Drug reference

meperidine

Mu-opioid receptor agonist (phenylpiperidine) · Analgesic

Mu-opioid receptor agonist (phenylpiperidine)Analgesic

CDSCO approved

EXCRETION

—

not curated

INTERACTIONS

9 major

incl. contraindicated

PREGNANCY

—

not curated

Top interactionssee all 12 →

SafinamideContraindicatedTextbookG&G 14e · p419, p424
IsocarboxazidSevereTextbookG&G 14e
MoclobemideSevereTextbookG&G 14e
PhenelzineSevereTextbookG&G 14e

Mechanism

Meperidine acts as a mu-opioid receptor agonist, producing analgesia and respiratory depression. It also possesses local anesthetic properties and can block neuronal reuptake of serotonin.

Indications

analgesiapostanesthetic shiveringpreoperative medicationsupplement to anesthesiaprevention or amelioration of infusion-related rigors and shaking chillsanalgesia during perioperative periodreduces shivering

Dosing

Adult: Parenteral: 50 mg/3 h
Pediatric: Parenteral: 0.75 mg/kg/2–3 h

Pharmacokinetics

Peak effect

Oral analgesia: 1-2 h; Subcutaneous/Intramuscular analgesia: 1 h; Intramuscular respiratory depression: 1 h

Duration

Analgesia: 1.5–3 h

Half-life

3 h (parent drug); 15–20 h (normeperidine metabolite)

Bioavailability

Oral: ~50% (due to first-pass metabolism)

Protein binding

58 ± 9%

Metabolism

Chiefly in the liver to N-demethyl product (normeperidine) and hydrolysis product (meperidinate).

Excretion

∼5 (1–25)%

Contraindications

patients taking MAO inhibitors
patients within 14 days after discontinuation of an MAO inhibitor
treatment of chronic pain (due to normeperidine toxicity)

Side effects

Common

nauseavomitingconstipation (less than morphine)urinary retention (less than morphine)pruritus

Serious

CNS excitation (tremors, muscle twitches, seizures) due to normeperidine accumulation
marked increase in heart rate (intravenous administration)
respiratory depression
hyperexcitability (due to normeperidine metabolite)
seizures (due to normeperidine metabolite)

Drug interactions

Safinamide

Contraindicated

Textbook

Stupor, rigidity, agitation, and hyperthermia.

Safinamide should not be given in combination with meperidine.

Source: G&G 14e · p419, p424

Isocarboxazid

Severe

Textbook

Serious drug interaction.

Avoid coadministration.

Source: G&G 14e

Moclobemide

Severe

Textbook

Serious drug interaction.

Avoid coadministration.

Source: G&G 14e

Phenelzine

Severe

Textbook

Serious drug interaction.

Avoid coadministration.

Source: G&G 14e

Procarbazine

Severe

Textbook

Serious drug interaction.

Avoid coadministration.

Source: G&G 14e

Rasagiline

Severe

Textbook

Serious drug interaction.

Avoid coadministration.

Source: G&G 14e

Selegiline

Severe

Textbook

Serious drug interaction.

Avoid coadministration.

Source: G&G 14e

Tranylcypromine

Severe

Textbook

Serious drug interaction.

Avoid coadministration.

Source: G&G 14e

Linezolid

Severe

Database

Serotonin syndrome.

CONTRAINDICATED. Avoid concomitant use. If linezolid is absolutely necessary, avoid meperidine. If symptoms occur, discontinue both drugs and provide supportive care.

Source: DDInter

Amitriptyline

Moderate

Textbook

Increased respiratory depression.

Monitor patient closely for increased respiratory depression. Adjust doses accordingly.

Source: G&G 14e · p459

Amoxapine

Moderate

Textbook

Increased respiratory depression.

Monitor patient closely for increased respiratory depression. Adjust doses accordingly.