Meperidine And Promethazine (Injection Route) Before Using

Description and Brand Names

Drug information provided by: Merative, Micromedex®

US Brand Name

Mepergan

Descriptions

Meperidine and promethazine combination injection is used to treat pain severe enough to require opioid treatment and when other pain medicines did not work well enough or cannot be tolerated. It is also used with other medicines just before or during an operation to help the anesthetic (numbing medicine) work better.

Meperidine belongs to the group of medicines called narcotic analgesics (pain medicines). It acts in the central nervous system (CNS) or brain to relieve pain.

Promethazine is an antihistamine. It works by preventing the effects of a substance called histamine, which is produced by the body. Histamine can cause itching, sneezing, runny nose, and watery eyes. It can sometimes close up the bronchial tubes (air passages of the lungs) and make breathing difficult.

When meperidine is used for a long time, it may become habit-forming, causing mental or physical dependence. However, people who have continuing pain should not let the fear of dependence keep them from using narcotics to relieve their pain. Mental dependence (addiction) is not likely to occur when narcotics are used for this purpose. Physical dependence may lead to withdrawal side effects if treatment is stopped suddenly. However, severe withdrawal side effects can usually be prevented by gradually reducing the dose over a period of time before treatment is stopped completely.

This medicine is to be given only by or under the immediate supervision of your doctor.

Before Using

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For this medicine, the following should be considered:

Allergies

Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Pediatric

Appropriate studies have not been performed on the relationship of age to the effects of Mepergan® injection in the pediatric population. Safety and efficacy have not been established.

Geriatric

Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of Mepergan® injection in the elderly. However, elderly patients are more likely to have age-related lung, kidney, liver, or heart problems, which may require caution and an adjustment in the dose for patients receiving Mepergan® injection.

Breastfeeding

There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.

Drug Interactions

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are receiving this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.

Bepridil
Bromopride
Calcium Oxybate
Cisapride
Dronedarone
Isocarboxazid
Levoketoconazole
Linezolid
Magnesium Oxybate
Mesoridazine
Methylene Blue
Nalmefene
Naltrexone
Ozanimod
Phenelzine
Pimozide
Piperaquine
Potassium Citrate
Potassium Oxybate
Procarbazine
Rasagiline
Safinamide
Samidorphan
Saquinavir
Selegiline
Sodium Oxybate
Sparfloxacin
Terfenadine
Thioridazine
Toloxatone
Tranylcypromine
Ziprasidone

Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

Acepromazine
Aclidinium
Adagrasib
Alfentanil
Alfuzosin
Almotriptan
Alprazolam
Amantadine
Amifampridine
Amiloride
Amineptine
Amiodarone
Amisulpride
Amitriptyline
Amitriptylinoxide
Amobarbital
Amoxapine
Amphetamine
Amprenavir
Anagrelide
Anileridine
Apalutamide
Apomorphine
Aprepitant
Aripiprazole
Aripiprazole Lauroxil
Armodafinil
Arsenic Trioxide
Asenapine
Atazanavir
Atropine
Avacopan
Azithromycin
Baclofen
Belladonna
Belzutifan
Bemetizide
Bendroflumethiazide
Benperidol
Bentazepam
Benzhydrocodone
Benzphetamine
Benzthiazide
Benztropine
Berotralstat
Biperiden
Boceprevir
Bosentan
Bromazepam
Bromopride
Brompheniramine
Bumetanide
Buprenorphine
Bupropion
Buserelin
Buspirone
Butabarbital
Butorphanol
Calcium Oxybate
Cannabidiol
Cannabis
Canrenoate
Canrenone
Carbamazepine
Carbinoxamine
Carisoprodol
Carphenazine
Cenobamate
Ceritinib
Cetirizine
Chloral Hydrate
Chlordiazepoxide
Chlorothiazide
Chlorpheniramine
Chlorpromazine
Chlorthalidone
Chlorzoxazone
Cilostazol
Cimetidine
Ciprofloxacin
Citalopram
Clarithromycin
Clemastine
Clidinium
Clobazam
Clofazimine
Clomipramine
Clonazepam
Clopamide
Clopidogrel
Clorazepate
Clothiapine
Cloxazolam
Clozapine
Cobicistat
Cocaine
Codeine
Conivaptan
Crizotinib
Cyclobenzaprine
Cyclopenthiazide
Cyclopentolate
Cyclosporine
Cyclothiazide
Cyproheptadine
Dabrafenib
Dantrolene
Daridorexant
Darifenacin
Darunavir
Dasatinib
Degarelix
Delamanid
Delavirdine
Delorazepam
Desipramine
Deslorelin
Desmopressin
Desvenlafaxine
Deutetrabenazine
Dexamethasone
Dexmedetomidine
Dextroamphetamine
Dextromethorphan
Dezocine
Diacetylmorphine
Diazepam
Diazoxide
Dibenzepin
Dichloralphenazone
Dicloxacillin
Dicyclomine
Difenoxin
Dihydrocodeine
Diltiazem
Dimenhydrinate
Diphenhydramine
Diphenoxylate
Dipyrone
Disopyramide
Disulfiram
Dixyrazine
Dofetilide
Dolasetron
Domperidone
Donepezil
Doxepin
Doxylamine
Dronedarone
Droperidol
Duloxetine
Duvelisib
Efavirenz
Elagolix
Eletriptan
Encorafenib
Enflurane
Entrectinib
Enzalutamide
Epinephrine
Eplerenone
Erythromycin
Escitalopram
Esketamine
Eslicarbazepine Acetate
Estazolam
Eszopiclone
Ethacrynic Acid
Ethchlorvynol
Ethopropazine
Ethylmorphine
Etozolin
Etrasimod
Etravirine
Fenfluramine
Fentanyl
Fesoterodine
Fexinidazole
Fingolimod
Flavoxate
Flecainide
Flibanserin
Fluconazole
Flunitrazepam
Fluoxetine
Fluphenazine
Flurazepam
Fluspirilene
Fluvoxamine
Formoterol
Fosamprenavir
Fosaprepitant
Foscarnet
Fosnetupitant
Fosphenytoin
Fospropofol
Fostemsavir
Frovatriptan
Furosemide
Gabapentin
Gabapentin Enacarbil
Gatifloxacin
Gemifloxacin
Gepirone
Givinostat
Glasdegib
Glucagon
Glycopyrrolate
Glycopyrronium Tosylate
Gonadorelin
Goserelin
Granisetron
Halazepam
Halofantrine
Haloperidol
Halothane
Hexobarbital
Histrelin
Homatropine
Hydrochlorothiazide
Hydrocodone
Hydroflumethiazide
Hydromorphone
Hydroxyamphetamine
Hydroxychloroquine
Hydroxytryptophan
Hydroxyzine
Hyoscyamine
Ibutilide
Idelalisib
Iloperidone
Imatinib
Imipramine
Indapamide
Indinavir
Inotuzumab Ozogamicin
Ipratropium
Isavuconazole
Isoflurane
Isradipine
Itraconazole
Ivabradine
Ivacaftor
Ivosidenib
Ketamine
Ketazolam
Ketobemidone
Ketoconazole
Lacosamide
Lapatinib
Larotrectinib
Lasmiditan
Ledipasvir
Lefamulin
Lemborexant
Lenvatinib
Lesinurad
Letermovir
LetibotulinumtoxinA-wlbg
Leuprolide
Levocetirizine
Levofloxacin
Levomilnacipran
Levorphanol
Lisdexamfetamine
Lithium
Lofepramine
Lofexidine
Lomitapide
Lonafarnib
Lopinavir
Loprazolam
Lorazepam
Lorcaserin
Lorlatinib
Lormetazepam
Loxapine
Lumacaftor
Lumefantrine
Macimorelin
Magnesium Oxybate
Maribavir
Mavacamten
Mavorixafor
Meclizine
Medazepam
Mefloquine
Melitracen
Melperone
Mepenzolate
Meperidine
Mephobarbital
Meprobamate
Meptazinol
Mesoridazine
Metaclazepam
Metaxalone
Methacholine
Methadone
Methamphetamine
Methdilazine
Methocarbamol
Methohexital
Methotrimeprazine
Methyclothiazide
Methylprednisolone
Metoclopramide
Metolazone
Metopimazine
Metrizamide
Metronidazole
Midazolam
Mifepristone
Milnacipran
Mirtazapine
Mitotane
Mobocertinib
Modafinil
Molindone
Moricizine
Morphine
Morphine Sulfate Liposome
Moxifloxacin
Nafarelin
Nafcillin
Nalbuphine
Naratriptan
Nefazodone
Nelfinavir
Netupitant
Nevirapine
Nicomorphine
Nilotinib
Nirmatrelvir
Nitrazepam
Nitrous Oxide
Nordazepam
Norfloxacin
Nortriptyline
Octreotide
Ofloxacin
Olanzapine
Oliceridine
Omaveloxolone
Ondansetron
Opipramol
Opium
Opium Alkaloids
Orphenadrine
Osilodrostat
Osimertinib
Oxaliplatin
Oxazepam
Oxcarbazepine
Oxitropium Bromide
Oxybutynin
Oxycodone
Oxymorphone
Ozanimod
Pacritinib
Palbociclib
Paliperidone
Palonosetron
Panobinostat
Papaveretum
Paregoric
Paritaprevir
Paroxetine
Pasireotide
Pazopanib
Pentamidine
Pentazocine
Pentobarbital
Perampanel
Perazine
Periciazine
Perphenazine
Phenobarbital
Phenytoin
Pimavanserin
Pimozide
Pinazepam
Pipenzolate Bromide
Piperacetazine
Piperazine
Pipotiazine
Pirenzepine
Piretanide
Piritramide
Pitolisant
Polythiazide
Ponesimod
Porfimer
Posaconazole
Potassium Oxybate
Prasugrel
Prazepam
Prednisone
Pregabalin
Primidone
Procainamide
Procarbazine
Prochlorperazine
Procyclidine
Promazine
Promethazine
Propafenone
Propantheline
Propiomazine
Propiverine
Propofol
Protriptyline
Quazepam
Quetiapine
Quinethazone
Quinine
Quizartinib
Ramelteon
Ranitidine
Ranolazine
Relugolix
Remifentanil
Remimazolam
Remoxipride
Revefenacin
Ribociclib
Rifabutin
Rifampin
Rifapentine
Rilpivirine
Ritlecitinib
Ritonavir
Rizatriptan
Rolapitant
Ropeginterferon Alfa-2b-njft
Saquinavir
Schisandra sphenanthera
Scopolamine
Secobarbital
Secretin Human
Selpercatinib
Sertindole
Sertraline
Sevoflurane
Sibutramine
Siponimod
Sodium Oxybate
Sodium Phosphate
Sodium Phosphate, Dibasic
Sodium Phosphate, Monobasic
Sofosbuvir
Solifenacin
Sorafenib
Sotalol
Spironolactone
St John's Wort
Stramonium
Sufentanil
Sulpiride
Sumatriptan
Sunitinib
Suvorexant
Tacrolimus
Tapentadol
Telaprevir
Telavancin
Telithromycin
Telotristat Ethyl
Temazepam
Tenofovir Disoproxil Fumarate
Terodiline
Tetrabenazine
Tetrazepam
Thiethylperazine
Thiopental
Thiopropazate
Thioproperazine
Thioridazine
Thiotepa
Thiothixene
Tianeptine
Ticagrelor
Ticlopidine
Tilidine
Tiotropium
Tizanidine
Tolonium Chloride
Tolterodine
Topiramate
Toremifene
Torsemide
Tramadol
Trazodone
Triamterene
Triazolam
Trichlormethiazide
Triclabendazole
Trifluoperazine
Trifluperidol
Triflupromazine
Trihexyphenidyl
Trimeprazine
Trimipramine
Triptorelin
Trofinetide
Troleandomycin
Tropicamide
Trospium
Tryptophan
Tucatinib
Umeclidinium
Vandetanib
Vardenafil
Vemurafenib
Venlafaxine
Verapamil
Vilanterol
Vilazodone
Vinflunine
Voclosporin
Vonoprazan
Voriconazole
Vortioxetine
Voxelotor
Xipamide
Zaleplon
Ziprasidone
Zolmitriptan
Zolpidem
Zopiclone
Zotepine
Zuclopenthixol
Zuranolone

Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

Aminolevulinic Acid
Belladonna
Belladonna Alkaloids
Betel Nut
Evening Primrose
Isoniazid
Midodrine
Phenylalanine

Other Interactions

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using this medicine with any of the following is usually not recommended, but may be unavoidable in some cases. If used together, your doctor may change the dose or how often you use this medicine, or give you special instructions about the use of food, alcohol, or tobacco.

Ethanol
Grapefruit Juice

Proper Use

A doctor or other trained health professional will give you this medicine in a hospital. This medicine is given as a shot into a muscle or into a vein.

Precautions

It is very important that your doctor check your progress while you are using this medicine to see if the medicine is working properly and to decide if you should continue to use it. Blood and urine tests may be needed to check for unwanted effects.

Do not use this medicine if you are using or have used an MAO inhibitor (MAOI) (eg, isocarboxazid [Marplan®], linezolid [Zyvox®], phenelzine [Nardil®], selegiline [Eldepryl®], tranylcypromine [Parnate®]) within the past 14 days.

Do not use too much of this medicine or use it more often than your doctor tells you to. This can be life-threatening. Signs of an overdose include: change or loss of consciousness, cold, clammy skin, coughing that sometimes produces a pink frothy sputum, decreased awareness or responsiveness, extreme dizziness or weakness, increased sweating, irregular, fast, or slow, or shallow breathing, pale or blue lips, fingernails, or skin, sleepiness or unusual drowsiness, slow heartbeat, seizures, swelling in legs and ankles, or trouble breathing. Call your doctor right away if you notice these symptoms.

This medicine will add to the effects of alcohol and other central nervous system (CNS) depressants. CNS depressants are medicines that slow down the nervous system, which may cause drowsiness or make you less alert. Some examples of CNS depressants are antihistamines or medicine for hay fever, allergies, or colds, sedatives, tranquilizers, or sleeping pills, prescription pain medicine or narcotics, barbiturates or seizure medicines, muscle relaxants, or anesthetics (numbing medicines), including some dental anesthetics. This effect may last for a few days after you stop using this medicine. Check with your medical doctor or dentist before taking any of the above while you are receiving this medicine.

This medicine may be habit-forming. If you feel that the medicine is not working as well, do not use more than your prescribed dose. Call your doctor for instructions.

This medicine may cause sleep-related breathing problems (eg, sleep apnea, sleep-related hypoxemia). Your doctor may decrease your dose if you have sleep apnea while using this medicine.

Using this medicine while you are pregnant may cause neonatal withdrawal syndrome in your newborn babies. Tell your doctor right away if your baby has an abnormal sleep pattern, diarrhea, a high-pitched cry, irritability, shakiness or tremors, weight loss, vomiting, or fails to gain weight.

Call your doctor right away if you have worsening of pain, increased sensitivity to pain, or new pain after taking this medicine. These may be symptoms of opioid-induced hyperalgesia and allodynia.

This medicine may cause a serious condition called serotonin syndrome when taken with certain medicines. Check with your doctor first before you take any other medicines. Call your doctor right away if you have a fever, confusion, restlessness, loss of coordination, or diarrhea.

This medicine may cause adrenal gland problems. Check with your doctor right away if you have darkening of the skin, diarrhea, dizziness, fainting, loss of appetite, mental depression, nausea, skin rash, unusual tiredness or weakness, or vomiting.

Dizziness, lightheadedness, or fainting may occur, especially when you get up suddenly from a lying or sitting position. Getting up slowly may help. Also, lying down for a while may relieve dizziness or lightheadedness. If this problem continues or gets worse, check with your doctor right away.

Do not change the dose or suddenly stop taking this medicine without first checking with your doctor. Your doctor may want you to gradually reduce the amount you are using before stopping it completely. This may help reduce the possibility of withdrawal symptoms, including anxiety, restlessness, fever or chills, joint pain, nausea or vomiting, loss of appetite. runny nose, stomach cramps, sweating, tremors, or trouble with sleeping.

This medicine may cause some people to become dizzy, lightheaded, faint, drowsy, or less alert than they are normally. Do not drive or do anything else that could be dangerous until you know how this medicine affects you. Getting up slowly from a lying or sitting position may also help.

This medicine may cause a serious allergic reaction called anaphylaxis and angioedema, which can be life-threatening and require immediate medical attention. Call your doctor right away if you have a rash, itching, hoarseness, large, hive-like swelling on the face, eyelids, lips, tongue, throat, hands, legs, feet, or sex organs, trouble breathing, trouble swallowing, or any swelling of your hands, face, or mouth while you are using this medicine.

Using narcotics for a long time can cause severe constipation. To prevent this, your doctor may direct you to take laxatives, drink a lot of fluids, or increase the amount of fiber in your diet. Be sure to follow the directions carefully, because continuing constipation can lead to more serious problems.

Using too much of this medicine may cause infertility (unable to have children). Talk with your doctor before using this medicine if you plan to have children.

Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.

Side Effects

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor or nurse immediately if any of the following side effects occur:

Incidence not known

Agitation
anxiety
blurred or loss of vision
chest pain, discomfort, or tightness
chills
cold sweats
coma
confusion
cool, pale skin
cough
darkening of the skin
decrease blood pressure
deepening of voice
diarrhea
difficulty in speaking
difficulty swallowing
disturbed color perception
dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position
double vision
drooling
dysphoria
false or unusual sense of well-being
fast, pounding, or irregular heartbeat or pulse
fever
halos around lights
headache
hives, itching, skin rash
increase blood pressure
increased hair growth
increased hunger
increased muscle mass
increased sensitivity to pain
loss of appetite
loss of balance control
mental depression
muscle trembling, jerking, or stiffness
nausea
nervousness
nightmares
night blindness
overactive reflexes
overbright appearance of lights
poor coordination
puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue
restlessness
redness to the face
seeing, hearing, or feeling things that are not there
seizures
shakiness
shakiness in the legs, arms, hands, and feet
shivering
shuffling walk
slow or irregular heartbeat
slurred speech
stiffness of the limbs
sweating
talking or acting with excitement you cannot control
trembling or shakiness of the hands or feet
trouble breathing
tunnel vision
twisting movements of the body
twitching
uncontrolled movements, especially of the face, neck, and back
uncoordinated muscle movements
unusual tiredness or weakness
vomiting
worsening of pain

Get emergency help immediately if any of the following symptoms of overdose occur:

Symptoms of overdose

Anxiety
blurred vision
change or loss of consciousness
chest pain or discomfort
chills
cold, clammy skin
cold sweats
coma
confusion
constricted pupils
cool, pale skin
coughing that sometimes produces a pink frothy sputum
difficult or trouble breathing
headache
increased hunger
increased sweating
irregular, fast or slow, or shallow breathing
lightheadedness, dizziness or fainting
nausea
nervousness
nightmares
pale or blue lips, fingernails, or skin
seizures
shakiness
sleepiness or unusual drowsiness
slow or irregular heartbeat
slurred speech
swelling in the legs and ankles
trouble breathing

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

Incidence not known

Constipation
decrease in frequency of urination
decrease in urine volume
difficulty in passing urine (dribbling)
dry mouth
increased sensitivity of the skin to sunlight
pain at the injection site
redness or other discoloration of the skin
severe sunburn
painful urination

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

Portions of this document last updated: July 01, 2024

Original article: https://www.mayoclinic.org/zh-hans/drugs-supplements/meperidine-and-promethazine-injection-route/before-using/drg-20562556

Meperidine And Promethazine (Injection Route)

Description and Brand Names

US Brand Name

Descriptions

Before Using

Allergies

Pediatric

Geriatric

Breastfeeding

Drug Interactions

Other Interactions

Other Medical Problems

Proper Use

Precautions

Side Effects

Incidence not known

Symptoms of overdose

Incidence not known

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