The safety and performance of meperidine in pediatric individuals has not been recognized. Literature reviews reveal that meperidine features a slower elimination charge in neonates and young infants compared to older kids and adults.
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Use the lowest successful dosage to the shortest length of time consistent with particular person client cure targets [see Warnings and safety measures (5)]. Because the hazard of overdose boosts as opioid doses enhance, reserve titration to greater doses of DEMEROL Injection for sufferers in whom decrease doses are insufficiently helpful and in whom the expected advantages of utilizing a bigger dose opioid Plainly outweigh the considerable risks.
Accumulation of meperidine and/or its Lively metabolite, normeperidine, can come about in patients with renal impairment. Meperidine need to as a result be applied with caution in people with renal impairment.
Use of opioid analgesics for an prolonged time period for the duration of pregnancy for medical or nonmedical needs may result in Actual physical dependence within the neonate and neonatal opioid withdrawal syndrome shortly after delivery.
In these clients, mixed agonist/antagonist and partial agonist analgesics might decrease the analgesic outcome and/or precipitate withdrawal indicators.
Meperidine causes miosis, even in total darkness. Pinpoint pupils are a sign of opioid overdose but are certainly not pathognomonic (e.g., pontine lesions of hemorrhagic or ischemic origins may perhaps make comparable conclusions). Marked mydriasis instead of miosis could possibly be viewed due to hypoxia in overdose conditions.
check individuals for signs of urinary retention or reduced gastric motility when DEMEROL Injection is applied concomitantly with anticholinergic medications.
Respiratory depression can come about at any time through opioid therapy, Specifically when initiating and following dosage raises with DEMEROL Injection. Consider this possibility when selecting an Preliminary dose and when generating dose adjustments [see Warnings and safety measures (five)]. •
aged people (aged sixty five a long time or older) may have increased sensitivity to meperidine. usually, use caution when choosing a dosage for an elderly patient, usually beginning within the low conclusion of the dosing assortment, reflecting the bigger frequency of decreased hepatic, renal, or cardiac operate and of concomitant disease or other drug therapy.
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Intravenous hydrocortisone or prednisolone are actually utilized to treat significant reactions, With all the addition of intravenous chlorpromazine in People situations exhibiting hypertension and hyperpyrexia. The usefulness and safety of narcotic antagonists within the procedure of those reactions is unidentified.
If concomitant use is necessary, consider dosage reduction of DEMEROL Injection until eventually steady drug effects are accomplished. check sufferers for respiratory depression and sedation at Recurrent intervals.
DEMEROL Injection should not be useful for an prolonged period of time unless the agony continues to be critical plenty of to call for an opioid analgesic and for which option therapy choices carry on being insufficient.