The cost-free fraction of meperidine in plasma could be larger in individuals in excess of 45 decades of age than in more youthful people.
the subsequent significant adverse reactions are described, or described in better depth, in other sections:
If concomitant use is necessary, consider growing the DEMEROL Injection dosage until eventually secure drug effects are attained.
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If the level of pain increases right after dosage stabilization, try and determine the supply of amplified discomfort prior to growing the DEMEROL Injection dosage. If following escalating the dosage, unacceptable opioid-similar adverse reactions are noticed (such as an increase in pain following a dosage increase), consider decreasing the dosage [see Warnings and safeguards (five)].
In these individuals, blended agonist/antagonist and partial agonist analgesics may perhaps lessen the analgesic result and/or precipitate withdrawal symptoms.
Meperidine causes miosis, even in total darkness. Pinpoint pupils are an indication of opioid overdose but are not pathognomonic (e.g., pontine lesions of hemorrhagic or ischemic origins might develop identical conclusions). Marked mydriasis in lieu of miosis could be observed as a consequence of hypoxia in overdose situations.
Meperidine is appreciably less efficient through the oral than through the parenteral route, but the exact ratio of oral to parenteral effectiveness is unknown.
Meperidine injection is utilised To ease average to intense discomfort. It may be made use of right before or in the course of surgical procedure, or to relieve discomfort for the duration of labor or shipping and delivery.
Other: ache at injection web-site; local tissue irritation and check here induration pursuing subcutaneous injection, significantly when repeated; antidiuretic impact.
There exists a marriage concerning rising meperidine plasma focus and growing frequency of dose-linked opioid adverse reactions for instance nausea, vomiting, CNS effects, and respiratory depression.
Propulsive peristaltic waves while in the colon are decreased, even though tone could possibly be amplified to the point of spasm, resulting in constipation. Other opioid-induced effects may well contain a reduction in biliary and pancreatic secretions, spasm of sphincter of Oddi, and transient elevations in serum amylase.
Risk Summary Meperidine seems inside the milk of nursing moms receiving the drug. The developmental and health advantages of breastfeeding really should be considered together with the mom's clinical want for DEMEROL Injection and any probable adverse effects to the breastfed toddler from DEMEROL Injection or from the fundamental maternal situation.
Accumulation of meperidine and/or its active metabolite, normeperidine, can manifest in sufferers with renal impairment. Meperidine should hence be applied with warning in sufferers with renal impairment.