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Demerol
Demerol (generic name: meperidine) is an opioid analgesic used to manage moderate to severe pain. It is often prescribed for pain relief after surgery or for managing pain associated with chronic conditions. Like other opioids, Demerol works by altering the way the brain and nervous system respond to pain, providing significant relief for acute and short-term pain. However, due to the potential for abuse and dependence, its use is typically limited.
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Frequently Asked Questions
How long does Demerol take to work?
Demerol typically begins to relieve pain within 15 to 30 minutes after oral administration and even more quickly when administered by injection.
Can Demerol be used for long-term pain management?
Demerol is generally not recommended for long-term use due to its potential for dependency and the risk of seizures with prolonged use. Other opioids or non-opioid pain management options are preferred for long-term treatment.
What should I do if I miss a dose of Demerol?
If you are on a regular dosing schedule, take the missed dose as soon as you remember. If it’s close to your next dose, skip the missed dose and resume your regular dosing schedule. Do not double the dose.
Can Demerol cause withdrawal symptoms?
Yes, stopping Demerol abruptly can cause withdrawal symptoms such as anxiety, sweating, nausea, and tremors. Always taper off under a doctor's guidance.
Is Demerol safe to use during pregnancy?
Demerol may be used during labor for pain relief, but its use during pregnancy should be closely monitored, as it can cause withdrawal symptoms in the newborn (neonatal opioid withdrawal syndrome).
Comprehensive Drug Guide
How Does Demerol Work?
Demerol works by binding to mu-opioid receptors in the brain and spinal cord. This binding reduces the perception of pain and alters the emotional response to pain, providing relief. Meperidine also has some serotonergic activity, which contributes to its effects but can increase the risk of serotonin syndrome when used with other serotonergic drugs.
Common Dosages
- 50 mg and 100 mg tablets
- Oral solution (50 mg/5 mL)
- Injectable solution (various strengths for IV or IM administration)
Typical Dosing
- For moderate to severe pain: The typical oral dose for adults is 50 to 150 mg every 3 to 4 hours as needed for pain.
- For injectable use: The dose is typically 50 to 100 mg intramuscularly or subcutaneously every 3 to 4 hours as needed, depending on the severity of the pain.
Typical Dosing
FDA Approved Indications
- Moderate to severe acute pain
- Postoperative pain
- Pain during labor (in specific cases)
Who Shouldn't Take Demerol?
- Severe respiratory depression
- Acute or severe asthma
- Paralytic ileus
- MAOI use within the last 14 days
- Known hypersensitivity to meperidine or any components of the formulation
Advice From The Pharmacist
- Take Demerol exactly as prescribed and avoid increasing the dose without consulting your doctor, as it can be habit-forming.
- Do not mix Demerol with alcohol or other CNS depressants, as this can increase the risk of dangerous side effects, including respiratory depression.
- If you experience symptoms of overdose, such as extreme drowsiness, slow or shallow breathing, or loss of consciousness, seek emergency medical help immediately.
Side Effects of Demerol
Common Side Effects
- Drowsiness
- Dizziness
- Nausea
- Vomiting
- Sweating
Uncommon/Severe Side Effects
- Respiratory depression
- Seizures
- Serotonin syndrome (when taken with serotonergic drugs)
- Addiction and dependence
Risks and Warnings of Demerol
- Respiratory Depression: Demerol, like all opioids, can cause significant respiratory depression, especially in elderly patients or those with preexisting respiratory conditions.
- Addiction and Abuse: Demerol has a high potential for abuse and dependence. Use should be closely monitored, especially in patients with a history of substance use disorder.
- Seizure Risk: At high doses or with prolonged use, Demerol can increase the risk of seizures, particularly in patients with renal impairment.
Interactions with Demerol
Common Drug Interactions
- MAOIs: Demerol should not be used with monoamine oxidase inhibitors (MAOIs) due to the risk of serious reactions, including serotonin syndrome.
- CNS depressants: Combining Demerol with other CNS depressants, such as benzodiazepines or alcohol, increases the risk of severe sedation and respiratory depression.
- Serotonergic drugs: The use of Demerol with serotonergic drugs (e.g., antidepressants like SSRIs) can increase the risk of serotonin syndrome.
Alternatives to Demerol
- Morphine: Another opioid used for moderate to severe pain management.
- Oxycodone: A potent opioid that is commonly used for long-term pain management.
- Hydromorphone: A more potent opioid used for severe pain.
