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meperidine and promethazine

Generic Name: meperidine and promethazine (me PER i deen and pro METH a zeen)
Brand Name: Mepergan, Mepergan Fortis, Meprozine

What is meperidine and promethazine?

Meperidine is an opioid pain medication. An opioid is sometimes called a narcotic.

Promethazine is a sedative and anti-nausea medication.

Meperidine and promethazine is a combination medicine used to treat moderate to severe pain.

Meperidine and promethazine may also be used for purposes other than those listed in this medication guide.

What is the most important information I should know about meperidine and promethazine?

Meperidine and promethazine can slow or stop your breathing, and may be habit-forming. MISUSE OF THIS MEDICINE CAN CAUSE ADDICTION, OVERDOSE, OR DEATH, especially in a child or other person using the medicine without a prescription.

Meperidine and promethazine should not be given to a child younger than 2 years old.

Do not use this medicine if you have used an MAO inhibitor in the past 14 days, such as isocarboxazid, linezolid, methylene blue injection, phenelzine, rasagiline, selegiline, or tranylcypromine.

Taking this medicine during pregnancy may cause life-threatening withdrawal symptoms in the newborn.

Fatal side effects can occur if you use this medicine with alcohol, or with other drugs that cause drowsiness or slow your breathing.

What should I discuss with my health care provider before taking meperidine and promethazine?

Do not use meperidine and promethazine if you have used an MAO inhibitor in the past 14 days. A dangerous drug interaction could occur. MAO inhibitors include isocarboxazid, linezolid, methylene blue injection, phenelzine, rasagiline, selegiline, tranylcypromine, and others.

Meperidine and promethazine is not approved for use by anyone younger 2 years old.

To make sure meperidine and promethazine is safe for you, tell your doctor if you have ever had:

  • asthma or other breathing disorder;

  • a head injury, brain tumor, or increased pressure inside the skull;

  • epilepsy or other seizure disorder;

  • heart disease or a heart rhythm disorder;

  • low blood pressure;

  • stomach problems;

  • problems with your gallbladder, adrenal gland, or thyroid;

  • sickle cell anemia;

  • urination problems;

  • drug or alcohol addiction;

  • abnormal curvature of the spine that affects breathing;

  • liver or kidney disease; or

  • if you use a sedative like Valium (diazepam, alprazolam, lorazepam, Ativan, Klonopin, Restoril, Tranxene, Versed, Xanax, and others).

Some medicines can interact with meperidine and promethazine and cause a serious condition called serotonin syndrome. Be sure your doctor knows if you also take stimulant medicine, opioid medicine, herbal products, or medicine for depression, mental illness, Parkinson's disease, migraine headaches, serious infections, or prevention of nausea and vomiting. Ask your doctor before making any changes in how or when you take your medications.

If you use meperidine and promethazine while you are pregnant, your baby could become dependent on the drug. This can cause life-threatening withdrawal symptoms in the baby after it is born. Babies born dependent on habit-forming medicine may need medical treatment for several weeks. Tell your doctor if you are pregnant or plan to become pregnant.

Meperidine and promethazine can pass into breast milk and may cause side effects in the nursing baby. Tell your doctor if you are breast-feeding.

How should I take meperidine and promethazine?

Follow all directions on your prescription label. Meperidine and promethazine can slow or stop your breathing. Never take this medicine in larger amounts, or for longer than prescribed. Tell your doctor if the medicine seems to stop working as well in relieving your pain.

Meperidine and promethazine may be habit-forming. Never share this medicine with another person, especially someone with a history of drug abuse or addiction. MISUSE OF NARCOTIC MEDICINE CAN CAUSE ADDICTION, OVERDOSE, OR DEATH, especially in a child or other person using the medicine without a prescription. Selling or giving away meperidine and promethazine is against the law.

Take this medicine with a full glass of water.

Take meperidine with food or milk if it causes stomach upset.

Do not stop using meperidine and promethazine suddenly, or you could have unpleasant withdrawal symptoms. Ask your doctor how to safely stop using this medicine.

Store at room temperature away from moisture and heat.

Keep track of your medicine. Meperidine and promethazine is a drug of abuse and you should be aware if anyone is using your medicine improperly or without a prescription.

Do not keep unused meperidine and promethazine that is no longer needed. Ask your pharmacist where to locate a community drug take-back disposal program. If there is no take-back program, flush any unused medicine down the toilet.

What happens if I miss a dose?

Since meperidine and promethazine is used for pain, you are not likely to miss a dose. Skip any missed dose if it is almost time for your next scheduled dose. Do not use extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. A meperidine and promethazine overdose can be fatal, especially in a child or other person using the medicine without a prescription. Overdose symptoms may include slow breathing and heart rate, severe drowsiness, muscle weakness, cold and clammy skin, blue-colored skin or lips, fainting, or coma.

What should I avoid while taking meperidine and promethazine?

Do not drink alcohol. Dangerous side effects or death could occur.

Avoid driving or operating machinery until you know how this medicine will affect you. Dizziness or severe drowsiness can cause falls or other accidents.

Avoid exposure to sunlight or tanning beds. Meperidine and promethazine can make you sunburn more easily. Wear protective clothing and use sunscreen (SPF 30 or higher) when you are outdoors.

Meperidine and promethazine side effects

Get emergency medical help if you have signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Like other opioid medicines, meperidine and promethazine can slow your breathing. Death may occur if breathing becomes too weak.

A person caring for you should seek emergency medical attention if you have slow breathing with long pauses, blue colored lips, or if you are hard to wake up.

Call your doctor at once if you have:

  • noisy breathing, sighing, shallow breathing;

  • a slow heart rate or weak pulse;

  • severe weakness or drowsiness, feeling like you might pass out;

  • confusion, hallucinations, feeling anxious or agitated;

  • pounding heartbeats or fluttering in your chest;

  • loss of balance or coordination;

  • sudden ill feeling, fever, chills, sore throat, easy bruising or bleeding;

  • vision problems; or

  • severe nervous system reaction--very stiff (rigid) muscles, high fever, sweating, confusion, fast or uneven heartbeats, tremors, feeling like you might pass out.

Seek medical attention right away if you have symptoms of serotonin syndrome, such as: agitation, hallucinations, fever, sweating, shivering, fast heart rate, muscle stiffness, twitching, loss of coordination, nausea, vomiting, or diarrhea.

Serious side effects may be more likely in older adults and those who are overweight, malnourished, or debilitated.

Long-term use of opioid medication may affect fertility (ability to have children) in men or women. It is not known whether opioid effects on fertility are permanent.

Common side effects may include:

  • dizziness, drowsiness;

  • nausea, vomiting, constipation,

  • dry mouth;

  • flushing (warmth, redness, or tingly feeling); or

  • sweating.

This is not a complete list of side effects and others may occur. Tell your doctor about any unusual or bothersome side effect. You may report side effects to FDA at 1-800-FDA-1088.

Side effects (in more detail)

Meperidine and promethazine dosing information

Usual Adult Dose for Pain:

One capsule (meperidine 50 mg-promethazine 25 mg) orally every 4 to 6 hours as needed for pain.

Comments:
-The oral combination product has not been found to be safe and effective by the US FDA; its labeling has not been approved by the FDA.
-The parenteral combination product is approved by the US FDA; however, it is not currently marketed.

Uses: This drug is possibly effective as an analgesic for moderate to moderately-severe pain. Because of the risks of addiction, abuse, and misuse, this drug should only be used in patients for whom alternative treatment options have not been tolerated or are not expected to be tolerated.

What other drugs will affect meperidine and promethazine?

Narcotic (opioid) medication can interact with many other drugs and cause dangerous side effects or death. Be sure your doctor knows if you also use:

  • other narcotic medications--opioid pain medicine or prescription cough medicine;

  • drugs that make you sleepy or slow your breathing--a sleeping pill, muscle relaxer, sedative, tranquilizer, or antipsychotic medicine; or

  • drugs that affect serotonin levels in your body--medicine for depression, Parkinson's disease, migraine headaches, serious infections, or prevention of nausea and vomiting.

This list is not complete. Other drugs may interact with meperidine and promethazine, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed in this medication guide.

Where can I get more information?

  • Your pharmacist can provide more information about meperidine and promethazine.
  • Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
  • Disclaimer: Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

Copyright 1996-2012 Cerner Multum, Inc. Version: 2.01.

Last reviewed: August 21, 2017
Date modified: November 15, 2017

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