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Removing meperidine from the health-system formulary--frequently asked questions

M Christina Beckwith1, Erin R Fox, Jane Chandramouli

  • 1University Hospitals and Clinics, and College of Pharmacy, University of Utah, Salt Lake City 84132, USA. Christina.beckwiths@hsc.utah.edu

Journal of Pain & Palliative Care Pharmacotherapy
|December 3, 2003
PubMed

Insights

Meperidine is not recommended as a first-line pain reliever due to safety concerns and lack of efficacy. This analysis guides clinicians on restricting its use and considering safer alternatives.

Area of Science:

  • Pharmacology
  • Clinical Pharmacy

Background:

  • Meperidine, an opioid analgesic approved for moderate to severe pain, has been used since the 1930s.
  • Current clinical practice suggests restricting or removing meperidine from formularies due to safety concerns.

Purpose of the Study:

  • To evaluate the formulary status of meperidine.
  • To provide evidence-based information for pharmacists and prescribers regarding meperidine's use and alternatives.

Main Methods:

  • Review of clinical evidence on meperidine's efficacy and safety.
  • Comparison of meperidine with other opioids regarding pharmacodynamics, pharmacokinetics, cost, and adverse effects.
  • Identification of alternative analgesics for various indications.

Main Results:

  • Meperidine is associated with adverse reactions, drug interactions, and normeperidine neurotoxicity.
  • Clinical evidence does not support meperidine's superiority over other opioids for biliary colic or pancreatitis.
  • Information on dosage equivalency, pharmacodynamics, pharmacokinetics, and cost is provided for comparison.

Conclusions:

  • Meperidine is no longer considered a first-line analgesic.
  • Restricting meperidine use and considering alternatives is recommended.
  • This document aids healthcare professionals in managing meperidine-related prescribing decisions.

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