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meperidine

Pronunciation

Generic Name: meperidine (me PER i deen)
Brand Name: Demerol HCl

What is meperidine?

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

Meperidine is used to treat moderate-to-severe pain.

Meperidine may also be used for purposes not listed in this medication guide.

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

You should not use meperidine if you have severe asthma or breathing problems.

Meperidine can slow or stop your breathing, and may be habit-forming. Use only your prescribed dose. Never share meperidine with another person.

MISUSE OF NARCOTIC MEDICINE CAN CAUSE ADDICTION, OVERDOSE, OR DEATH, especially in a child or other person using the medicine without a prescription.

Meperidine may cause life-threatening withdrawal symptoms in a newborn if the mother has taken this medicine during pregnancy.

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

What should I discuss with my healthcare provider before taking meperidine?

You should not use meperidine if you are allergic to it, or if you have severe asthma or breathing problems.

Do not use meperidine 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.

Some medicines can interact with meperidine and cause a serious condition called serotonin syndrome. Be sure your doctor knows if you also take 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.

To make sure meperidine is safe for you, tell your doctor if you have:

  • any type of breathing problem or lung disease;

  • a blockage in your stomach or intestines;

  • a history of head injury, brain tumor, or seizures;

  • a history of drug abuse, alcohol addiction, or mental illness;

  • urination problems;

  • liver or kidney disease;

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

  • sickle cell anemia;

  • abnormal curvature of the spine that affects breathing; or

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

It is not known whether meperidine will harm an unborn baby. Meperidine may cause breathing problems in your newborn if you use the medication during late pregnancy. Tell your doctor if you are pregnant.

Meperidine can pass into breast milk and may harm a nursing baby. You should not breast-feed while you are using meperidine.

How should I take meperidine?

Follow all directions on your prescription label. Meperidine can slow or stop your breathing, especially when you start using this medicine or whenever your dose is changed. Never take meperidine 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 may be habit-forming, even at regular doses. 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 is against the law.

Measure liquid medicine with the dosing syringe provided, or with a special dose-measuring spoon or medicine cup. If you do not have a dose-measuring device, ask your pharmacist for one.

Do not stop using meperidine suddenly after long-term use, or you could have unpleasant withdrawal symptoms. Ask your doctor how to avoid withdrawal symptoms when you stop using meperidine.

Never crush or break a meperidine pill to inhale the powder or mix it into a liquid to inject the drug into your vein. This practice has resulted in death with the misuse of meperidine and similar prescription drugs.

Store at room temperature away from moisture and heat.

Keep track of the amount of medicine used from each new bottle. Meperidine is a drug of abuse and you should be aware if anyone is using your medicine improperly or without a prescription.

Do not keep leftover meperidine pills or liquid. Ask your pharmacist where to locate a drug take-back disposal program. If there is no take-back program, flush any unused pills or liquid medicine down the toilet.

What happens if I miss a dose?

Since meperidine 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 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?

Do not drink alcohol. Dangerous side effects or death can occur when alcohol is combined with meperidine.

This medication may impair your thinking or reactions. Avoid driving or operating machinery until you know how meperidine will affect you. Dizziness or severe drowsiness can cause falls or other accidents.

Meperidine 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 narcotic medicines, meperidine can slow your breathing. Death may occur if breathing becomes too weak.

Stop using meperidine and call your doctor at once if you have:

  • weak or shallow breathing, slow heartbeat;

  • severe drowsiness, feeling like you might pass out;

  • confusion, mood changes, agitation, hallucinations;

  • tremors, muscle movements you cannot control, or a seizure (convulsions);

  • infertility, missed menstrual periods;

  • impotence, sexual problems, loss of interest in sex; or

  • low cortisol levels-- nausea, vomiting, loss of appetite, dizziness, worsening tiredness or weakness.

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.

Meperidine is more likely to cause breathing problems in older adults and people who are severely ill, malnourished, or otherwise debilitated.

Common side effects may include:

  • dizziness, drowsiness;

  • headache;

  • nausea, vomiting; or

  • sweating.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

See also: Side effects (in more detail)

Meperidine dosing information

Usual Adult Dose for Pain:

Oral:
50 to 150 mg orally every 3 to 4 hours as needed
Maximum dose: 600 mg per day

Parenteral:
50 to 150 mg IM or subcutaneously every 3 to 4 hours as needed; IM administration is preferred when repeated dose are required
-May be administered IV, however, lower doses are advised and administration should be very slow, preferably using a diluted solution

Patient Controlled Analgesia (PCA):
-Initial dose: 10 mg with a range of 1 to 5 mg per incremental dose; Lockout interval: 6 to 10 minutes; adjust dose based on patient response
For continuous IV infusion, the usual adult dose is 15 to 35 mg per hour

Comments:
-Due to the risks of addiction, abuse, and misuse, this drug should be reserved for use in patients for whom alternative treatment options have not been tolerated or are not expected to be tolerated or have not provided adequate analgesia, or are not expected to provide adequate analgesia.
-If adequate pain management cannot be achieved with a daily oral dose of 600 mg, alternative treatment is recommended.
-IV use should be restricted to settings in which a narcotic antagonist and facilities for assisted or controlled respiration are immediately available.
-The American Pain Society does not recommend use of this drug as an analgesic due to the accumulation of its toxic metabolite; this drug should not be used for the treatment of chronic pain.

Use: For the management of pain severe enough to require an opioid analgesic and for which alternative treatments are inadequate.

Usual Adult Dose for Anesthesia:

For Preoperative Medication:
Usual dose: 50 to 100 mg IM or subcutaneously 30 to 90 minutes before the beginning of anesthesia

For Obstetrical Analgesia:
Usual dose: 50 to 100 mg IM or subcutaneously when pain becomes regular; may repeat at 1 to 3 hour intervals

For Support of Anesthesia:
-Slow IV fractional doses or continuous IV infusion of a dilute (e.g. 1 mg/mL) solution; titrate to needs of patients

Comment:
-This drug should not be administered IV unless a narcotic antagonist and facilities for assisted or controlled respiration are immediately available.

Uses: As a preoperative medication and for support of anesthesia and obstetrical analgesia.

Usual Pediatric Dose for Pain:

Oral:
Initial dose: 1.1 to 1.8 mg/kg orally every 3 to 4 hours as needed
Maximum single dose: 50 to 150 mg
Maximum daily dose: 600 mg

Parenteral:
Initial dose: 1.1 to 1.8 mg/kg IM or subcutaneously every 3 to 4 hours as needed; IM administration is preferred when repeated doses are required
Maximum single dose: 50 to 150 mg

-May be administered IV, however, lower doses are advised and administration should be very slow, preferably using a diluted solution

Comments:
-The American Pain Society (APS) does not recommend this drug be used as an analgesic in infants, children, and those with acute vaso-occlusive crisis pain associated with sickle-cell disease.
-Due to the risks of addiction, abuse, and misuse, this drug should be reserved for use in patients for whom alternative treatment options have not been tolerated or are not expected to be tolerated or have not provided adequate analgesia, or are not expected to provide adequate analgesia.
-This drug should not be used for the treatment of chronic pain.

Use: For the management of pain severe enough to require an opioid analgesic and for which alternative treatments are inadequate.

Usual Pediatric Dose for Anesthesia:

For Preoperative Medication:
Usual dose: 1.1 to 2.2 mg/kg IM or subcutaneously 30 to 90 minutes before the beginning of anesthesia
Maximum dose: 50 to 100 mg

For Support of Anesthesia:
-Slow IV fractional doses or continuous IV infusion of a dilute (e.g. 1 mg/mL) solution; titrate to needs of patients

Comment:
-This drug should not be administered IV unless a narcotic antagonist and facilities for assisted or controlled respiration are immediately available.

Uses: As a preoperative medication and for support of anesthesia.

What other drugs will affect meperidine?

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, 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.
  • 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: 11.06.

Last reviewed: September 30, 2016
Date modified: May 03, 2017

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