Meperidine (Demerol): Uses, Side Effects, Interactions, Pictures, Warnings & Dosing

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Overview: Meperidine is an opioid pain medicine that is used to treat severe pain, and some forms may be used before surgery or procedure or to treat pain during labor and childbirth. It works on receptors in the body to help keep you from feeling pain. Common side effects include lightheadedness, dizziness, sleepiness, nausea, vomiting, and constipation. Talk to your health care provider right away if you develop confusion, shortness of breath, or trouble staying awake or feel like your pain is getting worse instead of better. Before taking meperidine, make sure to tell your health care provider about any health conditions you have or medicines you are taking.

Uses

What is meperidine used for?

Meperidine is an opioid pain medicine commonly used to treat severe pain. The injectable form of meperidine may also be used before some surgeries or procedures or for pain during labor or childbirth.

Meperidine may also be used for other conditions as determined by your health care provider.

How does meperidine work (mechanism of action)?

Meperidine works on receptors in the body to help keep you from feeling pain by altering how your body feels and responds to pain.

How is meperidine supplied (dosage forms)?

Brands and other names

Demerol

Dosage forms and strengths

50 mg/5 mL oral solution
50 mg, 100 mg oral tablets

Meperidine is also available in an injectable form that is given by a health care provider.

How should I store meperidine?

Oral Formulations. Meperidine should be stored at room temperature, between 68 F and 77 F (20 C and 25 C). It can be exposed to temperatures between 59 F and 86 F (15 C and 30 C) for shorter periods of time, such as when transporting it. Store in a cool and dry place.

Injectable Formulations. Meperidine injection is usually given by a health care provider in a hospital or clinic. You will not store it at home.

Side Effects

What are the most common side effects of meperidine?

The most common side effects of meperidine are listed below. Tell your health care provider if you have any of these side effects that bother you.

Lightheadedness or dizziness
Headache
Tiredness or sleepiness
Nausea or vomiting
Sweating
Constipation (see below)

There may be other side effects of meperidine that are not listed here. Contact your health care provider if you think you are having a side effect of a medicine. In the U.S., you can report side effects to the FDA at www.fda.gov/medwatch or by calling 800-FDA-1088 (800-332-1088). In Canada, you can report side effects to Health Canada at www.health.gc.ca/medeffect or by calling 866-234-2345.

What are the serious side effects of meperidine?

While less common, the most serious side effects of meperidine are described below, along with what to do if they happen.

Severe Allergic Reactions. Meperidine may cause allergic reactions, which can be serious. Get emergency help right away if you have any of the following symptoms of a serious allergic reaction.

Breathing problems or wheezing
Racing heart
Fever or general ill feeling
Swollen lymph nodes
Swelling of the face, lips, mouth, tongue, or throat
Trouble swallowing or throat tightness
Itching, skin rash, or pale red bumps on the skin called hives
Nausea or vomiting
Dizziness, feeling lightheaded, or fainting
Stomach cramps
Joint pain

Risk of Misuse and Addiction. Misusing meperidine can lead to serious side effects such as coma or death. Misuse means taking a medicine in a way other than how it was prescribed. Take meperidine exactly as prescribed. Tell your health care provider if you feel that meperidine is not working. Call your health care provider right away or go to the nearest emergency room if you have any of the following serious symptoms.

Sudden confusion or feeling disoriented
Feeling paranoid
Suicidal thoughts or actions
Seizures

Breathing Problems. Meperidine may cause slow or shallow breathing, especially if you have breathing problems from another condition or take other medicines that can slow your breathing. Tell your health care provider if you develop severe sleepiness or trouble breathing, especially when you start meperidine or when your dose is increased. Get emergency help if you have any of the following symptoms.

Changes in the color of your skin, including bluish color to your lips and fingernails
Confusion
Shortness of breath
Feeling dizzy, lightheaded, or fainting
Changes in your heart rate or rhythm, such as a fast, slow, pounding, or skipping heartbeat
Slow or shallow breathing
Excessive sleepiness or trouble staying awake

Increased Pain and Pain Sensitivity. Meperidine may cause allodynia, which is when you have pain from something that normally does not cause pain, such as brushing your hair. Meperidine may also cause hyperalgesia, which is when you are very sensitive to pain. Contact your health care provider right away if you have pain from things that did not cause pain before, worsening pain, or more pain sensitivity. Do not use more meperidine if your pain feels worse, as this may cause serious side effects.

Reduced Adrenal Function. Long-term use of meperidine can cause your body’s adrenal glands to stop making enough cortisol (the stress hormone). This is known as adrenal insufficiency. Adrenal insufficiency can get worse if your body is under stress because of fever, surgery, or trauma. Tell your health care provider if you have any of the following symptoms of adrenal insufficiency.

Nausea and vomiting
Weakness, tiredness, or lack of energy
Low blood pressure

Low Blood Pressure (Hypotension). Meperidine may cause low blood pressure. If you feel faint or dizzy, lie down. Tell your health care provider right away if you have any of the following symptoms of low blood pressure.

Dizziness, feeling lightheaded, or fainting
Confusion
Feeling weak or tired

Sphincter of Oddi Spasm. The sphincter of Oddi is a muscular valve in your body that controls the flow of bile and digestive juices from the pancreas into the small intestine. When this valve spasms, it may feel like getting a tight muscle cramp, causing pain and blocking the flow of these juices, which can lead to discomfort and digestive problems. This is more likely to happen if you do not have a gallbladder. Get emergency help if you have new or worse stomach pain or pain in the upper right side of your stomach-area that travels to your back or shoulder, with or without nausea and vomiting.

Constipation. Some people taking meperidine have had severe constipation. Some needed to go to the hospital. Get help right away if you have severe constipation.

Warnings & Precautions

Who should not use meperidine?

Allergies to Ingredients. People who are allergic to any of the following should not use meperidine.

Demerol
Meperidine
Any of the ingredients in the specific product dispensed

Your pharmacist can tell you all of the ingredients in the specific meperidine products they stock.

Lung problems. Meperidine should not be used if you have severe asthma, trouble breathing, or other lung problems. Meperidine can make these conditions worse.

Gut Blockage. Meperidine should not be used if you have a blockage of your gut (bowel obstruction) or a narrowing of the stomach or intestines. Meperidine can make these conditions worse.

Slowed Gut Movement. Paralytic ileus is a type of ileus in which your intestines are unable to move food through them. Meperidine can make this condition worse.

Drug Interactions. Meperidine should not be taken while you are using certain other medicines. Before taking meperidine, tell your health care provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. See the Interactions section for more details.

What should I know about meperidine before using it?

Do not use meperidine unless it has been prescribed to you by a health care provider. Use it as prescribed.

Do not share meperidine with other people, even if they have the same condition as you. It may harm them.

Keep meperidine out of the reach of children. Meperidine is a controlled substance because it can be misused or lead to dependence. Store meperidine in a safe place to protect it from theft. It is illegal to sell or give away this medicine.

Use an accurate measuring device to measure your dose of liquid meperidine. A household spoon is not an accurate measuring device and may cause you to take the wrong dose. Ask your pharmacist to recommend a right measuring device.

Mix each dose of liquid meperidine into a half glass of water before swallowing.

Meperidine can affect your alertness or coordination. Do not drive or do other activities that require alertness or coordination until you know how meperidine affects you.

People who are aged 65 or older can be at greater risk for some side effects from meperidine. Talk to your health care provider about your risks if you are in this age group.

Long-term use of meperidine may affect your ability to become pregnant or get a partner pregnant. Talk with your health care provider if you have any concerns.

If you have been taking meperidine on a regular basis, do not stop taking the medicine without talking to your health care provider. Stopping meperidine too quickly can cause serious withdrawal effects. Call your health care provider right away if you have any of the following symptoms.

Feeling restless
Watery eyes or runny nose
Yawning
Sweating or chills
Muscle, joint, or back pain
Dilated pupils
Irritability, anxiety, or trouble sleeping
Nausea, vomiting, diarrhea, stomach cramps, or loss of appetite
Increase in blood pressure, breathing rate, or heart rate

Your health care provider may ask you to have naloxone, a medicine used to reverse the effects of meperidine, on hand in case of an emergency. Make sure that you and a caregiver know how to use naloxone. If you have any questions, talk to your health care provider or pharmacist.

Dispose of expired, unwanted, or unused meperidine right away by taking your medicine to an authorized DEA-registered collector or drug take back program. If one is not available, you can flush meperidine down the toilet.

What should I tell my health care provider before using meperidine?

Tell your health care provider about all of your health conditions and any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. This will help them determine if meperidine is right for you.

In particular, make sure that you discuss any of the following.

Current and Past Health Conditions. Tell your health care provider if you have any of the following.

Head injury or brain problems, such as brain tumors or increased pressure around the brain
Seizures
Liver, kidney, or thyroid problems
Pancreas or gallbladder problems
Breathing problems, such as asthma or chronic obstructive pulmonary disease (COPD)
Sleep apnea
Adrenal gland problems or cancer (pheochromocytoma)
Heart problems
Problems peeing
Substance use disorder or living with someone who has this problem
Alcohol use disorder
History of opioid overdose
Mental health problems

Pregnancy. Meperidine may cause harm to a fetus. Tell your health care provider if you are pregnant or plan to become pregnant. Your health care provider will let you know if you should take meperidine while you are pregnant or trying to get pregnant. If you take meperidine on a regular basis during pregnancy, your baby may have withdrawal symptoms that can be life-threatening. Tell your health care provider if you took meperidine during your pregnancy, especially near the end of your pregnancy.

Breastfeeding. Meperidine passes into breast milk. Tell your health care provider if you are breastfeeding or plan to breastfeed. Your health care provider will let you know if you should take meperidine while breastfeeding. Tell your health care provider right away if your baby is more sleepy than usual, and get emergency help if your baby is having trouble breathing or is limp.

Interactions

Does meperidine interact with foods or drinks?

There are no known interactions between meperidine and foods or nonalcoholic drinks.

Do not drink alcohol or use prescription or over-the-counter medicines that contain alcohol. Using alcohol while taking meperidine can cause you to overdose and die.

Does meperidine interact with other medicines (drug interactions)?

Always tell your health care provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using.

In particular, make sure that you discuss if you are using any of the following before taking meperidine.

A monoamine oxidase inhibitor (MAOI) within the past two weeks, which is a medicine usually used for depression or Parkinson’s disease
A benzodiazepine, such as clonazepam (Klonopin), diazepam (Valium and others), or lorazepam (Ativan and others), which is a medicine used for anxiety, muscle spasms, or seizures
Any other medicine that causes dizziness and sleepiness, such as prescription pain medicines, sleep medicines, muscle relaxants, and medicines for anxiety
Any medicine that affects serotonin in your body, such as medicines for depression, anxiety, or certain mental health conditions, some migraine medicines, and some medicines for nausea and vomiting.
A mixed agonist/antagonist or partial agonist opioid analgesic, such as buprenorphine (Butrans, Sublocade), butorphanol, and others, which are medicines used to treat certain types of pain or opioid use disorder
A phenothiazine, such as chlorpromazine or prochlorperazine (Compro and others), which is a medicine that may be used to treat certain mental health conditions or severe nausea and vomiting
A macrolide antibiotic, such as clarithromycin or erythromycin (Ery-Tab and others), which is a medicine used for bacterial infections
Fluconazole (Diflucan), itraconazole (Sporanox, Tolsura), ketoconazole, posaconazole (Noxafil), or voriconazole (Vfend), which are medicines used for fungal infections
A protease inhibitor, such as ritonavir (Norvir) or nelfinavir (Viracept), which is a medicine commonly used to treat HIV
Rifampin, which is a medicine commonly used to treat an infection called tuberculosis
Carbamazepine or phenytoin, which are medicines used for seizures
A diuretic, also called a water pill, which is a medicine used to reduce edema (fluid retention) and blood pressure
An anticholinergic medicine, which includes antihistamines and medicines commonly used for overactive bladder, Parkinson’s disease, or stomach problems
Acyclovir, which is a medicine used for shingles and other viral infections
Cimetidine (Tagamet HB), which is a medicine used for heartburn

Some other medicines may alter the blood levels of meperidine. Tell your health care provider about all medicines that you take or have recently taken.

This may not be a complete list of medicines that can interact with meperidine. Always check with your health care provider.

Does interact with other drugs you are taking?

Enter your medication into the WebMD interaction checker