Meperidine (Injection)

Meperidine (Injection) is used to relieve moderate to severe pain. It may be used before or during surgery, or to ease pain during labor or delivery. Meperidine is part of a group of medicines called narcotic analgesics (pain medicines). It works on the central nervous system (CNS) to relieve pain.

When a narcotic medicine is used for a long time, it may become habit-forming, leading to mental or physical dependence. However, people with ongoing pain should not let the fear of dependence stop them from using narcotics to manage their pain. Mental dependence (addiction) is unlikely to happen when narcotics are used for this reason. Physical dependence may cause withdrawal side effects if treatment is stopped suddenly. However, severe withdrawal side effects can usually be avoided by slowly reducing the dose over time before stopping treatment completely.

This medicine is available only with your doctor's prescription.

It is very important for your doctor to check your progress while you are taking this medicine. This ensures that the medicine is working correctly and allows your doctor to monitor for any unwanted effects.

Do not use this medicine if you are currently using or have used a monoamine oxidase (MAO) inhibitor (for example, Eldepryl®, Marplan®, Nardil®, Parnate®) in the past 2 weeks. Using these medicines together may lead to unwanted effects such as confusion, agitation, restlessness, stomach or intestinal issues, a sudden high temperature, extremely high blood pressure, or convulsions.

Symptoms of an overdose include extreme dizziness or weakness, slow heartbeat or breathing, seizures, trouble breathing, and cold, clammy skin. Call your doctor immediately if you notice these symptoms.

This medicine will increase the effects of alcohol and other CNS depressants (medicines that can make you sleepy or less alert). Examples of CNS depressants include antihistamines or medicines for allergies or colds, sedatives, tranquilizers, or sleeping medicines, other prescription pain medicines or narcotics, medicines for seizures or barbiturates, muscle relaxants, or anesthetics, including some dental anesthetics. Check with your doctor before taking any of these medicines while using this medicine.

This medicine may cause sleep-related breathing problems (for example, sleep apnea or sleep-related hypoxemia). Your doctor may lower your dose if you have sleep apnea (when you stop breathing for short periods while sleeping) while using this medicine.

This medicine may be habit-forming. If you feel that the medicine is not working as well, do not take more than your prescribed dose. Call your doctor for guidance.

Using narcotics for a long time can cause severe constipation. To prevent this, your doctor may advise you to take laxatives, drink plenty of fluids, or increase your fiber intake. Be sure to follow these instructions carefully, as ongoing constipation can lead to more serious issues.

Dizziness, lightheadedness, or fainting may happen when you get up suddenly from lying down or sitting. Getting up slowly may help reduce this issue. Also, lying down for a while may relieve the dizziness or lightheadedness.

This medicine may cause dizziness, drowsiness, confusion, or disorientation. Make sure you know how this medicine affects you before you drive, operate machinery, or do anything else that could be dangerous if you are dizzy or not alert.

Before any kind of surgery (including dental surgery) or emergency treatment, inform the medical doctor or dentist in charge that you are using this medicine. Serious unwanted effects can occur if certain medicines are given along with Meperidine (Injection).

Contact your doctor immediately if you experience anxiety, restlessness, a fast heartbeat, fever, sweating, muscle spasms, twitching, nausea, vomiting, diarrhea, or seeing or hearing things that are not there. These may be signs of a serious condition called serotonin syndrome. Your risk may increase if you are also taking other medicines that affect serotonin levels in your body.

If you have been using this medicine regularly for several weeks or longer, do not suddenly stop using it without consulting your doctor. Your doctor may want you to gradually reduce your dosage before stopping completely. This can help prevent worsening of your condition and minimize the risk of withdrawal symptoms, such as abdominal cramps, anxiety, fever, nausea, runny nose, sweating, tremors, or trouble sleeping.

Using this medicine while pregnant may cause neonatal withdrawal syndrome in your newborn. Inform your doctor immediately if your baby has abnormal sleep patterns, diarrhea, a high-pitched cry, irritability, shakiness or tremors, weight loss, vomiting, or does not gain weight.

Using too much of this medicine may lead to infertility (being unable to have children). Speak with your doctor before using this medicine if you plan to have children.

Do not take other medicines unless you have discussed them with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.

In deciding to use a medication, the chances of using the medication must be weighed against the beneficial it will do. This is a decision you and your clinician will make. For this medicine, the following should be considered:

Allergies

Tell your physician if you have ever had any unusual or allergic reaction to this medication or any other medicines. Also inform your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Pediatric

Appropriate studies have not been performed on the relationship of age to the effects of meperidine injection in children. Safety and efficacy have not been established.

Geriatric

Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of Demerol™ in the elderly. However, elderly patients are more likely to have age-related kidney, liver, heart, or lung problems, which may require caution and an adjustment in the dose for patients receiving Demerol™.

No information is available on the relationship of age to the effects of meperidine injection in geriatric patients. Nevertheless, elderly patients are more likely to have age-related kidney or liver problems, which may require caution and an adjustment in the dose for patients receiving meperidine injection.

Breast Feeding

There are no adequate studies in women for determining infant risk when using this medicine during breastfeeding. Weigh the potential benefits against the potential chances before using this drug while breastfeeding.

Interactions with Drugs

Although certain drugs should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your clinician may want to change the dose, or other precautions may be necessary. When you are receiving this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using this medication with any of the following medicines is not recommended. Your doctor may decide not to treat you with this drug or change some of the other medicines you take.

• Furazolidone
• Iproniazid
• Isocarboxazid
• Linezolid
• Methylene Blue
• Moclobemide
• Nalmefene
• Naltrexone
• Nialamide
• Phenelzine
• Procarbazine
• Rasagiline
• Safinamide
• Samidorphan
• Selegiline
• Toloxatone
• Tranylcypromine

Using this drug with any of the following medicines is normally not advised, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the drugs.

• Acepromazine
• Alfentanil
• Almotriptan
• Alprazolam
• Amifampridine
• Amineptine
• Amiodarone
• Amitriptyline
• Amitriptylinoxide
• Amobarbital
• Amoxapine
• Amphetamine
• Amprenavir
• Anileridine
• Aprepitant
• Aripiprazole
• Armodafinil
• Asenapine
• Atazanavir
• Baclofen
• Benperidol
• Benzhydrocodone
• Benzphetamine
• Boceprevir
• Bosentan
• Bromazepam
• Bromopride
• Brompheniramine
• Buprenorphine
• Bupropion
• Buspirone
• Butabarbital
• Butorphanol
• Calcium Oxybate
• Cannabidiol
• Cannabis
• Carbamazepine
• Carbinoxamine
• Carisoprodol
• Carphenazine
• Cetirizine
• Chloral Hydrate
• Chlordiazepoxide
• Chlorpheniramine
• Chlorpromazine
• Chlorzoxazone
• Cimetidine
• Ciprofloxacin
• Citalopram
• Clarithromycin
• Clobazam
• Clomipramine
• Clonazepam
• Clopidogrel
• Clorazepate
• Clozapine
• Cobicistat
• Cocaine
• Codeine
• Conivaptan
• Crizotinib
• Cyclobenzaprine
• Cyclosporine
• Daridorexant
• Darunavir
• Delavirdine
• Desipramine
• Desmopressin
• Desvenlafaxine
• Dexamethasone
• Dexmedetomidine
• Dextroamphetamine
• Dextromethorphan
• Dezocine
• Diazepam
• Dibenzepin
• Dichloralphenazone
• Difenoxin
• Dihydrocodeine
• Diltiazem
• Diphenhydramine
• Diphenoxylate
• Dixyrazine
• Dolasetron
• Donepezil
• Doxepin
• Doxylamine
• Dronedarone
• Droperidol
• Duloxetine
• Efavirenz
• Eletriptan
• Enflurane
• Enzalutamide
• Erythromycin
• Escitalopram
• Esketamine
• Eslicarbazepine Acetate
• Estazolam
• Eszopiclone
• Ethchlorvynol
• Ethopropazine
• Ethylmorphine
• Etravirine
• Fenfluramine
• Fentanyl
• Flibanserin
• Fluconazole
• Fluoxetine
• Fluphenazine
• Flurazepam
• Fluspirilene
• Fluvoxamine
• Fosamprenavir
• Fosaprepitant
• Fosphenytoin
• Fospropofol
• Frovatriptan
• Gabapentin
• Gabapentin Enacarbil
• Gepirone
• Granisetron
• Halazepam
• Haloperidol
• Halothane
• Hexobarbital
• Hydrocodone
• Hydromorphone
• Hydroxyamphetamine
• Hydroxytryptophan
• Hydroxyzine
• Idelalisib
• Imatinib
• Imipramine
• Indinavir
• Isoflurane
• Itraconazole
• Ivacaftor
• Ketamine
• Ketazolam
• Ketobemidone
• Ketoconazole
• Lacosamide
• Lasmiditan
• Lemborexant
• Levocetirizine
• Levomilnacipran
• Levorphanol
• Lisdexamfetamine
• Lithium
• Lofepramine
• Lofexidine
• Lomitapide
• Lopinavir
• Lorazepam
• Lorcaserin
• Loxapine
• Lumacaftor
• Magnesium Oxybate
• Meclizine
• Melitracen
• Melperone
• Mephobarbital
• Meprobamate
• Meptazinol
• Mesoridazine
• Metaxalone
• Methadone
• Methamphetamine
• Methocarbamol
• Methohexital
• Methotrimeprazine
• Metopimazine
• Mibefradil
• Midazolam
• Mifepristone
• Milnacipran
• Mirtazapine
• Mitotane
• Modafinil
• Molindone
• Moricizine
• Morphine
• Morphine Sulfate Liposome
• Nafcillin
• Nalbuphine
• Naratriptan
• Nefazodone
• Nelfinavir
• Nevirapine
• Nicomorphine
• Nilotinib
• Nirmatrelvir
• Nitrazepam
• Nitrous Oxide
• Nortriptyline
• Olanzapine
• Ondansetron
• Opipramol
• Opium
• Opium Alkaloids
• Orphenadrine
• Oxazepam
• Oxcarbazepine
• Oxycodone
• Oxymorphone
• Ozanimod
• Palbociclib
• Palonosetron
• Papaveretum
• Paregoric
• Paroxetine
• Pentazocine
• Pentobarbital
• Perampanel
• Perazine
• Periciazine
• Perphenazine
• Phenobarbital
• Phenytoin
• Pimozide
• Piperacetazine
• Pipotiazine
• Piritramide
• Posaconazole
• Potassium Oxybate
• Prazepam
• Prednisone
• Pregabalin
• Primidone
• Prochlorperazine
• Promazine
• Promethazine
• Propiomazine
• Propofol
• Protriptyline
• Quazepam
• Quetiapine
• Ramelteon
• Ranitidine
• Ranolazine
• Remifentanil
• Remimazolam
• Remoxipride
• Rifabutin
• Rifampin
• Rifapentine
• Rizatriptan
• Ropeginterferon Alfa-2b-njft
• Saquinavir
• Scopolamine
• Secobarbital
• Sertindole
• Sertraline
• Sibutramine
• Sodium Oxybate
• St John's Wort
• Sufentanil
• Sulpiride
• Sumatriptan
• Suvorexant
• Tapentadol
• Telaprevir
• Telithromycin
• Temazepam
• Thiethylperazine
• Thiopental
• Thiopropazate
• Thioproperazine
• Thioridazine
• Tianeptine
• Tilidine
• Tizanidine
• Tolonium Chloride
• Topiramate
• Tramadol
• Trazodone
• Triazolam
• Trifluoperazine
• Trifluperidol
• Triflupromazine
• Trimeprazine
• Trimipramine
• Tryptophan
• Venlafaxine
• Verapamil
• Vilazodone
• Voriconazole
• Vortioxetine
• Zaleplon
• Ziprasidone
• Zolmitriptan
• Zolpidem
• Zopiclone
• Zotepine
• Zuranolone

Using this medication with any of the following medicines may cause an increased chance of certain side effects, but using both drugs may be the best treatment for you. If both medications are prescribed together, your clinician may change the dose or how often you use one or both of the medications.

• Isoniazid
• Ritonavir

Interactions with Food/Tobacco/Alcohol

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may additionally cause interactions to occur. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using this medicine with any of the following is usually not advised, but may be unavoidable in some cases. If used together, your doctor may change the dose or how frequently you use this medicine, or give you special instructions about the use of food, alcohol, or tobacco.

• Grapefruit Juice

Using this medication with any of the following may cause an increased risk of certain side effects but may be unavoidable in some cases. If used together, your doctor may change the dose or how frequently you use this drug, or give you special instructions about the use of food, alcohol, or tobacco.

• Ethanol

Other Medical Problems

The presence of other medical problems may affect the use of this medication. Make sure you inform your doctor if you have any other medical issues, especially:

• Addison's disease (adrenal gland issue) or
• Alcohol abuse, or history of or
• Brain tumor or
• Breathing issues, serious (eg, COPD, hypercapnia, hypoxia, sleep apnea) or
• Cor pulmonale (serious heart condition) or
• Depression, or history of or
• Drug dependence, especially with narcotics, or history of or
• Enlarged prostate (BPH, prostatic hypertrophy) or
• Head injuries, history of or
• Hypothyroidism (an underactive thyroid) or
• Pheochromocytoma (adrenal issue) or
• Issues with passing urine or
• Weakened physical condition—Use with caution. May raise chance for more serious side effects.

• Gallbladder issues or
• Heart rhythm issues (eg, atrial flutter, tachycardia) or
• Hypotension (low blood pressure) or
• Hypovolemia (low blood volume) or
• Pancreatitis (inflammation of the pancreas) or
• Seizures, history of—Use with caution. May make these conditions worse.

• Kidney disease or
• Liver disease—Use with caution. The effects may be increased because of slower removal of the medicine from the body.

• Lung or breathing issues (eg, asthma, respiratory depression), severe or
• Stomach or bowel blockage (eg, paralytic ileus)—Should not be used in patients with these conditions.

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor or nurse immediately if any of the following side effects occur:

Incidence not known

• Bluish color
• blurred vision
• changes in skin color
• chest pain or discomfort
• cold, clammy skin
• confusion
• convulsions
• difficult or troubled breathing
• dizziness
• dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position
• face is warm or hot to the touch
• fainting
• fast, pounding, or irregular heartbeat
• fast or weak pulse
• irregular, fast, slow, or shallow breathing
• pain
• pale or blue lips, fingernails, or skin
• redness to the face
• shakiness in the legs, arms, hands, or feet
• slow or irregular heartbeat
• sweating
• swelling of the foot or leg
• tenderness
• trembling or shaking of the hands or feet
• unconsciousness
• uncoordinated movement of the muscles
• unusual tiredness or weakness
• upper abdominal or stomach pain
• very low blood pressure or pulse
• very slow breathing

Get emergency help immediately if any of the following symptoms of overdose occur:

Symptoms of overdose

• Bluish lips or skin
• change in consciousness
• decreased awareness or responsiveness
• loss of consciousness
• severe sleepiness
• sleepiness or unusual drowsiness

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common

• Drowsiness
• nausea
• relaxed or calm feeling
• sleepiness
• sweating
• vomiting

Incidence not known

• Anxiety
• blurred or loss of vision
• confusion about identity, place, and time
• constipation
• disturbed color perception
• double vision
• dry mouth
• false or unusual sense of well-being
• halos around lights
• hardening or thickening of the skin
• headache
• hives or welts, itching skin, or rash
• hyperventilation
• irritability
• nervousness
• night blindness
• overbright appearance of lights
• red streaks on the skin
• redness of the skin
• restlessness
• seeing, hearing, or feeling things that are not there
• shaking or tremors
• swelling, tenderness, or pain at the injection site
• trouble sleeping
• tunnel vision
• weakness

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

In the U.S.

• Demerol

Available Dosage Forms:

• Solution

Therapeutic Class: Analgesic

Chemical Class: Opioid

A nurse or other trained health professional will give you this medicine in a hospital. This medicine is given through a needle placed in one of your veins, or as a shot under your skin or in a muscle.

Meperidine may sometimes be given at home to patients who do not need to be in the hospital or clinic. If you are using this medicine at home, your doctor or nurse will teach you how to prepare and inject the medicine. Be sure that you understand how to use the medicine.

You will be shown the body areas where this shot can be given. Use a different body area each time you give yourself a shot. Keep track of where you give each shot to make sure you rotate body areas. This will help prevent skin problems from the injections.

You might not use all of the medicine in each ampul or cartridge. Use each ampul or cartridge only one time. If the medicine in the vial or syringe has changed color, or if you see particles in it, do not use it.

Use a new needle and syringe each time you inject your medicine.

Throw away used needles in a hard, closed container that the needles cannot poke through. Keep this container away from children and pets.

Dosing

The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

• For injection dosage form:For moderate to severe pain: Adults—At first, 50 to 150 milligrams (mg) injected into a muscle or under your skin every 3 or 4 hours as needed. Children—Dose is based on body weight and must be determined by your doctor. The dose is usually 0.5 to 0.8 milligram (mg) per pound (lb) injected into a muscle or under your skin every 3 or 4 hours as needed.

Missed Dose

If you miss a dose of this medicine, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.

Storage

Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing.

Keep out of the reach of children.

Do not keep outdated medicine or medicine no longer needed.

Ask your healthcare professional how you should dispose of any medicine you do not use.

• What is pethidine used for?