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Meperidine is a medication with several important safety considerations that must be carefully understood by patients and healthcare providers. Below is crucial information regarding its use:

• Risk of Abuse and Addiction: Meperidine carries a significant risk for abuse and addiction, which can result in overdose and potentially fatal outcomes. To mitigate these risks, it is essential to use the smallest effective dose for the shortest duration. Consult your healthcare provider about having naloxone available for opioid overdoses and educate your family about recognizing and responding to these emergencies.

• Breathing Issues: This medication can cause severe breathing problems, especially when beginning treatment, after a dose increase, or if taken incorrectly. The risk is amplified when combined with alcohol or other sedatives. Immediate medical attention is required for symptoms like slow or shallow breathing, severe dizziness, or difficulty awakening.

• Interactions with Other Substances: Meperidine can interact with various drugs, altering its effects and potentially causing dangerous side effects. Avoid alcohol and consult your healthcare provider to understand which medications to avoid.

• Use During Pregnancy: Women who are pregnant or considering pregnancy should discuss the benefits and risks with their doctor. Meperidine should be used during pregnancy only if absolutely necessary due to potential birth defects and withdrawal symptoms in the newborn.

• Symptoms of Overdose: An opioid overdose may present as unresponsiveness, extremely slow breathing, extreme drowsiness, a slow heartbeat, or cold and clammy skin. Immediate medical assistance is crucial in such cases.

• Potential Withdrawal in Newborns: Long-term use during pregnancy can lead to neonatal opioid withdrawal syndrome, which can be life-threatening if not promptly addressed. Symptoms in newborns include persistent crying, breathing issues, irritability, and feeding difficulties.

• Serotonin Syndrome: Although rare, this life-threatening condition can occur, especially when combined with other serotonergic drugs. Symptoms include rapid heart rate, sweating, muscle stiffness, fever, and confusion.

• Adrenal Insufficiency: Prolonged use of opioids like meperidine may lead to low adrenal hormone levels, resulting in tiredness, weakness, or nausea. If symptoms occur, medical evaluation is necessary.

• Low Blood Pressure: Meperidine can cause a significant drop in blood pressure, leading to dizziness or fainting. Rise slowly from sitting or lying positions to minimize these effects.

• Physical Dependence and Withdrawal: Long-term use can lead to physical dependence. Do not abruptly stop taking meperidine without consulting your healthcare provider, who can guide a gradual tapering off to avoid withdrawal symptoms.

• Cognitive Impairment: The medication may cause extreme sleepiness or impaired cognitive function. Avoid activities requiring high concentration, such as driving, until you know how meperidine affects you.

• Precautions for Certain Conditions: Patients with seizure disorders or heart rhythm issues should discuss their medical history with their provider, as meperidine may exacerbate these conditions.

• Contraindications: Meperidine should not be used in individuals with severe breathing problems, acute asthma, those using MAOIs, or those with gastrointestinal blockages.

Always keep meperidine secured to prevent misuse and seek immediate medical help if accidental ingestion occurs. Consult your healthcare provider for any questions or concerns about using meperidine safely.

Common side effects:

• nausea
• vomiting
• constipation
• sweating
• lightheadedness
• dizziness
• drowsiness

Less common but important to monitor:

• weakness
• headache
• tremor
• confusion
• dry mouth
• low blood pressure
• rash

Serious side effects:

• allergic reactions
• trouble breathing
• hives
• swelling of the face, lips, tongue, or throat
• dangerously slow breathing
• extremely low blood pressure
• symptoms of an overdose
• extreme sleepiness
• cold or clammy skin
• slow heartbeat
• serotonin syndrome
• fast heart rate
• muscle stiffness
• hallucinations
• seizures
• severe drowsiness
• difficulty waking up
• signs of opioid withdrawal
• anxiety
• irritability

Interactions with high risk of serious adverse effects and should be avoided:

• MAO inhibitors (isocarboxazid, linezolid, methylene blue, moclobemide, phenelzine, selegiline, tranylcypromine)

Interactions with moderate risk that may require dose adjustment, closer monitoring, or timing changes:

• Mixed opioid agonist-antagonists (butorphanol, nalbuphine, pentazocine)
• Opioid blockers (naltrexone, samidorphan)
• Other CNS depressants (opioid pain or cough relievers like codeine, hydrocodone; alcohol; marijuana; sleep or anxiety medications like alprazolam, lorazepam, zolpidem; muscle relaxants like carisoprodol, cyclobenzaprine; antihistamines like cetirizine, diphenhydramine)
• Drugs that increase serotonin (SSRIs like fluoxetine, SNRIs like duloxetine, St. John's wort, MDMA)
• Drugs affecting meperidine metabolism (azole antifungals like ketoconazole, macrolide antibiotics like erythromycin, mifepristone, rifamycins like rifabutin, ritonavir, seizure medications like carbamazepine, phenytoin)