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Meperidine / promethazine Side Effects

Medically reviewed by Drugs.com. Last updated on Dec 21, 2020.

For the Consumer

Applies to meperidine/promethazine: oral capsule

Warning

  • This drug is a strong pain drug that can put you at risk for addiction, abuse, and misuse. Misuse or abuse of this drug can lead to overdose and death. Talk with your doctor.
  • Do not give this drug to a child younger than 2 years of age. It may cause very bad and sometimes deadly breathing problems.
  • Use with care in children 2 years of age and older. Talk with the doctor.
  • You will be watched closely to make sure you do not misuse, abuse, or become addicted to this drug.
  • This drug may cause very bad and sometimes deadly breathing problems. Call your doctor right away if you have slow, shallow, or trouble breathing.
  • The chance of very bad and sometimes deadly breathing problems may be greater when you first start this drug or anytime your dose is raised.
  • Even one dose of this drug may be deadly if it is taken by someone else or by accident, especially in children. If this drug is taken by someone else or by accident, get medical help right away.
  • Keep all drugs in a safe place. Keep all drugs out of the reach of children and pets.
  • Using this drug for a long time during pregnancy may lead to withdrawal in the newborn baby. This can be life-threatening. Talk with the doctor.
  • This drug has an opioid drug in it. Severe side effects have happened when opioid drugs were used with benzodiazepines or other drugs that may make you drowsy or slow your actions. This includes slow or troubled breathing and death. Benzodiazepines include drugs like alprazolam, diazepam, and lorazepam. Benzodiazepines may be used to treat many health problems like anxiety, trouble sleeping, or seizures. If you have questions, talk with your doctor.
  • Many drugs interact with this drug and can raise the chance of side effects like deadly breathing problems. Talk with your doctor and pharmacist to make sure it is safe to use this drug with all of your drugs.
  • Avoid drinking alcohol while taking this drug.
  • Get medical help right away if you feel very sleepy, very dizzy, or if you pass out. Caregivers or others need to get medical help right away if the patient does not respond, does not answer or react like normal, or will not wake up.

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, swallowing, 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 bad constipation.
  • Feeling very sleepy.
  • Chest pain.
  • Seizures.
  • Trouble breathing, slow breathing, or shallow breathing.
  • Shakiness.
  • 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 severe and sometimes deadly problem called serotonin syndrome may happen if you take this drug with 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; severe diarrhea, upset stomach, or throwing up; or severe 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.
  • Constipation.
  • Dizziness.
  • 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 1-800-332-1088. You may also report side effects at https://www.fda.gov/medwatch.

For Healthcare Professionals

Applies to meperidine / promethazine: injectable solution, oral capsule

General

The most frequently observed meperidine adverse reactions have included light-headedness, dizziness, sedation, nausea, vomiting, and sweating. Somnolence is the most prominent CNS effect reported with promethazine.[Ref]

Nervous system

Meperidine:

Common (1% to 10%): Lightheadedness, dizziness, sedation

Rare (less than 0.1%): Extrapyramidal reactions

Frequency not reported: Weakness, headache, tremor, uncoordinated muscle movements

Promethazine:

Common (1% to 10%): Drowsiness

Frequency not reported: Sedation, somnolence, dizziness, confusion, extrapyramidal symptoms, lassitude, tremors, convulsive seizures, neuroleptic malignant syndrome[Ref]

Hyperexcitability and extrapyramidal movements have been reported following a single dose of promethazine.[Ref]

Psychiatric

Hyperexcitability and abnormal movements have been reported following a single dose of promethazine.[Ref]

Meperidine:

Frequency not reported: Euphoria, dysphoria, agitation, transient hallucinations and disorientation

Promethazine:

Frequency not reported: Confusion, disorientation, euphoria, nervousness, insomnia, excitation, catatonic-like states, hysteria, hallucinations, nightmares, agitation, paradoxical reactions, hyperexcitability[Ref]

Respiratory

Meperidine:

Frequency not reported: Respiratory depression, respiratory arrest

Promethazine:

Frequency not reported: Asthma, respiratory depression, apnea, nasal stuffiness[Ref]

Gastrointestinal

Meperidine:

Common (1% to 10%): Nausea, vomiting

Frequency not reported: Dry mouth, constipation, biliary-tract spasm

Promethazine:

Frequency not reported: Dry mouth, nausea, vomiting, jaundice[Ref]

Cardiovascular

Meperidine:

Frequency not reported: Phlebitis, hypotension, tachycardia, bradycardia, palpitation, syncope, circulatory depression, shock, cardiac arrest, faintness

Promethazine:

Frequency not reported: Tachycardia, bradycardia, increased or decreased blood pressure, faintness[Ref]

Dermatologic

Meperidine:

Common (1% to 10%): Sweating

Frequency not reported: Facial flushing

Promethazine:

Frequency not reported: Dermatitis, photosensitivity, urticaria angioneurotic edema[Ref]

Other

Promethazine

Frequency not reported: Tinnitus, vertigo[Ref]

Hematologic

Promethazine:

Frequency not reported: Leukopenia, thrombocytopenia, thrombocytopenic purpura, agranulocytosis[Ref]

Ocular

Meperidine:

Frequency not reported: Visual disturbances

Promethazine:

Frequency not reported: Blurred vision, diplopia

More about meperidine / promethazine

Consumer resources

Professional resources

Related treatment guides

References

1. Geller RJ "Meperidine in patient-controlled analgesia: a near-fatal mishap." Anesth Analg 76 (1993): 655-7

2. Stone PA, Macintyre PE, Jarvis DA "Norpethidine toxicity and patient controlled analgesia." Br J Anaesth 71 (1993): 738-40

3. Inturrisi CE "Disposition of narcotics in patients with renal disease." Am J Med 62 (1977): 528-9

4. Drotts DL, Vinson DR "Prochlorperazine induces akathisia in emergency patients." Ann Emerg Med 34 (1999): 469-75

5. Marcantonio ER, Juarez G, Goldman L, et al. "The relationship of postoperative delirium with psychoactive medications." JAMA 272 (1994): 1518-22

6. Hagmeyer KO, Mauro LS, Mauro VF "Meperidine-related seizures associated with patient-controlled analgesia pumps." Ann Pharmacother 27 (1993): 29-32

7. "Product Information. Compazine (prochlorperazine)." SmithKline Beecham, Philadelphia, PA.

8. Shaw HL "Treatment of intractable cancer pain by electronically controlled parenteral infusion of analgesic drugs." Cancer 72 (1993): 3416-25

9. Baker FM, Cook P "Compazine complications: a review." J Natl Med Assoc 73 (1981): 409-12

10. Armstrong PJ, Bersten A "Normeperidine toxicity." Anesth Analg 65 (1986): 536-8

11. Samuels SI, Rabinov W "Difficulty reversing drug-induced coma in a patient with sleep apnea." Anesth Analg 65 (1986): 1222-4

12. Jones J, Sklar D, Dougherty J, White W "Randomized double-blind trial of intravenous prochlorperazine for the treatment of acute headache." JAMA 261 (1989): 1174-6

13. Boston Collaborative Drug Surveillance Program "Drug-induced extrapyramidal symptoms." JAMA 224 (1973): 889-91

14. Olive JM, Masana L, Gonzalez J "Meperidine and reversible parkinsonism." Mov Disord 9 (1994): 115-6

15. Olver IN, Laidlaw CR, Matthews JP, Bishop JF, Hayes AM, Wolf M, Toner GC "A randomised double blind crossover study of domperidone and prochlorperazine suppositories for controlling emesis in outpatients receiving chemotherapy." Eur J Cancer 30a (1994): 426-9

16. Fogarty T, Murray GB "Psychiatric presentation of meperidine toxicity." J Clin Psychopharmacol 7 (1987): 116-7

17. Stanski DR, Cherry C, Bradley R, et al "Efficacy and safety of single doses of intramuscular ketorolac tromethamine compared with meperidine for postoperative pain." Pharmacotherapy 10 (1990): s40-4

18. Reutens DC, Stewart-Wynne EG "Norpethidine induced myoclonus in a patient with renal failure." J Neurol Neurosurg Psychiatry 52 (1989): 1450-1

19. Elloway R, Sherman S, Maas L, et al "Meperidine-induced bronchospasm." Gastrointest Endosc 38 (1992): 93

20. Hey VM, Ostick DG, Mazumder JK, Lord WD "Pethidine, metoclopramide and the gastro-oesophageal sphincter." Anaesthesia 36 (1981): 173-6

21. "Product Information. Demerol (meperidine)." Sanofi Winthrop Pharmaceuticals, New York, NY.

22. Duxbury AJ, Ead RD, Turner EP "Erosive cheilitis related to prochlorperazine maleate." Br Dent J 153 (1982): 271-2

23. Reilly GD, Wood ML "Prochlorperazine--an unusual cause of lip ulceration." Acta Derm Venereol 64 (1984): 270-1

24. Manser TJ, Warner JF "Neuroleptic malignant syndrome associated with prochlorperazine." South Med J 83 (1990): 73-4

25. "Product Information. Phenergan (promethazine)." Wyeth-Ayerst Laboratories, Philadelphia, PA.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Some side effects may not be reported. You may report them to the FDA.