Demerol

MEPERIDINE HYDROCHLORIDE

Manufacturer: Validus Pharmaceuticals LLC

Score: 144.0

Quick Summary

Meperidine Hydrochloride is an opioid agonist used for the management of pain severe enough to require an opioid analgesic and for which alternative treatments are inadequate. It is also used for preoperative medication, support of anesthesia, and obstetrical analgesia. The drug has several warnings, including the risk of addiction, abuse, and misuse, life-threatening respiratory depression, and neonatal opioid withdrawal syndrome. Meperidine Hydrochloride should be used with caution in patients with significant respiratory depression, acute or severe bronchial asthma, and gastrointestinal obstruction. The initial dose for adults is 50 mg to 150 mg intramuscularly or subcutaneously every 3 to 4 hours, while children should receive 0.5 mg/lb to 0.8 mg/lb intramuscularly or subcutaneously up to the adult dose every 3 to 4 hours. Special population considerations include use during pregnancy, pediatric use, and geriatric use, with caution advised due to the potential for adverse effects.

Key Clinical Findings and Indications

Management of pain severe enough to require an opioid analgesic
Preoperative medication
Support of anesthesia
Obstetrical analgesia

Important Safety Information

Warning

Addiction, abuse, and misuse; life-threatening respiratory depression; neonatal opioid withdrawal syndrome

Contraindications

Significant respiratory depression
Acute or severe bronchial asthma
Concomitant use of monoamine oxidase inhibitors (MAOIs) or within 14 days of having taken an MAOI
Known or suspected gastrointestinal obstruction
Hypersensitivity to meperidine

Adverse Reactions

Respiratory depression
Nausea
Vomiting
Sweating
Lightheadedness
Dizziness
Sedation

Dosing Recommendations

General Guidance

Titrate the dosage of Meperidine Hydrochloride Injection slowly in geriatric patients and monitor closely for signs of central nervous system and respiratory depression

Pain management

Adult Dose

50 mg to 150 mg intramuscularly or subcutaneously every 3 to 4 hours

Pediatric Dose

0.5 mg/lb to 0.8 mg/lb intramuscularly or subcutaneously up to the adult dose every 3 to 4 hours

Preoperative medication

Adult Dose

50 mg to 100 mg intramuscularly or subcutaneously, 30 to 90 minutes before the beginning of anesthesia

Pediatric Dose

0.5 mg/lb to 1 mg/lb intramuscularly or subcutaneously up to the adult dose, 30 to 90 minutes before the beginning of anesthesia

Special Population Considerations

Pregnancy

Prolonged use of opioid analgesics during pregnancy may cause neonatal opioid withdrawal syndrome
Use during pregnancy only if the potential benefit justifies the potential risk to the fetus

Nursing Mothers

Meperidine is excreted in breast milk
Caution should be exercised when meperidine is administered to a nursing woman

Pediatric Use

The safety and efficacy of Meperidine Hydrochloride Injection in patients less than 18 years of age have not been established
Neonates and young infants may be more susceptible to the effects of meperidine

Geriatric Use

Elderly patients may have increased sensitivity to meperidine
Use caution when selecting a dosage for an elderly patient, usually starting at the low end of the dosing range