|Drug Name:||Meperidine Hydrochloride|
|Other Info:||The usual dosage is 1.1 mg/kg to 1.8 mg/kg orally up to the adult dose, every 3 or 4 hours as necessary. Each dose of the oral solution should be taken in one-half glass of water, since if taken undiluted, it may exert a slight topical anesthetic effect on mucous membranes.|
Meperidine is contraindicated in patients with hypersensitivity to meperidine.
Meperidine is contraindicated in patients who are receiving monoamine oxidase (MAO) inhibitors or those who have recently received such agents.
Therapeutic doses of meperidine have occasionally precipitated unpredictable, severe, and occasionally fatal reactions in patients who have received such agents within 14 days.
The mechanism of these reactions is unclear, but may be related to a preexisting hyperphenylalaninemia.
Some have been characterized by coma, severe respiratory depression, cyanosis, and hypotension, and have resembled the syndrome of acute narcotic overdose.
In other reactions the predominant manifestations have been hyperexcitability, convulsions, tachycardia, hyperpyrexia, and hypertension.
Although it is not known that other narcotics are free of the risk of such reactions, virtually all of the reported reactions have occurred with meperidine.
If a narcotic is needed in such patients, a sensitivity test should be performed in which repeated, small, incremental doses of morphine are administered over the course of several hours while the patient’s condition and vital signs are under careful observation.
(Intravenous hydrocortisone or prednisolone have been used to treat severe reactions, with the addition of intravenous chlorpromazine in those cases exhibiting hypertension and hyperpyrexia.The usefulness and safety of narcotic antagonists in the treatment of these reactions is unknown.)
Meperidine is an opioid agonist and a Schedule II controlled substance with an abuse liability similar to morphine. Meperidine can be abused in a manner similar to other opioid agonists, legal or illicit.This should be considered when prescribing or dispensing meperidine in situations where the physician or pharmacist is concerned about an increased risk of misuse, abuse, or diversion.