What is the typical dosing for Demerol (Meperidine) for pain management?

From the Guidelines

Demerol (meperidine) is typically dosed at 50-150 mg IM or IV, repeated every 3-4 hours as needed for pain. According to the provided evidence 1, the dosage of meperidine for pain management is listed as 50 to 150 mg IM or IV, with a repeat dose of 50 to 150 mg every three to four hours.

Important Considerations

• The use of meperidine is limited due to its potential for dependence and numerous drug interactions, as well as the risk of toxicity with repeated dosing 1.
• Meperidine should be used for short-term pain management only, and patients should be monitored for respiratory depression, especially when treatment is initiated or when used with other central nervous system depressants.
• For elderly patients or those with renal or hepatic impairment, lower doses should be used, often starting at 25-50 mg.

Key Points to Consider

• Meperidine is not recommended for chronic pain due to safety concerns, including the risk of seizures or other central nervous system toxicity caused by its metabolite, normeperidine.
• The maximum daily dose should not exceed 600 mg due to the risk of toxicity.
• Patients should be closely monitored for signs of overdose, including respiratory depression, hypotension, and altered mental status.
• Meperidine has fallen out of favor in modern pain management, with many institutions limiting its use or removing it from formularies in favor of safer opioid alternatives.

From the FDA Drug Label

DOSAGE AND ADMINISTRATION For Relief of Pain Dosage should be adjusted according to the severity of the pain and the response of the patient. Adults: The usual dosage is 50 to 150 mg orally every 3 or 4 hours as necessary. Pediatric Patients: The usual dosage is 1.1 mg/kg to 1. 8 mg/kg orally up to the adult dose, every 3 or 4 hours as necessary.

The typical dosing for Demerol (Meperidine) for pain management is:

• Adults: 50 to 150 mg orally every 3 or 4 hours as necessary 2
• Pediatric Patients: 1.1 mg/kg to 1.8 mg/kg orally up to the adult dose, every 3 or 4 hours as necessary 2

From the Research

Demerol Dosing for Pain Management

• The typical dosing for Demerol (Meperidine) is not explicitly stated in the provided studies, but its analgesic efficacy is compared to other pain management options.
• According to 3, meperidine is most often administered intramuscularly or intravenously, and its analgesic effects usually last 3-4 hours with parenteral administration.
• The study 4 mentions that physicians ordered intramuscular Demerol for pain management, but it does not specify the typical dosing.
• It is essential to note that meperidine should be considered a second-line agent in the treatment of pain when opioid analgesics are required, as stated in 3.
• The provided studies do not offer a clear recommendation for the typical dosing of Demerol for pain management, but they discuss its efficacy and potential side effects compared to other pain management options.

Comparison to Other Pain Management Options

• Tramadol is compared to meperidine in 5, which states that intravenous tramadol 50 to 150mg was equivalent in analgesic efficacy to morphine 5 to 15mg in patients with moderate pain following surgery.
• The study 4 compares the efficacy of transdermal fentanyl to intramuscular Demerol for breakthrough pain in patients with acute pancreatitis.
• Dipyrone (metamizole) is evaluated in 6 for its analgesic efficacy in acute postoperative pain, but it is not directly compared to Demerol.
• Neuraxial morphine is discussed in 7, which highlights the importance of finding the right balance between analgesic efficacy and minimizing dose-related adverse effects, such as respiratory depression.