Meperidine
Meperidine is a synthetic opioid analgesic used to treat moderate to severe pain. It works by binding to opioid receptors in the brain and spinal cord to reduce pain perception and produce sedation.
Meperidine is a short-acting opioid pain medication prescribed for acute, severe pain when other treatments are inadequate.
This medication carries a boxed (black box) warning — the strongest type of FDA warning. Review the full prescribing information before use.
Key facts at a glance
- ATC
- N02AB02
- RxNorm
- 6754
- Generic
- Meperidine
- Class
- atc-n02
- Brands
- Demerol
- Availability
- rx
- Lactation
- unknown
- Routes
- oral
- Forms
- injection, prefilled syringe, solution, tablet, capsule
- Regions
- US, EU, CN, JP
- Monitoring
- —
This page is for informational purposes only.
Do not use this information to diagnose yourself or to replace a physician's advice. Always consult a qualified healthcare provider before starting, stopping, or changing any medication. If you believe you are experiencing a medical emergency, call your local emergency number immediately.
Dosage and administration
- Usual dose
- 50-150mg every 3-4 hours as needed
- Maximum
- consult physician
- Frequency
- every 3-4 hours PRN
- Instructions
- Follow physician instructions
- Duration limits
- as prescribed
- Monitoring
- standard
- Usual dose
- 1-1.5 mg/kg/dose every 3-4 hours as needed
- Maximum
- consult physician
- Frequency
- every 3-4 hours PRN
- Instructions
- Follow physician instructions
- Duration limits
- as prescribed
- Monitoring
- standard
- Usual dose
- 25-50mg every 3-4 hours as needed
- Maximum
- consult physician
- Frequency
- every 3-4 hours PRN
- Instructions
- Follow physician instructions
- Duration limits
- as prescribed
- Monitoring
- standard
Overdose information
Special Populations
14 groupspregnancy
first trimesteravoid if possible
avoid use during pregnancy unless benefits outweigh risks; meperidine crosses the placenta
regular fetal monitoring
Use of this medication in this population requires careful consideration of risks and benefits.
pregnancy
second trimesteravoid if possible
use only if benefits clearly outweigh risks; consider alternative analgesics
fetal heart rate monitoring
Use of this medication in this population requires careful consideration of risks and benefits.
pregnancy
third trimesteravoid if possible
avoid use near delivery; can cause prolonged neonatal respiratory depression
intensive fetal and neonatal monitoring
Use of this medication in this population requires careful consideration of risks and benefits.
pediatric_age
neonatesnot recommended
avoid in neonates due to immature hepatic metabolism and increased risk of respiratory depression
continuous respiratory and cardiac monitoring
Use of this medication in this population requires careful consideration of risks and benefits.
pediatric_age
pediatric under 6 monthsavoid or use with extreme caution at reduced doses
use only in monitored setting; not recommended for repeated dosing due to normeperidine accumulation
close respiratory and neurological monitoring
Use of this medication in this population requires careful consideration of risks and benefits.
pediatric_age
pediatric 6 months to 12 yearsreduce dose based on weight; use lowest effective dose
avoid repeated dosing due to normeperidine accumulation; single dose or short-term use only
monitor for respiratory depression and sedation
Use with caution and monitor for adverse effects.
geriatric
geriatric 65 plusreduce initial dose by 25-50%
use lowest effective dose for shortest duration; increased sensitivity to CNS effects
monitor for sedation, respiratory depression, confusion, and falls
Use with caution and monitor for adverse effects.
renal_impairment
severe renal impairmentavoid use
meperidine is contraindicated in severe renal impairment due to normeperidine accumulation
not applicable - avoid use
Use of this medication in this population requires careful consideration of risks and benefits.
renal_impairment
moderate renal impairmentavoid if possible; if must use, reduce dose significantly and limit to single dose
avoid repeated dosing; normeperidine accumulates and is not dialyzable
monitor for signs of neurotoxicity, seizures, and respiratory depression
Use of this medication in this population requires careful consideration of risks and benefits.
renal_impairment
mild renal impairmentreduce dose and extend dosing interval
use with caution; avoid repeated dosing; monitor renal function
monitor for normeperidine accumulation and neurotoxicity
Use with caution and monitor for adverse effects.
hepatic_impairment
severe hepatic impairmentavoid if possible; if used, reduce dose significantly
impaired metabolism leads to prolonged half-life and increased bioavailability
close monitoring for respiratory depression and prolonged sedation
Use of this medication in this population requires careful consideration of risks and benefits.
hepatic_impairment
moderate hepatic impairmentreduce dose by 50%
use with caution; may require dose reduction and extended dosing intervals
monitor for excessive sedation and respiratory depression
Use with caution and monitor for adverse effects.
hepatic_impairment
mild hepatic impairmentmay require slight dose reduction
use with caution; monitor response
standard monitoring for opioid effects
Use with caution and monitor for adverse effects.
lactation
breastfeedingavoid use
meperidine is excreted in breast milk; avoid during breastfeeding
not applicable - avoid use
Use of this medication in this population requires careful consideration of risks and benefits.
Statistics and clinical data
Commonly prescribed since
General prescribing information
Drug class
Drug class information
Common uses
Common therapeutic uses
Controlled substance schedule
Regulatory classification
Treatment of acute, moderate to severe pain (e.g., preoperative medication, obstetric analgesia, post-operative pain). Due to its metabolite normeperidine, it is generally limited to short-term use (less than 48 hours) and not recommended for chronic pain management.
Meperidine is a full opioid agonist that binds primarily to mu-opioid receptors in the central nervous system. This interaction inhibits ascending pain pathways, altering the perception and emotional response to pain while also producing sedative effects.
High risk of dependence, abuse, and misuse. Contraindicated with MAOIs and in patients with severe respiratory depression. The metabolite normeperidine accumulates with repeated dosing, increasing risk of neurotoxicity (seizures). Not preferred for pain management due to unfavorable safety profile compared to other opioids. May cause serotonin syndrome when combined with serotonergic drugs.
Contraindications
Conditions and patient states where this medication should be avoided or used with caution.
Do not use (1)
Known allergy to this medication or its components
Use caution (1)
Consult healthcare provider for benefits vs risks assessment
Official drug label
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This information is for educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment.
This content is for general informational and educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the guidance of a qualified healthcare provider with any questions you have about a medical condition, and never disregard professional medical advice or delay seeking it because of something you read here.
If you think you may have a medical emergency, call your local emergency number or go to the nearest emergency department immediately.
Medically reviewed by WellAlly Editorial Team Last reviewed July 26, 2026. · Read our editorial policy