WARNING: ADDICTION, ABUSE, AND MISUSE; LIFE-THREATENING RESPIRATORY DEPRESSION; NEONATAL OPIOID WITHDRAWAL SYNDROME; CYTOCHROME P450 3A4 INTERACTION; RISKS FROM CONCOMITANT USE WITH BENZODIAZEPINES OR OTHER CNS DEPRESSANTS; and MONOAMINE OXIDASE (MOA) INHIBITORS INTERACTIONSDemerol Injection exposes patients and other users to the risks of opioid addiction, abuse, and misuse, which can lead to overdose and death.
Assess each patient's risk prior to prescribing Demerol Injection, and monitor all patients regularly for the development of these behaviors and conditions [Serious, life-threatening, or fatal respiratory depression may occur with use of Demerol Injection.
Use of Demerol Injection with MAO inhibitors within last 14 days is contraindicated [see Contraindications (4), Warnings and Precautions (5.6), Drug Interactions (7)].
Demerol Injection should not be used for treatment of chronic pain.
Elderly patients should usually be given meperidine at the lower end of the dose range and observed closely.
Individually titrate Demerol Injection to a dose that provides adequate analgesia and minimizes adverse reactions.
The dose of Demerol Injection should be proportionately reduced (usually by 25 to 50 percent) when administered concomitantly with phenothiazines and many other tranquilizers since they potentiate the action of Demerol Injection.
Injectable, Carpuject Single-dose cartridge with Luer Lock for the Carpuject Syringe System: 25 mg/m L, 50 mg/m L, 75 mg/m L, and 100 mg/m L.
If unacceptable opioid-related adverse reactions are observed, consider reducing the dosage.If the patient develops these signs or symptoms, raise the dose to the previous level and taper more slowly, either by increasing the interval between decreases, decreasing the amount of change in dose, or both.Do not abruptly discontinue Demerol Injection in a physically-dependent patient The usual dosage is 50 mg to 100 mg intramuscularly or subcutaneously, 30 to 90 minutes before the beginning of anesthesia.Repeated slow intravenous Injections of fractional doses (e.g., 10 mg/m L) or continuous intravenous infusion of a more dilute solution (e.g., 1 mg/m L) should be used.The dose should be titrated to the needs of the patient and will depend on the premedication and type of anesthesia being employed, the characteristics of the particular patient, and the nature and duration of the operative procedure.