Adult Dosing
Relief of moderate to severe pain
- Usual dose: 50-150 mg PO q3-4 hrs as indicated
- Reduce the dose by 25-50% when co-administered with phenothiazines and certain tranquilizers
Notes:- Less effective orally than on parenteral administration
- Dose adjustment should be based on severity of the pain and the patient's response
Pediatric Dosing
Relief of moderate to severe pain
- Usual dose: 1.1 to 1.8 mg/kg PO up to the adult dose, q3-4 hrs as indicated
Notes:- Less effective orally than on parenteral administration
- Dose adjustment should be based on severity of the pain and the patient's response
[Outline]
See Supplemental Patient Information
- Avoid using meperidine for treatment of chronic pain; should only be used for acute episodes of moderate to severe pain. Long-term use may increase the risk of toxicity such as seizures
- Meperidine is an opioid agonist and a Schedule II controlled substance having an abuse liability similar to morphine. Strongly consider this when prescribing or dispensing this drug in situations where physician/pharmacist is concerned about an increased risk of misuse, abuse, or diversion
- If used in conjunction with alcohol, other opioids, or illicit drugs, it may result in additive CNS depressive effects
- Respiratory depressant effects of meperidine and secondary elevation of cerebrospinal fluid pressure may be markedly exaggerated in the presence of head injury, other intracranial lesions, or preexisting increase in intracranial pressure
- Use cautiously in patients having an acute asthmatic attack, chronic obstructive pulmonary disease or cor pulmonale, decreased respiratory reserve, preexisting respiratory depression, hypoxia, or hypercapnia, atrial flutter and other supraventricular tachycardias. In such patients, usual therapeutic doses of meperidine may decrease respiratory drive while simultaneously increasing airway resistance to the point of apnea
- Patients with depleted blood volume, or using meperidine with drugs such as phenothiazines or certain anesthetics may be prone to severe hypotension
- Advise patients not to involve in potentially hazardous tasks such as driving a car or operating machinery after consuming this drug, as it may impair their mental and/or physical abilities. Orthostatic hypotension may result in ambulatory patients
- Avoid using meperidine in pregnant women prior to the labor period
- Meperidine may produce depression of respiration and psychophysiologic functions in the newborn indicating resuscitation; hence, not recommended during labor
- Use cautiously in patients who are concurrently receiving CNS depressants including sedatives or hypnotics, general anesthetics, phenothiazines, other tranquilizers, and alcohol because it may produce respiratory depression, hypotension, profound sedation, or coma
- Patients receiving meperidine should use agonist/antagonist analgesics with caution
- Preexisting convulsions may be aggravated with the administration of meperidine in patients with convulsive disorders; convulsions may occur in individuals without a history of convulsive disorders
- Therapy may obscure the diagnosis or clinical course in patients with acute abdominal conditions
- Tolerance and physical dependence may result during chronic opioid therapy
Cautions: Use cautiously in
- Renal impairment
- Hepatic impairment
- Head injury or intracranial lesions
- CNS depression
- Seizure disorder
- Pulmonary impairment
- Prostatic hypertrophy
- Urethral stricture
- Adrenal insufficiency
- Myxedema or hypothyroidism
- Substance abuse
- Acute alcoholism
- Sickle cell anemia
- Addison’s disease
- Pheochromocytoma
- Delirium tremens
- Toxic psychosis
- Kyphoscoliosis with respiratory depression
- Labor and delivery
- Neonates or infants
- Elderly or debilitated patients
Supplemental Patient Information
- Caution patients that the therapy could impair the mental and/or physical abilities needed to perform potentially hazardous activities such as driving a car or operating heavy machinery
- Caution patients about the potential additive effects of meperidine on concomitant use with other CNS depressants, including other opioids, phenothiazines, sedative/hypnotics and alcohol
- Instruct patients to avoid abrupt discontinuation of the drug as it could precipitate withdrawal symptoms during cessation of therapy. Provide a dose schedule to accomplish an effective and safe tapering and a gradual discontinuation of the medication
- Advise women of childbearing potential who become or are trying to become pregnant to consult a physician before initiating or continuing therapy with meperidine
Pregnancy Category:C
Breastfeeding: This drug is compatible and considered safe during breastfeeding based upon data from AAP Policy Guidelines (available at http://aappolicy.aappublications.org/cgi/content/full/pediatrics;108/3/776). Single dose for anesthesia or conscious sedation usually does not cause problems in older breastfed infants. If the baby shows signs of increased sleepiness (more than usual), difficulty breastfeeding, breathing difficulties, or limpness, a physician should be contacted immediately. This information is based upon LactMed database (available at http://toxnet.nlm.nih.gov/cgi-bin/sis/htmlgen?LACT last accessed 28 April 2011). As per manufacturer's data, because of the potential for serious adverse reactions in nursing infants, a decision should be made whether to discontinue nursing or to discontinue the drug, analyzing the importance of the drug to the mother.
Pricing data from www.DrugStore.com in U.S.A.
- Demerol 50 MG TABS [Bottle] (SANOFI-AVENTIS U.S.)
30 mg = $55.07
90 mg = $157.65 - Meperidine HCl 50 MG/5ML SOLN [Bottle] (ROXANE)
500 5ml = $69.99
1500 5ml = $209.98 - Meperidine HCl 100 MG TABS [Bottle] (TEVA PHARMACEUTICALS USA)
20 mg = $26.66
30 mg = $39.99 - Meperidine HCl 50 MG TABS [Bottle] (TEVA PHARMACEUTICALS USA)
20 mg = $19.99
30 mg = $27.99
Warning: This pricing information is subject to change at the sole discretion of DS Pharmacy. For the most current and up-to-date pricing information, please visit drugstore.com.
