Mepergan Fortis Side Effects
Generic Name: meperidine / promethazine
Note: This document contains side effect information about meperidine / promethazine. Some of the dosage forms listed on this page may not apply to the brand name Mepergan Fortis.
For the Consumer
Applies to meperidine / promethazine: oral capsule
What are some side effects that I need to call my doctor about right away?
WARNING/CAUTION: Even though it may be rare, some people may have very bad and sometimes deadly side effects when taking a drug. Tell your doctor or get medical help right away if you have any of the following signs or symptoms that may be related to a very bad side effect:
- Signs of an allergic reaction, like rash; hives; itching; red, swollen, blistered, or peeling skin with or without fever; wheezing; tightness in the chest or throat; trouble breathing or talking; unusual hoarseness; or swelling of the mouth, face, lips, tongue, or throat.
- Very bad dizziness or passing out.
- Fast or slow heartbeat.
- A heartbeat that does not feel normal.
- Fever or chills.
- Sore throat.
- Hallucinations (seeing or hearing things that are not there).
- Mood changes.
- Feeling confused.
- Very hard stools (constipation).
- Feeling very sleepy.
- Chest pain.
- Trouble breathing, slow breathing, or shallow breathing.
- Any unexplained bruising or bleeding.
- Change in eyesight.
- Yellow skin or eyes.
- A very bad and sometimes deadly health problem called neuroleptic malignant syndrome (NMS) may happen. Call your doctor right away if you have any fever, muscle cramps or stiffness, dizziness, very bad headache, confusion, change in thinking, fast heartbeat, heartbeat that does not feel normal, or are sweating a lot.
- Some people who take this drug may have muscle movements that cannot be controlled. Call your doctor right away if you have any trouble controlling body movements or if you have muscle problems with your tongue, face, mouth, or jaw like tongue sticking out, puffing cheeks, mouth puckering, or chewing.
- A very bad and sometimes deadly health problem called serotonin syndrome may happen if you take this drug with drugs for depression, migraines, or certain other drugs. Call your doctor right away if you have agitation; change in balance; confusion; hallucinations; fever; fast or abnormal heartbeat; flushing; muscle twitching or stiffness; seizures; shivering or shaking; sweating a lot; very bad diarrhea, upset stomach, or throwing up; or very bad headache.
What are some other side effects of this drug?
All drugs may cause side effects. However, many people have no side effects or only have minor side effects. Call your doctor or get medical help if any of these side effects or any other side effects bother you or do not go away:
- Upset stomach or throwing up.
- Hard stools (constipation).
- Feeling sleepy.
- Dry mouth.
- Sweating a lot.
These are not all of the side effects that may occur. If you have questions about side effects, call your doctor. Call your doctor for medical advice about side effects.
You may report side effects to the FDA at 1-800-FDA-1088. You may also report side effects at http://www.fda.gov/medwatch.
For Healthcare Professionals
Applies to meperidine / promethazine: injectable solution, oral capsule
Central nervous system side effects of meperidine may be either depressant or excitatory. Excitatory symptoms are sometimes ignored as possible side effects of meperidine, but may be due to the accumulation of a metabolite, normeperidine. Accumulation of normeperidine occurs more frequently in patients with renal insufficiency and in patients who are receiving meperidine via a patient-controlled analgesia pump.
Meperidine may increase intracranial pressure, and therefore should be used with caution in patients with head injuries. Severe adverse effects, such as respiratory depression, may be treated with the opioid antagonist naloxone.
A case of seizures has been reported in a patient with porphyria receiving meperidine.[Ref]
Central nervous system adverse effects of meperidine include sleepiness, respiratory depression, delirium, seizures, tremors, dizziness, visual disturbances, muscle twitches, dilated pupils, and Parkinsonian symptoms.
Nervous system side effects are common with the use of promethazine and include excessive sedation, drowsiness, fatigue, paradoxical excitation, and decreased motor coordination. Extrapyramidal effects (including oculogyric crises, torticollis and tongue protrusion), encephalitic symptoms, convulsions, and psychosis have been rarely reported.[Ref]
Psychiatric adverse effects of meperidine include fearfulness, agitation, paranoia, hypervigilance, and auditory and visual hallucinations.[Ref]
Psychological dependence on meperidine may develop.[Ref]
Meperidine may cause contraction of the sphincter of Oddi, thereby increasing intrabiliary pressure. As a result, meperidine may aggravate rather than relieve biliary colic.
Constipation is less common with meperidine than some other narcotics.[Ref]
Gastrointestinal effects of meperidine including increased gastroesophageal reflux, increased biliary pressure, dry mouth, nausea, and vomiting have been reported.
Gastrointestinal effects of promethazine include nausea and vomiting.[Ref]
There are case reports of bronchospasm occurring in patients with a history of asthma after receiving meperidine. Because of this effect and possible respiratory depression, meperidine should be used with caution in patients with severe reactive or obstructive pulmonary disease.[Ref]
Bronchospasm has been reported with the use of meperidine in patients with underlying pulmonary disease.
Respiratory depression and arrest may occur rarely, especially with parenteral administration of promethazine. Equipment for resuscitation should be available when parenteral promethazine is used.[Ref]
Cardiovascular effects including phlebitis have been reported in patients who are receiving meperidine. Hypotension has been reported rarely.
Cardiovascular effects have been rarely observed with the use of promethazine and include tachycardia, bradycardia, and transient hypotension. Prolongation of the QT interval, heart block, and malignant arrhythmias have been reported in association with other phenothiazines.[Ref]
The hypotension reported in patients receiving meperidine occurs most commonly in patients who are under anesthesia, who are dehydrated, and who are receiving other medications.[Ref]
Genitourinary effects including urinary retention have been reported in patients who are receiving meperidine.[Ref]
Dermatologic effects including rash and sweating have been reported in patients who are receiving meperidine.[Ref]
The neuroleptic malignant syndrome has been rarely observed during treatment with promethazine.[Ref]
Fever, altered consciousness, autonomic dysfunction, and muscle rigidity are the hallmarks of the neuroleptic malignant syndrome. The neuroleptic malignant syndrome is associated with a case fatality rate of about 20%. Immediate discontinuation of promethazine and intensive monitoring and supportive care are indicated.[Ref]
Inadvertent intra-arterial injection of promethazine carries a high risk of distal necrosis and frequently requires amputation of the affected limb. Subcutaneous injection has more rarely caused chemical irritation and necrosis.[Ref]
Hypersensitivity reactions to promethazine include rare reports of rash, pruritus, hypotension, photosensitivity, and tachycardia.[Ref]
Hematologic effects of promethazine include rare cases of neutropenia.[Ref]
Immunologic reactions with the use of promethazine include rare reports of a systemic lupus erythematosus syndrome.[Ref]
Central and obstructive apneas have been observed in infants given promethazine. Promethazine has been implicated by some as a possible cause of the Sudden Infant Death Syndrome (SIDS).[Ref]
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Some side effects of Mepergan Fortis may not be reported. Always consult your doctor or healthcare specialist for medical advice. You may also report side effects to the FDA.
More about Mepergan Fortis (meperidine / promethazine)
- Side Effects
- During Pregnancy
- Drug Images
- Drug Interactions
- Support Group
- 2 Reviews – Add your own review/rating
- Drug class: narcotic analgesic combinations
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