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Meperidine



Meperidine (also known as pethidine) is a synthetic opioid analgesic, first synthesized in 1932. It is used for treating moderate to severe pain, and occasionally to treat rigor or shivering.

Meperidine is not suitable for treatment of chronic pain. This is partly because on repeated dosing, patients will experience an accumulation of the toxic metabolite, normeperidine. Normeperidine is a potent central nervous system irritant, and accumulation of normeperidine can cause generalized seizures.

Meperidine was one of the opioids of choice for the treatment of acute and chronic severe pain by many physicians for a large part of the 20th century. Meperidine was supposed to be safer and carry less risk of addiction than morphine. However, due to the low potency, short duration of action, and toxicity of meperidine relative to other available opioid analgesics, it has fallen out of favor in recent years for all but a few specific indications.

Brand Names


    Demerol

Street Names

    Demmies

Formulations

    * Demerol - tablet, meperidine hydrochloride (HCl): 50 mg, 100 mg
    * Demerol - oral solution, meperidine HCl: 50 mg/5 mL

Medical Uses

    * relief of moderate to severe acute pain
    * prevention of rigors and treatment of rigors and post-anesthesia shivers


Route of Administration

    oral, intranasal, rectal, intravenous (IV)

Half-life

    3-5 h

Medical Dosage

    * pain relief: 50 to 100 mg orally every 4 h; 25 to 100 mg injected (IV, IM, SC) every 4 h
    * rigors/shivers: 12.5 to 50 mg IV every 20 minutes until controlled

Legality

    Meperidine is a Schedule II drug in the United States.
    Meperidine is a Schedule I drug in Canada.

Images

    Intravenous



References
  • Schumacher MA, Basbaum AI, Way WL, Opioid Analgesics & Antagonists (Chapter 31) in: Basic and Clinical Pharmacology. 12e. Katzung BG, Masters SB, Trevor AJ (Editors). McGraw-Hill / Lange, 2012.
  • Simopoulos TT, Smith HS, Peeters-Asdourian C, Stevens DS. Use of meperidine in patient-controlled analgesia and the development of a normeperidine toxic reaction. Archives of Surgery Jan 2002; 137(1):84-8. [PubMed] [PDF]
  • McHugh GJ. Norpethidine accumulation and generalized seizure during pethidine patient-controlled analgesia. Anaesthesia and Intensive Care Jun 1999; 27(3):289-91. [PubMed]
  • Clinical Practice Guideline for Management of Opioid Therapy for Chronic Pain. United States Department of Veterans Affairs / Department of Defense, May 2010. [PDF]
  • Controlled Substances - Alphabetical Order. DEA Office of Diversion Control, May 2013. [PDF]
  • Controlled Drugs and Substances Act. Minister of Justice, Canada, Nov 2012. [PDF]



Related Pages

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Updated October 29, 2013