Meperidine (injection): Difference between revisions

Jump to navigation Jump to search
VisualWikitext
No edit summary
No edit summary
Line 13: Line 13:


<!--FDA-Labeled Indications and Dosage (Adult)-->
<!--FDA-Labeled Indications and Dosage (Adult)-->
|fdaLIADAdult======Condition1=====
|fdaLIADAdult===Indications==


* Dosing Information
* For the relief of moderate to severe pain


:* Dosage
* For preoperative medication


=====Condition2=====
* For support of anesthesia


* Dosing Information
* For obstetrical analgesia


:* Dosage
==Dosage==


=====Condition3=====
'''For Relief of Pain'''


* Dosing Information
* Dosage should be adjusted according to the severity of the [[pain]] and the response of the patient. While subcutaneous administration is suitable for occasional use, intramuscular administration is preferred when repeated doses are required. If intravenous administration is required, dosage should be decreased and the injection made very slowly, preferably utilizing a diluted solution. The dose of DEMEROL should be proportionately reduced (usually by 25 to 50 percent) when administered concomitantly with phenothiazines and many other tranquilizers since they potentiate the action of DEMEROL.


:* Dosage
* The usual dosage is 50 mg to 150 mg intramuscularly or subcutaneously every 3 or 4 hours as necessary. Elderly patients should usually be given meperidine at the lower end of the dose range and observed closely.


=====Condition4=====
'''For Preoperative Medication'''


* Dosing Information
* The usual dosage is 50 mg to 100 mg intramuscularly or subcutaneously, 30 to 90 minutes before the beginning of anesthesia. Elderly patients should usually be given meperidine at the lower end of the dose range and observed closely.


:* Dosage
'''For Support of Anesthesia'''


<!--Off-Label Use and Dosage (Adult)-->
* Repeated slow intravenous injections of fractional doses (e.g., 10 mg/mL) or continuous intravenous infusion of a more dilute solution (e.g., 1 mg/mL) should be used. The dose should be titrated to the needs of the patient and will depend on the premedication and type of anesthesia being employed, the characteristics of the particular patient, and the nature and duration of the operative procedure. Elderly patients should usually be given meperidine at the lower end of the dose range and observed closely.


<!--Guideline-Supported Use (Adult)-->
'''For Obstetrical Analgesia'''
|offLabelAdultGuideSupport======Condition1=====


* Developed by:
* The usual dosage is 50 mg to 100 mg intramuscularly or subcutaneously when pain becomes regular, and may be repeated at 1- to 3-hour intervals.


* Class of Recommendation:
* Parenteral drug products should be inspected visually for particulate and discoloration prior to administration whenever solution and container permit.


* Strength of Evidence:
|offLabelAdultGuideSupport=There is limited information regarding <i>Off-Label Guideline-Supported Use</i> of {{PAGENAME}} in adult patients.


* Dosing Information


:* Dosage
|offLabelAdultNoGuideSupport=There is limited information regarding <i>Off-Label Non–Guideline-Supported Use</i> of {{PAGENAME}} in adult patients.


=====Condition2=====


There is limited information regarding <i>Off-Label Guideline-Supported Use</i> of {{PAGENAME}} in adult patients.
|fdaLIADPed=There is limited information regarding <i>FDA-Labeled Use</i> of {{PAGENAME}} in pediatric patients.


<!--Non–Guideline-Supported Use (Adult)-->
|offLabelAdultNoGuideSupport======Condition1=====


* Dosing Information
|offLabelPedGuideSupport=There is limited information regarding <i>Off-Label Guideline-Supported Use</i> of {{PAGENAME}} in pediatric patients.


:* Dosage


=====Condition2=====
|offLabelPedNoGuideSupport=There is limited information regarding <i>Off-Label Non–Guideline-Supported Use</i> of {{PAGENAME}} in pediatric patients.


There is limited information regarding <i>Off-Label Non–Guideline-Supported Use</i> of {{PAGENAME}} in adult patients.


<!--Pediatric Indications and Dosage-->
|clinicalTrials=* The major hazards of meperidine, as with other narcotic analgesics, are [[respiratory depression]] and, to a lesser degree, circulatory [[depression]]; respiratory arrest, [[shock]], and [[cardiac arrest]] have occurred.


<!--FDA-Labeled Indications and Dosage (Pediatric)-->
* The most frequently observed adverse reactions include [[lightheadedness]], [[dizziness]], [[sedation]], [[nausea]], [[vomiting]], and sweating. These effects seem to be more prominent in ambulatory patients and in those who are not experiencing severe pain. In such individuals, lower doses are advisable. Some adverse reactions in ambulatory patients may be alleviated if the patient lies down.
|fdaLIADPed======Condition1=====


* Dosing Information
'''Other adverse reactions include:'''


:* Dosage
* Nervous System. Mood changes (e.g. [[euphoria]], [[dysphoria]]), weakness, [[headache]], [[agitation]], [[tremor]], involuntary muscle movements (e.g. muscle twitches, [[myoclonus]]), severe [[convulsions]], transient [[hallucinations]] and [[disorientation]], [[confusion]], [[delirium]], visual disturbances. Inadvertent injection about a nerve trunk may result in sensory-motor [[paralysis]] which is usually, though not always, transitory.


=====Condition2=====
* Gastrointestinal. [[Dry mouth]], [[constipation]], biliary tract spasm.


There is limited information regarding <i>FDA-Labeled Use</i> of {{PAGENAME}} in pediatric patients.
* Cardiovascular. [[Flushing]] of the face, [[tachycardia]], [[bradycardia]], [[palpitation]], [[hypotension]] , [[syncope]], [[phlebitis]] following intravenous injection.


<!--Off-Label Use and Dosage (Pediatric)-->
* Genitourinary. [[Urinary retention]].


<!--Guideline-Supported Use (Pediatric)-->
* Allergic. [[Pruritus]], [[urticaria]], other skin rashes, wheal and flare over the vein with intravenous injection.
|offLabelPedGuideSupport======Condition1=====


* Developed by:
:*[[Hypersensitivity reactions]], [[anaphylaxis]].


* Class of Recommendation:
:*Histamine release leading to [[hypotension]] and/or [[tachycardia]], [[flushing]], sweating, and [[pruritus]].


* Strength of Evidence:
* Other. [[Pain]] at injection site; local tissue irritation and induration following subcutaneous injection, particularly when repeated; antidiuretic effect.
 
* Dosing Information
 
:* Dosage
 
=====Condition2=====
 
There is limited information regarding <i>Off-Label Guideline-Supported Use</i> of {{PAGENAME}} in pediatric patients.
 
<!--Non–Guideline-Supported Use (Pediatric)-->
|offLabelPedNoGuideSupport======Condition1=====
 
* Dosing Information
 
:* Dosage
 
=====Condition2=====
 
There is limited information regarding <i>Off-Label Non–Guideline-Supported Use</i> of {{PAGENAME}} in pediatric patients.
 
<!--Contraindications-->
|contraindications=* Condition1
 
<!--Warnings-->
|warnings=* Description
 
====Precautions====
 
* Description
 
<!--Adverse Reactions-->
 
<!--Clinical Trials Experience-->
|clinicalTrials=There is limited information regarding <i>Clinical Trial Experience</i> of {{PAGENAME}} in the drug label.
 
=====Body as a Whole=====
 
 
 
 
=====Cardiovascular=====
 
 
 
 
=====Digestive=====
 
 
 
 
=====Endocrine=====
 
 
 
 
=====Hematologic and Lymphatic=====
 
 
 
 
=====Metabolic and Nutritional=====
 
 
 
 
=====Musculoskeletal=====
 
 
 
 
=====Neurologic=====
 
 
 
 
=====Respiratory=====
 
 
 
 
=====Skin and Hypersensitivy Reactions=====
 
 
 
 
=====Special Senses=====
 
 
 
 
=====Urogenital=====
 
 
 
 
=====Miscellaneous=====
 
 
 
<!--Postmarketing Experience-->
|postmarketing=There is limited information regarding <i>Postmarketing Experience</i> of {{PAGENAME}} in the drug label.
|postmarketing=There is limited information regarding <i>Postmarketing Experience</i> of {{PAGENAME}} in the drug label.


=====Body as a Whole=====
=====Cardiovascular=====
=====Digestive=====
=====Endocrine=====
=====Hematologic and Lymphatic=====
=====Metabolic and Nutritional=====
=====Musculoskeletal=====
=====Neurologic=====
=====Respiratory=====
=====Skin and Hypersensitivy Reactions=====
=====Special Senses=====
=====Urogenital=====
=====Miscellaneous=====
<!--Drug Interactions-->
|drugInteractions=* Drug
:* Description


<!--Use in Specific Populations-->
|useInPregnancyFDA=* '''Pregnancy Category'''
|useInPregnancyFDA=* '''Pregnancy Category'''
|useInPregnancyAUS=* '''Australian Drug Evaluation Committee (ADEC) Pregnancy Category'''
|useInPregnancyAUS=* '''Australian Drug Evaluation Committee (ADEC) Pregnancy Category'''
Line 314: Line 149:


<!--How Supplied-->
<!--How Supplied-->
|howSupplied=*
|howSupplied=* For Parenteral Use
 
* Solutions of DEMEROL for parenteral use are clear and colorless and are available as follows:
 
[[File:Demerol supply.png|thumb|none|600px|This image is provided by the National Library of Medicine.]]
 
* Carpuject™ are packaged in a Slim-Pak™ tamper detection package. To prevent needle-stick injuries, needles should not be recapped, purposely bent, or broken by hand. Blunt cannulas should not be recapped, purposely bent or broken by hand.
 
'''NOTE''': The pH of DEMEROL solutions is adjusted between 3.5 and 6 with sodium hydroxide or hydrochloric acid. Multiple-dose vials contain metacresol 0.1 percent as preservative. No preservatives are added to the ampuls or Carpuject™ sterile cartridge units.
|packLabel=<!--Patient Counseling Information-->
|packLabel=<!--Patient Counseling Information-->
|fdaPatientInfo=There is limited information regarding <i>Patient Counseling Information</i> of {{PAGENAME}} in the drug label.
|fdaPatientInfo=There is limited information regarding <i>Patient Counseling Information</i> of {{PAGENAME}} in the drug label.
Line 323: Line 166:
<!--Brand Names-->
<!--Brand Names-->
|brandNames=* DEMEROL®<ref>{{Cite web | title =meperidine hydrochloride injection, solution| url =http://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=b31d1308-28c3-43f4-e0a6-2f3ed76b8975 }}</ref>
|brandNames=* DEMEROL®<ref>{{Cite web | title =meperidine hydrochloride injection, solution| url =http://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=b31d1308-28c3-43f4-e0a6-2f3ed76b8975 }}</ref>
|lookAlike=
|drugShortage=
|drugShortage=
}}
}}

Revision as of 12:44, 14 May 2015

Meperidine (injection)
Adult Indications & Dosage
Pediatric Indications & Dosage
Contraindications
Warnings & Precautions
Adverse Reactions
Drug Interactions
Use in Specific Populations
Administration & Monitoring
Overdosage
Pharmacology
Clinical Studies
How Supplied
Images
Patient Counseling Information
Precautions with Alcohol
Brand Names
Look-Alike Names

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Kiran Singh, M.D. [2]

Disclaimer

WikiDoc MAKES NO GUARANTEE OF VALIDITY. WikiDoc is not a professional health care provider, nor is it a suitable replacement for a licensed healthcare provider. WikiDoc is intended to be an educational tool, not a tool for any form of healthcare delivery. The educational content on WikiDoc drug pages is based upon the FDA package insert, National Library of Medicine content and practice guidelines / consensus statements. WikiDoc does not promote the administration of any medication or device that is not consistent with its labeling. Please read our full disclaimer here.

Overview

Meperidine (injection) is a {{{drugClass}}} that is FDA approved for the treatment of {{{indication}}}. Common adverse reactions include .

Adult Indications and Dosage

FDA-Labeled Indications and Dosage (Adult)

Indications

  • For the relief of moderate to severe pain
  • For preoperative medication
  • For support of anesthesia
  • For obstetrical analgesia

Dosage

For Relief of Pain

  • Dosage should be adjusted according to the severity of the pain and the response of the patient. While subcutaneous administration is suitable for occasional use, intramuscular administration is preferred when repeated doses are required. If intravenous administration is required, dosage should be decreased and the injection made very slowly, preferably utilizing a diluted solution. The dose of DEMEROL should be proportionately reduced (usually by 25 to 50 percent) when administered concomitantly with phenothiazines and many other tranquilizers since they potentiate the action of DEMEROL.
  • The usual dosage is 50 mg to 150 mg intramuscularly or subcutaneously every 3 or 4 hours as necessary. Elderly patients should usually be given meperidine at the lower end of the dose range and observed closely.

For Preoperative Medication

  • The usual dosage is 50 mg to 100 mg intramuscularly or subcutaneously, 30 to 90 minutes before the beginning of anesthesia. Elderly patients should usually be given meperidine at the lower end of the dose range and observed closely.

For Support of Anesthesia

  • Repeated slow intravenous injections of fractional doses (e.g., 10 mg/mL) or continuous intravenous infusion of a more dilute solution (e.g., 1 mg/mL) should be used. The dose should be titrated to the needs of the patient and will depend on the premedication and type of anesthesia being employed, the characteristics of the particular patient, and the nature and duration of the operative procedure. Elderly patients should usually be given meperidine at the lower end of the dose range and observed closely.

For Obstetrical Analgesia

  • The usual dosage is 50 mg to 100 mg intramuscularly or subcutaneously when pain becomes regular, and may be repeated at 1- to 3-hour intervals.
  • Parenteral drug products should be inspected visually for particulate and discoloration prior to administration whenever solution and container permit.

Off-Label Use and Dosage (Adult)

Guideline-Supported Use

There is limited information regarding Off-Label Guideline-Supported Use of Meperidine (injection) in adult patients.

Non–Guideline-Supported Use

There is limited information regarding Off-Label Non–Guideline-Supported Use of Meperidine (injection) in adult patients.

Pediatric Indications and Dosage

FDA-Labeled Indications and Dosage (Pediatric)

There is limited information regarding FDA-Labeled Use of Meperidine (injection) in pediatric patients.

Off-Label Use and Dosage (Pediatric)

Guideline-Supported Use

There is limited information regarding Off-Label Guideline-Supported Use of Meperidine (injection) in pediatric patients.

Non–Guideline-Supported Use

There is limited information regarding Off-Label Non–Guideline-Supported Use of Meperidine (injection) in pediatric patients.

Contraindications

There is limited information regarding Meperidine (injection) Contraindications in the drug label.

Warnings

There is limited information regarding Meperidine (injection) Warnings' in the drug label.

Adverse Reactions

Clinical Trials Experience

  • The most frequently observed adverse reactions include lightheadedness, dizziness, sedation, nausea, vomiting, and sweating. These effects seem to be more prominent in ambulatory patients and in those who are not experiencing severe pain. In such individuals, lower doses are advisable. Some adverse reactions in ambulatory patients may be alleviated if the patient lies down.

Other adverse reactions include:

  • Allergic. Pruritus, urticaria, other skin rashes, wheal and flare over the vein with intravenous injection.
  • Other. Pain at injection site; local tissue irritation and induration following subcutaneous injection, particularly when repeated; antidiuretic effect.

Postmarketing Experience

There is limited information regarding Postmarketing Experience of Meperidine (injection) in the drug label.

Drug Interactions

There is limited information regarding Meperidine (injection) Drug Interactions in the drug label.

Use in Specific Populations

Pregnancy

Pregnancy Category (FDA):

  • Pregnancy Category


Pregnancy Category (AUS):

  • Australian Drug Evaluation Committee (ADEC) Pregnancy Category

There is no Australian Drug Evaluation Committee (ADEC) guidance on usage of Meperidine (injection) in women who are pregnant.

Labor and Delivery

There is no FDA guidance on use of Meperidine (injection) during labor and delivery.

Nursing Mothers

There is no FDA guidance on the use of Meperidine (injection) with respect to nursing mothers.

Pediatric Use

There is no FDA guidance on the use of Meperidine (injection) with respect to pediatric patients.

Geriatic Use

There is no FDA guidance on the use of Meperidine (injection) with respect to geriatric patients.

Gender

There is no FDA guidance on the use of Meperidine (injection) with respect to specific gender populations.

Race

There is no FDA guidance on the use of Meperidine (injection) with respect to specific racial populations.

Renal Impairment

There is no FDA guidance on the use of Meperidine (injection) in patients with renal impairment.

Hepatic Impairment

There is no FDA guidance on the use of Meperidine (injection) in patients with hepatic impairment.

Females of Reproductive Potential and Males

There is no FDA guidance on the use of Meperidine (injection) in women of reproductive potentials and males.

Immunocompromised Patients

There is no FDA guidance one the use of Meperidine (injection) in patients who are immunocompromised.

Administration and Monitoring

Administration

  • Oral
  • Intravenous

Monitoring

There is limited information regarding Monitoring of Meperidine (injection) in the drug label.

  • Description

IV Compatibility

There is limited information regarding IV Compatibility of Meperidine (injection) in the drug label.

Overdosage

Acute Overdose

Signs and Symptoms

  • Description

Management

  • Description

Chronic Overdose

There is limited information regarding Chronic Overdose of Meperidine (injection) in the drug label.

Pharmacology

There is limited information regarding Meperidine (injection) Pharmacology in the drug label.

Mechanism of Action

Structure

File:Meperidine (injection)01.png
This image is provided by the National Library of Medicine.

Pharmacodynamics

There is limited information regarding Pharmacodynamics of Meperidine (injection) in the drug label.

Pharmacokinetics

There is limited information regarding Pharmacokinetics of Meperidine (injection) in the drug label.

Nonclinical Toxicology

There is limited information regarding Nonclinical Toxicology of Meperidine (injection) in the drug label.

Clinical Studies

There is limited information regarding Clinical Studies of Meperidine (injection) in the drug label.

How Supplied

  • For Parenteral Use
  • Solutions of DEMEROL for parenteral use are clear and colorless and are available as follows:
This image is provided by the National Library of Medicine.
  • Carpuject™ are packaged in a Slim-Pak™ tamper detection package. To prevent needle-stick injuries, needles should not be recapped, purposely bent, or broken by hand. Blunt cannulas should not be recapped, purposely bent or broken by hand.

NOTE: The pH of DEMEROL solutions is adjusted between 3.5 and 6 with sodium hydroxide or hydrochloric acid. Multiple-dose vials contain metacresol 0.1 percent as preservative. No preservatives are added to the ampuls or Carpuject™ sterile cartridge units.

Storage

There is limited information regarding Meperidine (injection) Storage in the drug label.

Images

Drug Images

{{#ask: Page Name::Meperidine (injection) |?Pill Name |?Drug Name |?Pill Ingred |?Pill Imprint |?Pill Dosage |?Pill Color |?Pill Shape |?Pill Size (mm) |?Pill Scoring |?NDC |?Drug Author |format=template |template=DrugPageImages |mainlabel=- |sort=Pill Name }}

Package and Label Display Panel

{{#ask: Label Page::Meperidine (injection) |?Label Name |format=template |template=DrugLabelImages |mainlabel=- |sort=Label Page }}

Patient Counseling Information

There is limited information regarding Patient Counseling Information of Meperidine (injection) in the drug label.

Precautions with Alcohol

  • Alcohol-Meperidine (injection) interaction has not been established. Talk to your doctor about the effects of taking alcohol with this medication.

Brand Names

Look-Alike Drug Names

There is limited information regarding Meperidine (injection) Look-Alike Drug Names in the drug label.

Drug Shortage Status

Price

References

The contents of this FDA label are provided by the National Library of Medicine.

  1. ↑ "meperidine hydrochloride injection, solution".

{{#subobject: 

 |Page Name=Meperidine (injection)
 |Pill Name=No image.jpg
 |Drug Name=
 |Pill Ingred=|+sep=;
 |Pill Imprint=
 |Pill Dosage={{{dosageValue}}} {{{dosageUnit}}}
 |Pill Color=|+sep=;
 |Pill Shape=
 |Pill Size (mm)=
 |Pill Scoring=
 |Pill Image=
 |Drug Author=
 |NDC=

}}

{{#subobject: 

 |Label Page=Meperidine (injection)
 |Label Name=Meperidine (injection)11.png

}}

{{#subobject: 

 |Label Page=Meperidine (injection)
 |Label Name=Meperidine (injection)11.png

}}

Retrieved from "https://www.wikidoc.org/index.php?title=Meperidine_(injection)&oldid=1097663"