About Demerol
Demerol is a narcotic analgesic (opiate pain medication) prescribed
for short-term treatment of moderate to severe pain. Demerol acts
on the central nervous system and smooth muscle tissue, slowing
the central nervous system.
Demerol has few side effects when taken as recommended by
your doctor, but some cautions should be observed. Interactions
may occur with certain medications that could alter or increase
the effect of either Demerol, or the other medication. While
Demerol is an effective pain reliever, narcotic analgesics
have been associated with an increased risk of addiction when
used improperly, or for too long. Never take Demerol in greater
doses, double doses, or for a longer period of time than recommended
by your doctor.
Demerol is only available by prescription, and should not
be mixed with any other pain medication except by the advice
of your doctor.
Demerol Side Effects
Demerol side effects are usually mild, and tend to diminish over
time. As with all narcotic medications, it can impair performance.
Driving or operating heavy machinery is not advised, as Demerol
can interfere with mental and physical abilities. Become familiar
with your reaction to Demerol before performing potentially hazardous
tasks while taking it.
Common Demerol side effects: are constipation, dizziness,
dry mouth, headache, itching, nausea, sedation, sweating, vomiting,
or weakness. If you feel lightheaded or nauseous, lying down may
alleviate these symptoms.
Breathing: High doses of Demerol, or patient sensitivity,
can cause breathing irregularity or other respiratory depression.
Respiratory depression is the most serious likely side effect of
Demerol, and may be more likely with certain combinations of medication.
Check the drug interaction list carefully, and be cautious with
any drug that slows the central nervous system or 'may cause drowsiness.'
If you have breathing difficulties, Demerol may not be right for
you.
Head Injuries: Demerol's narcotic effects can cause an
increase of pressure in the cerebral and spinal fluid. If a patient
has suffered a head injury, both the pressure increase and the respiratory
suppression can be exaggerated. Demerol may interfere with an
accurate diagnosis or treatment of head injuries.
Acute Abdominal Conditions: Demerol may interfere with diagnosis and treatment of acute abdominal conditions.
Dependence: Mental and physical dependence can develop if
Demerol is used for long periods of time. Long use of Demerol
can create a tolerance condition where the medication no longer
works at the initial dosage.
Overdose: Demerol overdose is characterized by seizure,
slowed breathing, extreme drowsiness progressing to stupor or coma,
limp muscles, or cold, clammy skin. Severe Demerol overdose may
result in death due to cardiac arrest or stopped breathing. Seek
emergency medical treatment immediately if you suspect an overdose.
Severe side effects rarely occur at the prescribed dosage of Demerol.
Do not exceed the dosage that has been prescribed to you. Take Demerol
only as much, and as often, as recommended by your doctor.
Many cases of drug overdose involving prescription medications
are related to mixing drugs that accelerate each other's effects.
Never mix a pain medication like Demerol with another prescription
drug that you or your physician suspect may not be safe. Never mix
Demerol with over the counter medications that have not been approved
by your doctor or pharmacist, and avoid mixing it with street drugs
of any type. Ignoring drug interaction warnings has resulted in
dangerous or fatal overdose in some patients.
Cautions: Demerol should be prescribed with caution to patients
with Addison's disease or kidney, liver, thyroid, or urogenital
tract problems. Tell your doctor if you have ever had an allergic
reaction to Demerol, or any other medication.
Demerol Interactions
Demerol works by slowing the central nervous system. It should
be used with caution with other drugs that have similar effects.
Non-opioid pain medication, which includes most over the counter
pain medication, and non-steroidal anti-inflammatory (NSAID) medication
is usually safe to take in combination with Demerol. (Though over
the counter pain medications should not be mixed with each other.)
Consult your doctor regarding a combination which will be effective
for you.
Demerol can change or increase the effects of certain drugs,
and your physician should be advised if you are taking any of the
following.
- Alcohol - Demerol and alcohol can accelerate central nervous
system depression. Avoid mixing the two, as this could result
in a fatal overdose.
- Antihistamines like Tavist or Benadryl
- Antiseizure medication like Cerebyx (fosphenytoin), Dilantin
(phenytoin), or Tegretol (carbamazepine)
- Benzodiazepines (a class of antidepressants, anti-panic agents,
and muscle relaxants) such as Ativan
(lorazepam), Valium (diazepam),
Halcion (triazolam), Restoril (temazepam), Librium(chlordiazepoxide),
Xanax (alprazolam),
Tranxene-SD (clorazepate), Paxipam (halazepam), ProSom (estazolam),
Klonopin (clonazepam),
and others, should be used cautiously with Demerol.
- Desyrel (trazodone) - Risk of additive
CNS depression.
- MAO inhibitors - Demerol must not be mixed with MAO (monoamine
oxidase) inhibitors such as the antidepressants Nardil, Marplan,
or Parnate. It should not be taken for 2 weeks after you have
stopped using these medications.
- Narcotic analgesics of any other kind, like Darvon (propoxyphene),
Darvocet (propoxyphene, acetaminophen), Codeine, Percocet
(oxycodone, acetaminophen), Vicodin
(hydrocodone, acetaminophen), Vicoprofen
(hydrocodone and ibuprofen) or OxyContin
(oxycodone) should not be mixed with Demerol.
- Norflex (orphenadrine)
- Risk of oversedation.
- Sedatives like Fioricet
(butalbital, acetaminophen, and caffeine), Fiorinal,
Phenobarbitol, Seconal, or other barbiturates.
- Skeletal muscle relaxants - such as Flexeril
(cyclobenzaprine), Skelaxin
(metaxalone), Soma (carisoprodol),
or Robaxin (methocarbamol)
may increase respiratory depression when mixed with Demerol.
- Sleep medication like Ambien
(zolpidem), Sonata (zaleplon),
or over the counter sleeping pills should be used with Demerol
only as, and if, advised by your doctor.
- Street drugs of any type must never be mixed with Demerol
as this could result in a fatal overdose.
- Tagamet (cimetidine)
- Tranquilizers such as Haldol (haloperidol), Mellaril (thioridazine),
or Thorazine (chlorpromazine) may cause oversedation.
- Trexan (naltrexone) - Causes narcotic pain medication to be
ineffective.
- Tricyclic antidepressants such as Elavil
(amitriptyline), Asendin (amoxapine), Anafranil (clomipramine),
Pertofrane or Norpramin (desipramine), Sinequan
(doxepin), Tofranil (imipramine), Aventyl or Pamelor (nortriptyline),
Vivactil (protriptyline), and Surmontil (trimipramine), may increase
the central nervous system suppressant effects from either the
antidepressant, or the Demerol.
- Ultram (tramadol)
- Zidovudine (AZT, Retrovir) - Narcotic pain medication increases
blood levels of this drug, potentially making side effects more
severe.
In addition to the above medications, tell your doctor if you are
using any other major antidepressants or central nervous system
depressants in combination with Demerol. Be cautious about taking
Demerol with any medicine warning that it 'may cause drowsiness.'
Demerol Dosages
Demerol dosage for adults is usually started at 50 - 150 mg every
3 - 4 hours, though 100 mg per dose is most common. If you take
a high dosage of Demerol, your doctor may suggest stepping down
treatment gradually to avoid withdrawal symptoms.
Demerol Directions
If you miss a dose of Demerol, take it as soon as you remember.
If you are within an hour or so of your next dose, skip the missed
dose and go back to your schedule. Taking double doses of Demerol
is not recommended, as it may lead to an overdose or dependence.
Do not crush tablets before taking, as this could release the drug
into the bloodstream too fast, possibly resulting in an overdose.
Do not freeze the oral solution.
Inform your doctor, dentist, or anesthesiologist that you are taking
Demerol before any kind of surgery or medical test. This medication
may interfere with certain test results. Demerol should not be combined
with certain medications given during surgery.
Store Demerol away from direct light and heat. Store in a dry location;
avoid storing it in the bathroom, near sinks, or other areas where
it may become damp. Do not use after the expiration date.
Keep Demerol away from children; both when storing it, and when
discarding any unused medication.
Demerol may cause drowsiness or disorientation. Be cautious if
you plan to drive or operate heavy machinery, avoid these activities
if you find yourself feeling tired or experience slowed reactions.
Demerol and Pregnancy
Demerol has not been well studied for effects during pregnancy. Caution is advised in prescribing Demerol to pregnant women.
Babies born to mothers taking opiates like Demerol can experience
withdrawal symptoms after birth. The Demerol withdrawal symptoms
in the baby may include: irritability, hyperactivity, tremors, faster
breathing, increased stools, fever, vomiting, sneezing, and yawning.
The severity of the symptoms is not always tied to how much, or
how long the mother used Demerol (or other opiate).
Demerol and Children
Demerol may sometimes be prescribed at low doses for children,
usually 0.5 - 0.8 mg per pound of total body weight. The maximum
frequency is typically 3-4 hours between doses.
Demerol and Seniors
Demerol does not seem to affect the senior population differently,
but lower starting dosages are recommended. There is a higher occurrence
among the elderly of Addison's disease or kidney, liver, thyroid,
or urogenital tract problems. Demerol should be prescribed with
care to these patients, and the elderly may have to be watched more
carefully for respiratory depression.
Demerol is a trademark of Sanofi Synthelabo
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This document is provided for information only. It is not a substitute for consultation with a physician, either to diagnose symptoms or prescribe treatment. Any dosages mentioned are general guidelines only, please follow the directions of your doctor or pharmacist exactly when taking medication. We have made every effort to ensure that this information is accurate, but only your doctor can say if a medication, or drug combination, is safe for you. Information intended for US residents only.
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