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Meperidine is available in the following formulations:

• Meperidine 50mg Tablets: For oral administration
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• Meperidine 50mg/ml Solution: For injection (IM, IV, SC)
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Meperidine (Demerol) is a synthetic opioid analgesic that acts primarily as a mu-opioid receptor agonist. It has a relatively rapid onset of action but shorter duration compared to many other opioids, making it suitable for acute pain management in specific clinical scenarios.

Meperidine is primarily used for:

• Management of moderate to severe acute pain
• Perioperative analgesia
• Obstetric analgesia during labor (with caution)
• Management of rigors associated with amphotericin B administration
• Short-term pain management when other opioids are contraindicated

Dosing is individualized based on the specific medical indication, patient characteristics, and concurrent medications. Typical dosage ranges include:

• For oral administration: 50-150mg every 3-4 hours as needed, not to exceed 600mg in 24 hours
• For parenteral administration: 50-100mg IM or SC every 3-4 hours as needed; 25-50mg IV slowly over 2-3 minutes
• For elderly patients: Lower initial doses with careful titration
• For patients with renal impairment: Reduced dosage and extended intervals

Important Safety Information

Meperidine is a Schedule II controlled substance with potential for abuse and dependence. It should be administered by or under the supervision of healthcare professionals familiar with its use.

Meperidine has several important safety considerations that limit its use in certain clinical scenarios:

• Its active metabolite, normeperidine, has a long half-life (15-30 hours) and can accumulate with repeated dosing, potentially causing CNS excitation, tremors, myoclonus, and seizures
• Not recommended for chronic pain management due to the risk of normeperidine accumulation
• Contraindicated in patients taking monoamine oxidase inhibitors (MAOIs) due to risk of severe, potentially fatal reactions
• Use with caution in patients with renal impairment, as normeperidine is eliminated primarily through the kidneys

Potential Side Effects

Common side effects include sedation, dizziness, nausea, vomiting, hypotension, and sweating. Serious adverse effects requiring immediate intervention include respiratory depression, serotonin syndrome (particularly when used with other serotonergic medications), and seizures due to normeperidine accumulation.

Meperidine should be used with caution in patients with respiratory impairment, head injury, increased intracranial pressure, impaired hepatic or renal function, and in elderly or debilitated patients.

For more information about pain management medications and opioid safety, please visit these authoritative resources:

• American Society of Anesthesiologists
• FDA Drug Safety Information
• MedlinePlus Meperidine Information

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Meperidine is a synthetic opioid analgesic with the following characteristics:

• Chemical Name: Ethyl 1-methyl-4-phenylisonipecotate hydrochloride
• Mechanism of Action: Primarily mu-opioid receptor agonist
• Onset of Action: 15-45 minutes when administered orally; 10-15 minutes when administered IM; 1-5 minutes when administered IV
• Duration of Action: 2-4 hours for analgesia
• Metabolism: Hepatic, with formation of the active metabolite normeperidine
• Elimination Half-life: 2-4 hours for meperidine; 15-30 hours for normeperidine
• Potency Comparison: Approximately 1/10 the potency of morphine for analgesia

Meperidine has several unique characteristics that differentiate it from other opioid analgesics:

• Rapid onset of action compared to oral morphine
• Shorter duration of action than many other opioids
• Anticholinergic properties that may reduce smooth muscle spasm
• May cause less biliary tract spasm than morphine
• Historically used for obstetric analgesia, though other agents are now preferred
• Effective for treatment of postoperative shivering
• One of few opioids effective for amphotericin B-induced rigors

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