Demerol Side Effects

Generic name: meperidine

Medically reviewed by Drugs.com. Last updated on Sep 25, 2024.

Note: This document provides detailed information about Demerol Side Effects associated with meperidine. Some dosage forms listed on this page may not apply specifically to the brand name Demerol.

Applies to meperidine: injection solution.

Other dosage forms:

• oral solution, oral syrup, oral tablet

Important warnings This medicine can cause some serious health issues

Injection route (solution)

Meperidine hydrochloride has the potential for addiction, abuse, and misuse, which can lead to overdose and death.

Assess each patient's risk before prescribing, and monitor for development of these behaviors or conditions.

Serious, life-threatening, or fatal respiratory depression may occur.

Monitor closely, especially upon initiation or following a dose increase.

Prolonged use of meperidine hydrochloride during pregnancy can result in neonatal opioid withdrawal syndrome, which may be life-threatening if not recognized and treated.

If opioid use is required for a prolonged period in a pregnant woman, advise the patient of the risk of neonatal opioid withdrawal syndrome and ensure that appropriate treatment will be available.

Concomitant use or discontinuation of concomitantly used cytochrome P450 3A4 inhibitors may effect meperidine plasma concentrations and lead to fatal respiratory depression, profound sedation, opioid toxicity, and/or opioid withdrawal.

Careful monitoring of patients should occur when meperidine and cytochrome P450 3A4 inhibitors are concurrently used.

Concomitant use of benzodiazepines and opioids may result in profound sedation, respiratory depression, coma, and death.

Reserve concomitant prescribing for patients with inadequate alternative treatment options.

Limit dosages and durations to the minimum required and follow patients for signs and symptoms of respiratory depression and sedation.

Concomitant use of meperidine hydrochloride with MAOIs or use of MAOIs within the last 14 days is contraindicated and can lead to coma, severe respiratory depression, cyanosis, and hypotension.

Common side effects of Demerol

Some side effects of meperidine 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 side effects

• 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

Serious side effects of Demerol

Along with its needed effects, meperidine (the active ingredient contained in Demerol) 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 while taking meperidine:

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 while taking meperidine:

Symptoms of overdose

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

For healthcare professionals

Applies to meperidine: compounding powder, injectable solution, intravenous solution, oral syrup, oral tablet.

General adverse events

The most frequently reported adverse reactions have included lightheadedness, dizziness, sedation, nausea, vomiting, and sweating.^[Ref]

Respiratory

• Frequency not reported: Respiratory depression, respiratory arrest^[Ref]

Nervous system

• Frequency not reported: Serotonin syndrome, hyperexcitability, convulsions, weakness, headache, tremor, involuntary muscle movements (e.g. muscle twitches, myoclonus), delirium, dizziness, drowsiness, fainting, neurotoxicity, lightheadedness^[Ref]

Therapeutic doses of this drug have precipitated unpredictable, severe, and occasionally fatal reactions in patients who have received MAOIs within 14 days of receiving this drug. The mechanism of this reaction is unclear, but may be related to preexisting hyperphenylalaninemia. Reactions have included coma, severe respiratory depression, cyanosis, and hypotension. IV hydrocortisone or prednisolone have been used to treat severe reactions, with IV chlorpromazine used in cases exhibiting hypertension and hyperpyrexia. The usefulness and safety of narcotic antagonists is unknown.

Neurotoxicity associated with increased concentrations of active metabolite have occurred. Reactions have included a range of excitatory effects including tremor, hallucinations, seizures, coma, and mood changes.^[Ref]

Psychiatric

• Frequency not reported: Mood changes (e.g. euphoria, dysphoria), agitation, transient hallucinations and disorientation, confusion, dependence, anxiety, nervousness^[Ref]

Cardiovascular

• Frequency not reported: Severe hypotension, orthostatic hypotension, syncope, shock, cardiac arrest, circulatory depression, flushing, tachycardia, bradycardia, palpitations, hypotension, hypertension^[Ref]

Hypersensitivity

• Frequency not reported: Wheel and flare over the vein with IV injection, hypersensitivity reactions, anaphylaxis, histamine release leading to hypotension and/or tachycardia, sweating, flushing, and pruritus^[Ref]

Local

• Frequency not reported: Sensory-motor paralysis, phlebitis, injection site pain, local tissue irritation and induration following subcutaneous injection^[Ref]

Inadvertent injection about a nerve trunk may result in sensory-motor paralysis which is usually transitory. Phlebitis has been reported following IV injection.^[Ref]

Other

• Frequency not reported: Vertigo, hypothermia^[Ref]

Genitourinary

• Frequency not reported: Urinary retention, micturition difficulties, decreased libido, renal colic, anuria^[Ref]

Gastrointestinal

• Frequency not reported: Dry mouth, constipation, biliary tract spasm, nausea, vomiting, decreased gastric emptying^[Ref]

Dermatologic

• Frequency not reported: Pruritus, urticaria, other skin rashes, sweating^[Ref]

Musculoskeletal

• Frequency not reported: Muscle twitching, muscle rigidity^[Ref]

Endocrine

• Frequency not reported: Adrenal insufficiency, androgen deficiency^[Ref]

Hepatic

• Frequency not reported: Biliary spasm, choledochoduodenal sphincter spasm^[Ref]

Renal

• Frequency not reported: Antidiuretic effect^[Ref]

Ocular

• Frequency not reported: Visual disturbances, dry eye, pupillary constriction, miosis, decreased corneal reflex, mydriasis^[Ref]

Metabolic

• Frequency not reported: Anorexia^[Ref]

Frequently asked questions

• What is pethidine used for?

Further information

Demerol side effects can vary depending on the individual. Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Note: Medication side effects may be underreported. If you are experiencing side effects that are not listed, submit a report to the FDA by following this guide.

Medical Disclaimer