What is pethidine used for?
- Pethidine, also known in the US as meperidine (brand name: Demerol), is classified as a prescription opioid pain medication (opioid analgesic), also called a narcotic. Pethidine is used for the relief of moderate to severe pain for which alternative treatments are inadequate.
- In the US, it was first approved for medical use by the FDA in 1942 by the name of meperidine. It is classified by the DEA as Schedule II Controlled Substance. Meperidine is considered a high-alert drug in the US due to a significant risk of dangerous side effects when used in error. Newer and safer opioids for pain management are now available.
- The American Pain Society and Institute for Safe Medication Practices (ISMP) do not recommend meperidine's use as an analgesic. Significant risk may exist in the elderly (65 years of age or older), those with kidney dysfunction and in pediatric patients.
In the US, meperidine is available as a brand name product and as a generic. The generic form is available commercially as an oral tablet, oral syrup, and injection (including a preservative-free injection). The brand name Demerol product is only available as an injection. The injection is given via subcutaneous, intramuscular, or intravenous (IV) administration.
According to Health Canada, meperidine is only available as a 50 mg/mL injection in that country. The brand name form Demerol is no longer listed as an available medicine in the Canadian Drug Product Database.
In some countries, this medicine may only be approved for veterinary use.
Is pethidine available in the US?
Pethidine is available in the US by the generic name of meperidine.
- Demerol (Meperidine Hydrochloride) Injection; 25 mg/mL, 50 mg/mL, 75 mg/mL, and 100 mg/mL
- Meperidine Hydrochloride injection; Preservative Free; 10 mg/mL
- Meperidine Hydrochloride Oral Tablet; 50 mg
- Meperidine Hydrochloride Injection; 25 mg/mL, 50 mg/mL, 75 mg/mL, and 100 mg/mL
- Meperidine Hydrochloride oral syrup; 50 mg/5mL
Because meperidine comes in multiple strengths, the US package insert contains a Boxed Warning to ensure accuracy when prescribing, dispensing, and administering Meperidine Hydrochloride Oral Solution. Dosing errors due to confusion between mg and mL, and other Meperidine Hydrochloride Oral Solutions of different concentrations, can result in accidental overdose and death.
Because it is an opioid narcotic, meperidine is associated with a risk of addiction, misuse, overdose and fatal respiratory depression. Additional Boxed Warnings include:
- accidental ingestion (especially by children) can be fatal
- neonatal opioid withdrawal syndrome
- risks of CPY 3A4 drug interactions
- risk of profound sedation, respiratory depression, coma, and death when used with other CNS depressants; including alcohol
- and use of meperidine with MAOIs within last 14 days is contraindicated
How does pethidine come in the United Kingdom (UK)?
Pethidine is the common (generic) name used in the UK for meperidine.
- Pethidine 50 mg/mL Solution for Injection
- Pethidine Hydrochloride 50 mg Tablets
- Pethidine Hydrochloride 50 mg/mL Solution for Injection
- Pethidine Injection BP
- Pethidine Injection BP 50 mg/mL and 100 mg/2 mL
- Pethidine Tablets BP 50 mg
What is the chemical formula, molecular weight, and chemical names for pethidine (meperidine)?
- 4-Piperidinecarboxylic acid, 1-metyl-4-phenyl-, etyl ester
- Etyl-1-metyl-4-phenylpiperidine-4-carboxylate (IUPAC)
Which countries have pethidine available?
Pethidine is available in multiple countries around the world, but may be found by a different generic or brand name. Note that some medications may also be available in countries not listed or recently discontinued in that country. Always consult country-specific product labeling before use.
Countries that pethidine, meperidine, or its equivalent may be found in include:
- Hong Kong
- New Zealand
- South Africa
- United States
- United Kingdom
This information is not a substitute for the expertise and judgement of your physician, pharmacist or other healthcare provider. It does not mean that the use of any medication in any country is safe, legal, appropriate or effective for you. Consult with your healthcare professional before taking any medication.
- HIGH ALERT Medication Feature: Reducing Patient Harm from Opiates. Institute for Safe Medication Practices (ISMP). Accessed June 30, 2022 at https://www.ismp.org/resources/high-alert-medication-feature-reducing-patient-harm-opiates
- Meperidine. Prescribing information. March 1, 2021. Drugs.com. Accessed June 30, 2022 at https://www.drugs.com/pro/meperidine.html
- Pethidine 50 mg tablets. Martindale Pharma. Dec. 2020. https://www.medicines.org.uk/emc/files/pil.3402.pdf
- Meperidine-pethidine drug information. Up to Date. Accessed June 30, 2022 at https://www.uptodate.com/contents/meperidine-pethidine-drug-information
- Government of Canada. Drug Product Database. Accessed June 30, 2022 at https://health-products.canada.ca/dpd-bdpp/dispatch-repartition.do