. Please discuss with your doctor or pharmacist any potential food or alcohol interactions before using this drug.

What health conditions may interact with pethidine/meperidine hydrochloride?

Pethidine/meperidine hydrochloride may interact with your health condition. This interaction may worsen your health condition or alter the way the drug works. It is important to always let your doctor and pharmacist know all the health conditions you currently have.

Especially if you have:

  • A history of lung or breathing problems (e.g., asthma, chronic obstructive pulmonary disease [COPD], cor pulmonale)
  • Low levels of oxygen or high levels of carbon dioxide in the blood
  • Sickle cell anemia
  • Adrenal gland problems (e.g., Addison disease, pheochromocytoma)
  • Curvature of the spine (scoliosis)
  • Thyroid problems
  • Low blood pressure
  • An enlarged prostate
  • Urinary blockage or trouble urinating
  • Lung, liver, or kidney problems
  • Heart problems (e.g., fast or irregular heartbeat)
  • Seizures
  • Stomach or bowels problems (e.g., inflammatory bowel disease)
  • Recently had any head injury, brain tumor or other growths, or increased pressure in the brain
  • A history of alcohol or substance abuse or dependence, mental or mood problems, or suicidal thoughts or attempts
  • Diarrhea due to taking an antibiotic (pseudomembranous colitis), constipation, stomach pain, low blood volume, dehydration, drowsiness, or severe weakness.

Dosage

The information provided is not a substitute for any medical advice. You should ALWAYS consult with your doctor or pharmacist before using pethidine/meperidine hydrochloride.

What is the dose of pethidine/meperidine hydrochloride for an adult?

Adult

Pethidine/meperidine hydrochloride is not recommended as a first choice analgesic by The American Pain Society and ISMP (2007); if no other options, limit use in acute pain to ≤48hr; doses should not exceed 600 mg/24hr; oral route is not recommended for treatment of acute or chronic pain.

Pain: The recommended dose is 50-150 mg PO/IM/SC q3-4hr PRN; adjust dose based degree of response.

Preoperatively: The recommended dose is 50-150 mg IM/SC q3-4hr PRN.

Continuous infusion: The recommended dose is 15-35 mg/hr.

Obstetrical analgesia: The recommended dose is 50-100 mg IM/SC; repeated q1-3hr PRN.

Dosing Modifications

  • Renal impairment: Avoid use.
  • Hepatic impairment: Consider lower initial dose; increased opioid effect possible in cirrhosis.

Geriatric

Pain: 50 mg PO q4hr or 25 mg IM q4hr; treatment for acute pain should be limited to 1-2 doses.

What is the dose of pethidine/meperidine hydrochloride for a child?

Meperidine is not recommended as a first choice analgesic by The American Pain Society and ISMP (2007); if no other options, limit use in acute pain to ≤48hr; doses should not exceed 600 mg/24hr; oral route is not recommended for treatment of acute or chronic pain.

Pain: The recommended dose is 1-1.8 mg/kg PO/IM/SC q3-4hr PRN; individual dose not to exceed 100 mg.

Preoperatively: The recommended dose is 1.1-2.2 mg/kg IM/SC 30-90 minutes before initiation of anesthesia.

How is pethidine/meperidine hydrochloride available?

Pethidine/meperidine hydrochloride is available in the following dosage forms and strengths:

  • Syrup 50mg/5mL
  • Tablet: Schedule II 50mg, 100mg
  • Injectable solution: Schedule II 25mg/ mL, 50mg/ mL, 75mg/ mL, 100mg/ mL

What should I do in case of an emergency or overdose?

In case of an emergency or an overdose, call your local emergency services or go to your nearest emergency room.

What should I do if I miss a dose?

If you miss a dose of pethidine/meperidine hydrochloride, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and take your regular dose as scheduled. Do not take a double dose.

Hello Health Group does not provide medical advice, diagnosis or treatment.

 

Sources

Review Date: April 19, 2017 | Last Modified: April 19, 2017

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