Meperidine (Oral)

Meperidine is an oral medication that acts on the central nervous system for the relief of pain in patients.

Overview

Meperidine is used for the relief of moderate or severe pain. It is a part of the group of medications known as narcotic analgesics and has an effect on the central nervous system. The medication is for use on short-term pain only and should not be used over a long period to relieve the pain suffered from chronic or recurrent conditions.

If Meperidine is used for a prolonged period of time it is a habit-forming medication that can result in both physical and mental dependence. Patients should not allow this to put them off use of narcotic analgesics altogether, however, as proper use of the medication is unlikely to cause mental dependence. Physical dependence can occur and withdrawal symptoms may be experienced if such medications as Meperidine are stopped suddenly. Patients can have their dose gradually reduced, however, and this will enable a healthy and effective cessation of treatment to be achieved.

Meperidine is available only when prescribed by a doctor and is administered as a syrup, solution or tablet. It is provided as Demerol or Meperitab to patients for them to administer at home. Sometimes this oral medication may be prescribed following previous treatment with an injected version of the same medication.

Condition treated

  • Moderate to severe pain

Type Of Medicine

  • Narcotic analgesic

Side Effects

In addition to relieving pain, narcotic analgesics such as Meperidine can also cause unwanted side effects to occur. While not all side effects of use may occur in any one patient, where they do occur patients may need to seek medical attention.

You should check with your doctor immediately if you are experiencing any of the following side effects from the use of Meperidine:

Frequency of incidence not known:

  • Wheezing
  • Upper abdominal or stomach pain
  • Unusual tiredness or weakness
  • Trembling or shaking of the hands or feet
  • Tightness in the chest
  • Sweating
  • Skin rash
  • Shortness of breath
  • Shakiness in the legs, arms, hands, or feet
  • Rhythmic movement of the muscles
  • Redness of the face, neck, arms, and occasionally, upper chest
  • Puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue
  • Pale or blue lips, fingernails, or skin
  • Painful urination
  • Muscle twitching or jerking
  • Lightheadedness, dizziness, or fainting
  • Itching
  • Irregular, fast, slow, or shallow breathing
  • Hives
  • Feeling of warmth
  • Fast, slow, pounding, or irregular heartbeat
  • Fainting
  • Dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position
  • Difficulty with swallowing
  • Difficulty in passing urine (dribbling)
  • Difficult or troubled breathing
  • Decrease in urine volume
  • Decrease in the frequency of urination
  • Cough
  • Convulsion
  • Confusion
  • Cold, clammy skin
  • Chest pain or discomfort
  • Blurring of vision

Overdose is possible when taking Meperidine and you should be alert to the symptoms of this. If you believe that you or anyone else is suffering from an overdose from the use of Meperidine then you should seek emergency medical attention right away. The symptoms of overdose can include the following:

  • Sleepiness or unusual drowsiness
  • Severe sleepiness
  • Loss of consciousness
  • Decreased awareness or responsiveness
  • Change in consciousness
  • Bluish color of the fingernails, lips, skin, palms, or nail beds

Certain other side effects may also occur with the use of Meperidine. These side effects are milder and would not normally require that you seek medical attention. Often they will abate over time as the body becomes used to the presence of Meperidine. If these side effects are ongoing or are bothersome, however, then you can seek advice from your healthcare professional as to how you can alleviate them:

Occurring more commonly:

  • Vomiting
  • Relaxed and calm
  • Nausea
  • Drowsiness

Frequency of incidence not known:

  • Weakness
  • Tunnel vision
  • Trouble with sleeping
  • Seeing, hearing, or feeling things that are not there
  • Restlessness
  • Redness of the skin
  • Overbright appearance of lights
  • Night blindness
  • Nervousness
  • Irritability
  • Hyperventilation
  • Hives or welts
  • Headache
  • Halos around lights
  • False or unusual sense of well-being
  • Dry mouth
  • Double vision
  • Disturbed color perception
  • Difficulty having a bowel movement (stool)
  • Confusion about identity, place, and time
  • Blurred or loss of vision
  • Anxiety

Other side effects that have not been listed herein could also occur. You should contact your doctor if Meperidine causes any other side effects and should seek advice. If you believe that your immediate health is at risk, however, then you should always seek emergency medical care.

Dosage

You should use this medication only as you have been directed to by your doctor. You should not ever take a greater dose of it nor use it more frequently than ordered. You should also cease use when you have been directed to and should not continue use after this date. This medication is habit-forming and will cause addiction to occur if it is mistreated. Elderly patients in particular may be susceptible to the effects of this medication and are more likely to form a habit of dependency.

You should always measure liquid forms of this medication with the measurement device provided. This will ensure you are taking the correct dose. Other items may not have the correct volume and may provide an incorrect dose. You should take the liquid medication with a cup and a half of water to ensure that all of the medication is consumed.

The dose of this medication that you receive will depend on a wide range of factors and your personal conditions will be taken into account. You should always follow your doctor's directions for use and should not ever make changes to your dosing without being directed to by your doctor. The following information is based on averages only and should not be used to manage your dose:

  • Adults should be treated with 50-150mg of this medication once every four hours as it is required.
  • Children aged 1+ should be given a dose based on their body weight as calculated by the doctor. The usual dose is between 1.1-1.8mg/kg given every 3-4 hours as is required for pain management.
  • The use of this medication in children below the age of one should be determined by the prescribing doctor.

If a dose of this medication is missed then take it as soon as possible as required. Never take a double dose of this medication, do not take a dose more frequently than prescribed and return to your normal dosing schedule as soon as possible.

Interactions

Certain medications should never be used in conjunction with one another. This is because they can interact in the body and this can have severe unwanted medical complications. In other cases medications may stop one another from working or may increase the side effects or severity of side effects experienced.

To avoid interactions from occurring with Meperidine you will need to inform your doctor of all medications that you are taking. Meperidine can interact with prescribed medication, over the counter treatments, herbal remedies and even nutritional supplements. It is especially important that you inform your doctor if you are taking any of the following medications:

The use of Meperidine with the following is not recommended. Your doctor may choose not to treat you with this medication or may change your other medications:

  • Tranylcypromine
  • Toloxatone
  • Selegiline
  • Safinamide
  • Rasagiline
  • Procarbazine
  • Phenelzine
  • Pargyline
  • Nialamide
  • Naltrexone
  • Moclobemide
  • Linezolid
  • Isocarboxazid
  • Iproniazid
  • Clorgyline

The use of Meperidine with the following treatments is not normally recommended. In some cases you may be prescribed both, however. The doctor may make adjustments to the dose of this or other medications to reduce the interaction risk:

  • Zotepine
  • Zopiclone
  • Zolpidem
  • Zolmitriptan
  • Ziprasidone
  • Zaleplon
  • Vortioxetine
  • Vilazodone
  • Venlafaxine
  • Tryptophan
  • Trimipramine
  • Trifluperidol
  • Triazolam
  • Trazodone
  • Tramadol
  • Topiramate
  • Tolonium Chloride
  • Tizanidine
  • Tilidine
  • Tianeptine
  • Thiothixene
  • Thiopropazate
  • Thiopental
  • Temazepam
  • Tapentadol
  • Suvorexant
  • Sumatriptan
  • Sulpiride
  • Sufentanil
  • St John's Wort
  • Sodium Oxybate
  • Sibutramine
  • Sertraline
  • Sertindole
  • Secobarbital
  • Rizatriptan
  • Risperidone
  • Remoxipride
  • Remifentanil
  • Ramelteon
  • Quetiapine
  • Quazepam
  • Protriptyline
  • Propoxyphene
  • Propofol
  • Primidone
  • Prazepam
  • Piritramide
  • Piperacetazine
  • Pimozide
  • Pimavanserin
  • Phenobarbital
  • Periciazine
  • Perazine
  • Perampanel
  • Pentobarbital
  • Pentazocine
  • Paroxetine
  • Paregoric
  • Papaveretum
  • Palonosetron
  • Paliperidone
  • Oxymorphone
  • Oxycodone
  • Oxazepam
  • Orphenadrine
  • Opium Alkaloids
  • Opium
  • Opipramol
  • Olanzapine
  • Nortriptyline
  • Nitrous Oxide
  • Nitrazepam
  • Nicomorphine
  • Nefazodone
  • Naratriptan
  • Nalbuphine
  • Morphine Sulfate Liposome
  • Morphine
  • Moricizine
  • Molindone
  • Mirtazapine
  • Milnacipran
  • Midazolam
  • Methylene Blue
  • Methohexital
  • Methocarbamol
  • Methdilazine
  • Methadone
  • Metaxalone
  • Meptazinol
  • Meprobamate
  • Mephobarbital
  • Mephenesin
  • Meperidine
  • Melperone
  • Melitracen
  • Medazepam
  • Meclizine
  • Lurasidone
  • Lormetazepam
  • Lorcaserin
  • Lorazepam
  • Lofepramine
  • Lithium
  • Levorphanol
  • Levomilnacipran
  • Ketobemidone
  • Ketazolam
  • Ketamine
  • Isoflurane
  • Imipramine
  • Iloperidone
  • Hydroxyzine
  • Hydroxytryptophan
  • Hydromorphone
  • Hydrocodone
  • Hexobarbital
  • Halothane
  • Haloperidol
  • Halazepam
  • Granisetron
  • Furazolidone
  • Frovatriptan
  • Fospropofol
  • Fluvoxamine
  • Fluspirilene
  • Flurazepam
  • Fluoxetine
  • Flunitrazepam
  • Flibanserin
  • Fentanyl
  • Ethylmorphine
  • Ethchlorvynol
  • Eszopiclone
  • Estazolam
  • Escitalopram
  • Enflurane
  • Eletriptan
  • Duloxetine
  • Droperidol
  • Doxylamine
  • Doxepin
  • Donepezil
  • Dolasetron
  • Diphenoxylate
  • Diphenhydramine
  • Dihydrocodeine
  • Difenoxin
  • Dichloralphenazone
  • Dibenzepin
  • Diazepam
  • Diacetylmorphine
  • Dezocine
  • Dextromethorphan
  • Dexmedetomidine
  • Desvenlafaxine
  • Desipramine
  • Dantrolene
  • Cyclobenzaprine
  • Codeine
  • Cocaine
  • Clozapine
  • Clorazepate
  • Clonazepam
  • Clomipramine
  • Clobazam
  • Citalopram
  • Cimetidine
  • Chlorzoxazone
  • Chlorpheniramine
  • Chlordiazepoxide
  • Chloral Hydrate
  • Carphenazine
  • Carisoprodol
  • Cariprazine
  • Carbinoxamine
  • Carbamazepine
  • Butorphanol
  • Butalbital
  • Butabarbital
  • Buspirone
  • Buprenorphine
  • Brompheniramine
  • Bromopride
  • Bromazepam
  • Benperidol
  • Baclofen
  • Asenapine
  • Aripiprazole
  • Anileridine
  • Amoxapine
  • Amobarbital
  • Amitriptylinoxide
  • Amitriptyline
  • Amisulpride
  • Amineptine
  • Alprazolam
  • Almotriptan
  • Alfentanil
  • Acepromazine

Using Meperidine with the following will increase the risk of certain side effects occurring. Your doctor may prescribe both with adjustments made to the dose or frequency of use of one or both treatments:

  • Trimeprazine
  • Triflupromazine
  • Trifluoperazine
  • Thioridazine
  • Thiethylperazine
  • Ritonavir
  • Propiomazine
  • Promethazine
  • Promazine
  • Prochlorperazine
  • Pipotiazine
  • Phenytoin
  • Perphenazine
  • Methotrimeprazine
  • Mesoridazine
  • Isoniazid
  • Fosphenytoin
  • Fluphenazine
  • Ethopropazine
  • Chlorpromazine
  • Acetophenazine

Meperidine can also interact with other medications not listed here. It is vital that you inform your doctor of all medications and substances that you are taking before you begin use.

Medications may also interact with other foods and drinks that you consume. Your doctor could advise not to consume certain foods, drinks or substances around the time of use. For Meperidine it is important that you avoid use of the following because it can increase the side effects experienced:

  • Ethanol

Certain medical problems can also prohibit the use of some medications. This is because a condition may be worsened by a medication intended for the treatment of another condition. In other cases certain conditions can increase the effect of medications and create overdose or increased severity of effects. It is important that you inform your doctor of all medical conditions from which you suffer. This is especially important with the following conditions:

The risk of more serious side effects occurring will be increased with the following conditions:

  • Addison disease
  • History of alcohol abuse
  • Severe asthma
  • Brain disease
  • Severe breathing problems
  • Central nervous system depression
  • Chronic obstructive pulmonary disease
  • Cor pulmonale
  • History of drug dependence, especially with narcotics
  • History of head injuries
  • Hypothyroidism (an underactive thyroid)
  • Kyphoscoliosis (severe curvature of the spine with breathing problems)
  • Mental illness
  • Pheochromocytoma (adrenal gland tumor)
  • Prostatic hypertrophy (enlarged prostate, BPH)
  • Respiratory depression (very slow breathing)
  • Sickle cell anemia (inherited blood disorder)
  • Weakened physical condition

The following conditions may be worsened by use:

  • Hypotension
  • Hypovolemia
  • History of seizures

The effects and side effects of Meperidine may be increased in patients with the following conditions:

Meperidine use can also be affected by other medical conditions not listed here. You must ensure that your doctor is aware of your full medical condition and history before you begin use of this medication.

Warnings

Before you begin use of Meperidine it is important to understand the risks of use and weigh them against the benefits. Meperidine can be habit-forming if misused and can be life-threatening in high doses. Patients should consider all of this with their doctor having ensured that all of the following has been taken into account:

Allergies ' You must inform your doctor if you have ever reacted badly to any medication in the past. Inform them of all other allergies you suffer too including allergies to animals, dyes, preservatives, foods and other substances. In some cases use of this medication may be prevented by allergies.

Pediatric ' This medication has been tested for safety and efficiency in children aged 1+. The dose given must be calculated by the prescribing doctor but safety and efficiency of use has been established.

Geriatric' There are no known limitations in the use of this medication in elderly people. Elderly patients may be more sensitive to treatment and may need dose control, but there are know known age-specific requirements. Elderly patients may also have other medical problems that may limit the use of Meperidine.

Pregnancy ' You must inform your doctor that you are pregnant before beginning use. There is a category C risk through all trimesters to the use of this medication when pregnant. You should inform your doctor at once if you believe you have become pregnant during use of this treatment.

Breastfeeding' There are no adequate studies on the risks posed to infants from breastfeeding during use of Meperidine. You should weigh the potential risks against the benefits of use with your doctor before beginning treatment.

Your doctor will need to make regular checks on your progress when you are taking this medication. Doing so will allow the doctor to determine the effect of the treatment, determine whether you should continue using it and look for unwanted side effects. Do not miss appointments during use of this medication.

This medication should not ever be used within two weeks of having taken an MAO inhibitor. If Meperidine is used within this period you will experience confusion, agitation, restlessness, stomach problems, intestinal problems, high temperature, high blood pressure and potentially convulsions. Do not ever take these medications together.

Meperidine will increase the effect of central nervous system depressants. These are medications and substances that typically make you drowsy or less alert and these symptoms will be intensified with dangerous results. CNS depressants are commonplace and include but are not limited to the following:

  • Alcohol
  • Antihistamines
  • Cold medication
  • Cough syrup
  • Sedatives
  • Tranquilizers
  • Sleeping medication
  • Pain medication
  • Narcotics
  • Seizure medication
  • Barbiturates
  • Muscle relaxants
  • Anesthetics

You should not take or consume any of the above while you are taking Meperidine. The risk of doing so is severe and must not be realized. If you have any concerns about this or questions then you should consult your doctor for advice.

Meperidine can be habit-forming and should not be misused. If you do not think that the medication is working then contact your doctor. Do not take more than the instructed dose.

The use of medications such as Meperidine for long periods of time may cause you to suffer severe constipation. You may be directed to drink lots of fluid and increase the fiber in your diet to limit this effect. Alternatively or in addition to this you may be given laxatives. Follow all of these directions carefully as continued constipation can cause serious additional problems to occur.

You should rise from sitting and lying down slowly while you are using this medication to prevent yourself from fainting or becoming dizzy or lightheaded.

Before you undergo any kind of surgery you must inform your medical professional that you are taking this medication. You may need to stop use before you begin treatment.

When you have been taking this medication for a long time you will need to have your dose gradually reduced. Doing so will enable you to stop use without suffering withdrawal symptoms. You should not ever stop your use of this treatment suddenly.

Tell your doctor if you are pregnant or plan to become pregnant before you begin use. Harm to the baby can occur with use during pregnancy.

Do not ever take any other medication in conjunction with Meperidine unless it has been approved for use by your doctor. There are many drug interactions that can occur with Meperidine and the consequences of use can be severe.

Storage

This medication can be stored at room temperature. You should keep it out of direct light, away from heat and away from moisture. Prevent the medication from freezing.

Always keep this medication securely out of the reach of children, even when the medication is for their treatment.

You should not keep any outdated or unused medication. Dispose of it promptly and as directed by your healthcare professional.

Meperidine can cause serious unwanted effects when taken by people who have not been introduced slowly to strong pain medications. You should not store it where other adults may access it and take it inadvertently.

Summary

Meperidine is a narcotic analgesic that is used in the treatment of moderate to severe pain over the short-term. This medication should not be used in the treatment of chronic pain or any long-term conditions.

Use of Meperidine can be habit-forming and you must only ever use it as you have been directed to by your doctor. It should not ever be used in greater doses nor more frequently than prescribed. You should also never allow anyone else to use this medication. The effects of Meperidine on people who are not used to powerful pain medication can be very severe and may cause significant unwanted side effects to occur.

When patients have been taking this medication for a long period they will need to have their dose reduced gradually so that they may be able to cease use without the occurrence of withdrawal symptoms. Patients should never stop use or change their dose without first consulting their doctor for advice.

Meperidine can interact with a wide range of medications. Patients should not take any other medications with Meperidine unless they have been approved by the prescribing doctor. This includes all over the counter medications as well as prescribed treatments.

Patients being treated with Meperidine should not consume alcohol during use. To do so can cause serious unwanted side effects to occur. All central nervous system depressants should also be avoided during treatment.