Meperidine and promethazine

This product is available in concentration providing 25 mg each of meperidine hydrochloride and promethazine hydrochloride per mL with 0.1 mg edetate disodium, 0.04 mg calcium chloride, and not more than 0.75 mg sodium formaldehyde sulfoxylate, 0.25 mg sodium metabisulfite, and 5 mg phenol with sodium acetate buffer.

Meperidine and promethazine can slow or stop your breathing, and may be habit-forming. MISUSE OF THIS MEDICINE CAN CAUSE ADDICTION, OVERDOSE, OR DEATH, especially in a child or other person using the medicine without a prescription.

Meperidine and promethazine should not be given to a child younger than 2 years old.

Do not use this medicine if you have used an MAO inhibitor in the past 14 days, such as isocarboxazid, linezolid, methylene blue injection, phenelzine, rasagiline, selegiline, or tranylcypromine.

Taking this medicine during pregnancy may cause life-threatening withdrawal symptoms in the newborn.

Fatal side effects can occur if you use this medicine with alcohol, or with other drugs that cause drowsiness or slow your breathing.

Follow all directions on your prescription label. Meperidine and promethazine can slow or stop your breathing. Never take this medicine in larger amounts, or for longer than prescribed. Tell your doctor if the medicine seems to stop working as well in relieving your pain.

Meperidine and promethazine may be habit-forming. Never share this medicine with another person, especially someone with a history of drug abuse or addiction. MISUSE OF NARCOTIC MEDICINE CAN CAUSE ADDICTION, OVERDOSE, OR DEATH, especially in a child or other person using the medicine without a prescription. Selling or giving away meperidine and promethazine is against the law.

Take this medicine with a full glass of water.

Take meperidine with food or milk if it causes stomach upset.

Do not stop using meperidine and promethazine suddenly, or you could have unpleasant withdrawal symptoms. Ask your doctor how to safely stop using this medicine.

Store at room temperature away from moisture and heat.

Keep track of your medicine. Meperidine and promethazine is a drug of abuse and you should be aware if anyone is using your medicine improperly or without a prescription.

Do not keep unused meperidine and promethazine that is no longer needed. Ask your pharmacist where to locate a community drug take-back disposal program. If there is no take-back program, flush any unused medicine down the toilet.

Since meperidine and promethazine is used for pain, you are not likely to miss a dose. Skip any missed dose if it is almost time for your next scheduled dose. Do not use extra medicine to make up the missed dose.

Do not drink alcohol. Dangerous side effects or death could occur.

Avoid driving or operating machinery until you know how this medicine will affect you. Dizziness or severe drowsiness can cause falls or other accidents.

Avoid exposure to sunlight or tanning beds. Meperidine and promethazine can make you sunburn more easily. Wear protective clothing and use sunscreen (SPF 30 or higher) when you are outdoors.

Narcotic (opioid) medication can interact with many other drugs and cause dangerous side effects or death. Be sure your doctor knows if you also use:

• other narcotic medications--opioid pain medicine or prescription cough medicine;

• drugs that make you sleepy or slow your breathing--a sleeping pill, muscle relaxer, sedative, tranquilizer, or antipsychotic medicine; or

• drugs that affect serotonin levels in your body--medicine for depression, Parkinson's disease, migraine headaches, serious infections, or prevention of nausea and vomiting.

This list is not complete. Other drugs may interact with meperidine and promethazine, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed in this medication guide.

Meperidine is a opioid analgesic; promethazine is a phenothiazine derivative with sedative and anti-emetic activity. Also see individual agents.

Pain: Oral: One meperidine 50 mg/promethazine 25 mg capsule every 4 to 6 hours as needed.

There are no dosage adjustments provided in the manufacturer's labeling; use with caution.

Pain relief, respiratory and mental status; observe patient for excessive sedation, CNS depression, seizures, respiratory depression.

Alternate recommendations: Chronic pain (long-term therapy outside of end-of-life or palliative care, active cancer treatment, sickle cell disease, or medication-assisted treatment for opioid use disorder): Evaluate benefits/risks of opioid therapy within 1 to 4 weeks of treatment initiation and with dose increases. Re-evaluate benefits/risks every 3 months during therapy or more frequently in patients at increased risk of overdose or opioid use disorder. Urine drug testing is recommended prior to initiation and re-checking should be considered at least yearly (includes controlled prescription medications and illicit drugs of abuse). State prescription drug monitoring program (PDMP) data should be reviewed by clinicians prior to initiation and periodically during therapy (frequency ranging from every prescription to every 3 months) (Dowell [CDC 2016]).