GENERIC NAME: MEPERIDINE/PROMETHAZINE - ORAL (meh-PAIR-id-een/pro-METH-uh-zeen)
BRAND NAME(S): Mepergan Fortis, Meprozine
USES: This combination medicine is used to treat moderate to severe pain. Meperidine is a narcotic pain reliever similar to morphine. Promethazine is used to prevent and treat nausea and vomiting. It may also be used to help you feel calmer before/after surgery or to help the meperidine work better.Meperidine acts on certain centers in the brain to give you pain relief. Promethazine is an antihistamine (phenothiazine type) that works by acting on certain parts of the brain to decrease anxiety and nausea.Promethazine should not be used in children younger than 2 years since it might cause serious slow/shallow breathing (respiratory depression).
HOW TO USE: Take this medication by mouth, usually every 4 to 6 hours as needed or as directed by your doctor. You may take this drug with or without food. If you have nausea, you may take this drug with food, although this may cause your body to absorb less of the drug and get less benefit from it. Consult your doctor or pharmacist about other ways to decrease nausea (e.g., lying down for 1-2 hours with as little head movement as possible).The dosage is based on your medical condition and response to therapy. Pain medications work best if they are used as the first signs of pain occur. If you wait until the pain has worsened, the medication may not work as well.You may also take long-acting narcotic medications or use narcotic patches for ongoing pain if so directed by your doctor. In that case, this medication might be used for sudden (breakthrough) pain only as needed. Also follow your doctor's or pharmacist's instructions for safely using non-narcotic pain relievers (e.g., naproxen, ibuprofen). Ask your doctor if you have any questions.This medication may cause withdrawal reactions, especially if it has been used regularly for a long time or in high doses. In such cases, withdrawal symptoms (such as restlessness, runny nose, watering eyes, trouble sleeping, severe abdominal/muscle pain, nausea, vomiting, rapid breathing, and fast heartbeat) may occur if you suddenly stop using this medication. To prevent withdrawal reactions, your doctor may reduce your dose gradually. Consult your doctor or pharmacist for more details, and report any withdrawal reactions immediately.Though very unlikely, this medication can also be habit-forming and may result in abnormal drug-seeking behavior (addiction). To lessen the risk of becoming addicted, do not increase your dose, take it more frequently, or use it for a longer time than prescribed. Properly stop the medication when so directed.When used for an extended period, this medication may not work as well and may require different dosing. Talk with your doctor if this medication stops working well.Inform your doctor if your pain persists or worsens.
SIDE EFFECTS: Nausea, vomiting, blurred vision, constipation, dry mouth, flushing, sweating, lightheadedness, dizziness, and drowsiness may occur. If any of these effects persist or worsen, notify your doctor or pharmacist promptly.Some people, particularly children, may experience excitability rather than drowsiness.To prevent constipation, maintain a diet adequate in fiber, drink plenty of water, and exercise. If you become constipated while using this drug, consult your pharmacist for help in selecting a laxative (e.g., stimulant-type with stool softener).Remember that your doctor has prescribed this medication because he or she has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.Tell your doctor immediately if any of these unlikely but serious side effects occur: slow/shallow breathing, fainting, slow/irregular/fast heartbeat, involuntary muscle movements/stiffness, mental/mood changes (e.g., confusion, hallucinations, nervousness), numbness, restlessness, shakiness (tremors), trouble urinating.Tell your doctor immediately if any of these rare but very serious side effects occur: severe stomach/abdominal pain, very high fever, persistent nausea/vomiting, seizures, increased sweating, change in the amount of urine, dark urine, yellowing eyes/skin.A very serious allergic reaction to this drug is rare. However, seek immediate medical attention if you notice any of the following symptoms of a serious allergic reaction: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.In the US -Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.
PRECAUTIONS: Before taking this medication, tell your doctor or pharmacist if you are allergic to meperidine; or to promethazine; or to any other phenothiazines (e.g., prochlorperazine); or if you have any other allergies.This medication should not be used if you have certain medical conditions. Before using this medicine, consult your doctor or pharmacist if you have: severe breathing problems (e.g., respiratory depression, carbon dioxide retention), a certain bowel disease (paralytic ileus), severe infectious diarrhea (e.g., Clostridium difficile-associated diarrhea), intoxication with drugs that can cause drowsiness or slow/shallow breathing (e.g., alcohol or tranquilizers/sedatives).Before taking this medication, tell your doctor or pharmacist your medical history, especially of: abdominal problems (e.g., gallbladder disease, pancreatitis), adrenal gland problem (e.g., Addison's disease, pheochromocytoma), large blood loss (e.g., recent blood donation, stomach/intestinal bleeding), brain disorders (e.g., seizures, head injury, tumor, increased intracranial pressure), a certain eye problem (narrow-angle glaucoma), heart problems (e.g., irregular heartbeat, high/low blood pressure), kidney disease, liver disease, lung diseases (e.g., asthma, chronic obstructive pulmonary disease-COPD, emphysema), mental/mood disorders (e.g., depression, toxic psychosis), certain nervous system problems (e.g., neuroleptic malignant syndrome, Reye's syndrome), personal or family history of regular use/abuse of drugs/alcohol, sickle cell anemia, a certain spinal problem (kyphoscoliosis), sun sensitivity with other medications, underactive thyroid (hypothyroidism), trouble urinating (e.g., due to enlarged prostate or narrowing of the urethra).Meperidine is usually only used for a short time. Repeated or high doses may cause drug levels to build up in the body and cause serious side effects such as seizures and shaking. Caution is advised if this medication is used for conditions which require long-term or high-dosage treatment (e.g., sickle cell anemia, burns, cancer). Consult your doctor or pharmacist for details.This drug may make you dizzy or drowsy or cause blurred vision. Do not drive, use machinery, or do any activity that requires alertness or clear vision until you are sure you can perform such activities safely. Avoid alcoholic beverages.To lower your risk of dizziness and lightheadedness, get up slowly when rising from a sitting or lying position.Promethazine may make you more sensitive to the sun. Avoid prolonged sun exposure, tanning booths, and sunlamps. Use a sunscreen and wear protective clothing when outdoors.This medication can reduce sweating, making you more likely to get heat stroke. Avoid strenuous work/exercise, drink plenty of fluids, and dress lightly while in hot weather.Kidney function declines as you grow older. This medication is removed by the kidneys. Therefore, elderly people may be more sensitive to the effects of the drug, especially confusion and drowsiness.Caution is advised when using this drug in children because they may be more sensitive to the effects of the drug, especially slowed breathing. Special caution should be taken in children who have lost a large amount of fluid (dehydration), have liver disease, and those who are hard to wake up from sleep.During pregnancy, this medication should be used only when clearly needed. Using it for long periods or in high doses near the expected delivery date is not recommended because of possible harm to the unborn baby. Discuss the risks and benefits with your doctor. Infants born to mothers who have used this medication for an extended time may have withdrawal symptoms such as irritability, abnormal/persistent crying, vomiting, or diarrhea. Tell your doctor immediately if you notice any of these symptoms in your newborn.This drug passes into breast milk and could have undesirable effects on a nursing infant. Therefore, breast-feeding is not recommended while using this drug. Consult your doctor before breast-feeding.
Quick GuideChronic Pain Syndrome: Treatment and Management for CPS
DRUG INTERACTIONS: Your health care professionals may already be aware of any possible drug interactions and may be monitoring you for them. Do not start, stop, or change the dosage of any medicine before checking with them first.This drug should not be used with the following medications because very serious interactions may occur: epinephrine for low blood pressure, metrizamide, narcotic blockers (e.g., naltrexone, naloxone), sibutramine.Avoid taking MAO inhibitors (e.g., furazolidone, isocarboxazid, linezolid, moclobemide, phenelzine, procarbazine, rasagiline, selegiline, tranylcypromine) within 2 weeks before, during, and after treatment with this medication. In some cases, a serious (possibly fatal) drug interaction may occur.If you are currently using any of these medications listed above, tell your doctor or pharmacist before starting meperidine.Before taking this medication, tell your doctor or pharmacist of all prescription and nonprescription/herbal products you may use, especially of: acyclovir, anticholinergics (e.g., benztropine, belladonna alkaloids), cimetidine, certain other pain medications (e.g., narcotic agonist/antagonist such as butorphanol/nalbuphine), phenytoin, ritonavir.Also report the use of drugs that might increase seizure risk when combined with meperidine such as bupropion, isoniazid (INH), phenothiazines (e.g., thioridazine), theophylline, or tricyclic antidepressants (e.g., amitriptyline), among others. Consult your doctor or pharmacist for details.Tell your doctor or pharmacist if you also take drugs that cause drowsiness such as: certain antihistamines (e.g., diphenhydramine), anti-seizure drugs (e.g., carbamazepine), medicine for sleep or anxiety (e.g., alprazolam, diazepam, zolpidem), muscle relaxants, narcotic pain relievers (e.g., codeine), psychiatric medicines (e.g., chlorpromazine, risperidone, amitriptyline, trazodone).Check the labels on all your medicines (e.g., allergy, cough-and-cold products) because they may contain drowsiness-causing ingredients. Ask your pharmacist about using those products safely.This medication may interfere with certain laboratory tests (e.g., amylase, lipase tests), possibly causing false test results. Make sure laboratory personnel and all your doctors know you use this drug.This document does not contain all possible interactions. Therefore, before using this product, tell your doctor or pharmacist of all the products you use. Keep a list of all your medications with you, and share the list with your doctor and pharmacist.
OVERDOSE: If overdose is suspected, contact your local poison control center or emergency room immediately. US residents should call the US National Poison Hotline at 1-800-222-1222. Canada residents should call a provincial poison control center. Symptoms of overdose may include: slow breathing, slow heartbeat, muscle stiffness/twitching, hot dry skin, widened pupils, seizure, loss of consciousness.
NOTES: Do not share this medication with others. It is against the law.This medication has been prescribed for your current condition only. Do not use it later for another condition unless told to do so by your doctor. A different medication may be necessary in that case.
MISSED DOSE: Not applicable.
STORAGE: Store in a tightly closed container at room temperature between 68-77 degrees F (20-25 degrees C) away from moisture and light. Do not store in the bathroom. Keep all medicines away from children and pets.Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company for more details about how to safely discard your product.
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You are encouraged to report negative side effects of prescription drugs to the FDA. Visit the FDA MedWatch website or call 1-800-FDA-1088.