section name header

Information

AHFS Class:

28:08.08 Opiate Agonists


Generic Name

Pethidine Hydrochloride

Products

Meperidine hydrochloride is available as an injection solution in concentrations of 25, 50, 75, and 100 mg/mL in 1-mL single-dose vials, prefilled syringes, or cartridges.436; 437 Each mL contains meperidine hydrochloride 25, 50, 75, or 100 mg in water for injection with sodium hydroxide and hydrochloric acid or acetic acid and sodium acetate for pH adjustment.436; 437 Sodium chloride may have been added for isotonicity.436

Meperidine hydrochloride 50 mg/mL is also available in 30-mL multiple-dose vials with each mL containing meperidine hydrochloride 50 mg and metacresol 1 mg as a preservative with sodium hydroxide and hydrochloric acid for pH adjustment.436

Equivalency

Meperidine hydrochloride 25, 50, 75, or 100 mg is equivalent to 21.79, 43.58, 65.36, or 87.15 mg, respectively, of meperidine.436

pH

The pH is adjusted to 3.5 to 6.436; 437

Osmolality

The osmolality of meperidine hydrochloride 50 mg/mL was determined to be 302 mOsm/kg.1233

Trade Name(s)

Demerol

Administration

Meperidine hydrochloride is administered by intramuscular or subcutaneous injection, or by slow intravenous injection or intravenous infusion following dilution.436; 437 A concentration of 10 mg/mL of meperidine hydrochloride has been recommended for slow intravenous injection and a concentration of 1 mg/mL has been recommended for continuous intravenous infusion.436

Stability

Meperidine hydrochloride in intact containers should be stored at controlled room temperature.436; 437 The solution should be clear and colorless.436; 437 Do not use if the color is darker than pale yellow, or if any other discoloration or precipitate is present.436

Syringes

Meperidine hydrochloride (Wyeth) 5 and 10 mg/mL in dextrose 5% and sodium chloride 0.9% was packaged in 30-mL Plastipak (Becton Dickinson) syringes capped with Monoject (Sherwood) tip caps. Syringes were stored at 23°C exposed to light and protected from light, 4°C protected from light, and frozen at -20°C protected from light for 12 weeks. Both concentrations at all storage conditions were stable for at least 12 weeks.1894

Preservative-free meperidine hydrochloride (Abbott) was diluted to concentrations of 0.25, 1, 10, 20, and 30 mg/mL with dextrose 5% and with sodium chloride 0.9%. The solutions were packaged in 60-mL polypropylene syringes (Becton Dickinson), sealed with Luer lock caps, and stored at 22 and 4°C for 28 days protected from light. The solutions were visually colorless and free of precipitation over the course of the study. Little or no loss of meperidine hydrochloride occurred in either solution at either temperature in 28 days.2200

Sorption

Meperidine hydrochloride was shown not to exhibit sorption to PVC bags and tubing, polyethylene tubing, Silastic tubing, and polypropylene syringes.536; 606

Central Venous Catheter

Meperidine hydrochloride (Wyeth) 4 mg/mL in dextrose 5% was found to be compatible with the ARROWg+ard Blue Plus (Arrow International) chlorhexidine-bearing triple-lumen central catheter. Essentially complete delivery of the drug was found with little or no drug loss occurring. Furthermore, chlorhexidine delivered from the catheter remained at trace amounts with no substantial increase due to the delivery of the drug through the catheter.2335

Compatibility

Solution Compatibility

Additive Compatibility

Drugs in Syringe Compatibility

Y-Site Injection Compatibility (1:1 Mixture)

Additional Compatibility Information

Chlorpromazine and Hydroxyzine

Chlorpromazine hydrochloride (Elkins-Sinn) 6.25 mg/mL, hydroxyzine hydrochloride (Pfizer) 12.5 mg/mL, and meperidine hydrochloride (Winthrop) 25 mg/mL, in both glass and plastic syringes, have been reported to be physically compatible and chemically stable for at least 1 year at 4 and 25°C when protected from light.989

Chlorpromazine and Promethazine

Chlorpromazine hydrochloride, meperidine hydrochloride, and promethazine hydrochloride combined as an extemporaneous mixture for preoperative sedation, developed a brownish-yellow color after 2 weeks of storage with protection from light. The discoloration was attributed to the metacresol preservative content of the meperidine hydrochloride product used. Use of meperidine hydrochloride which contains a different preservative resulted in a solution that remained clear and colorless for at least 3 months when protected from light.1148

Other Info

References

For a list of references cited in the text of this monograph, search the monograph titled References.

Copyrights

ASHP® Injectable Drug InformationTM. Selected Revisions March 31, 2024. © Copyright, 2024. American Society of Health-System Pharmacists®, 4500 East-West Highway, Suite 900, Bethesda, Maryland 20814.