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Demerol: Uses, Side Effects and Dosage

Updated:
Facts
Status:
Prescription (Rx) NARCOTICS (CDSA I) Current status: Cancelled Post Market
Strength:
50 mg
Active ingredient:
ATC code:
Similar drugs:

Source: Health Canada – Drug Product Database (DPD) and product monographs · About this document

Patient Medication Information: uses, side effects, how to take - Demerol

Serious Warnings and Precautions

  • Even if you take DEMEROL as prescribed you are at a risk for opioid addiction, abuse and misuse. This can lead to overdose and death.
  • When you take DEMEROL it must be swallowed whole. Do not cut, break, crush, chew, or dissolve the tablet. This can be dangerous and can lead to death or seriously harm you.
  • You may get life-threatening breathing problems while taking DEMEROL. This is less likely to happen if you take it as prescribed by your doctor. Babies are at risk of life-threatening breathing problems if their mothers take opioids while pregnant or nursing.
  • You should never give anyone your DEMEROL. They could die from taking it. If a person has not been prescribed DEMEROL, taking even one dose can cause a fatal overdose. This is especially true for children.

  • If you took DEMEROL while you were pregnant, whether for short or long periods of time or in small or large doses, your baby can suffer life-threatening withdrawal symptoms after birth. This can occur in the days after birth and for up to 4 weeks after delivery. If your baby has any of the following symptoms:

    • has changes in their breathing (such as weak, difficult or fast breathing)
    • is unusually difficult to comfort
    • has tremors (shakiness)
    • has increased stools, sneezing, yawning, vomiting, or fever

Seek immediate medical help for your baby.

  • Taking DEMEROL with other opioid medicines, benzodiazepines, alcohol, or other central nervous system depressants (including street drugs) can cause severe drowsiness, decreased awareness, breathing problems, coma, and death.

What is DEMEROL used for?

DEMEROL is used to manage your pain.

How does DEMEROL work?

DEMEROL is a painkiller belonging to the class of drugs known as opioids. It relieves pain by acting on specific nerve cells of the spinal cord and brain.

What are the ingredients in DEMEROL?

Medicinal ingredients: meperidine HCl

Non-medicinal ingredients: calcium phosphate (dibasic), calcium sulfate, corn starch, stearic acid and talc. Gluten-, lactose-, sucrose- and tartrazine-free.

DEMEROL comes in the following dosage forms:

Tablets, 50 mg

Do not use DEMEROL if:

  • your doctor did not prescribe it for you
  • you are allergic to meperidine hydrochloride or any of the other ingredients in DEMEROL (see What are the ingredients in DEMEROL?)
  • you can control your pain by the occasional use of other pain medications. This includes those available without a prescription
  • you have severe asthma, trouble breathing, or other breathing problems
  • you have any heart problems
  • you have bowel blockage or narrowing of the stomach or intestines
  • you have severe pain in your abdomen
  • you have a head injury
  • you are at risk for seizures

  • you suffer from alcoholism

  • you are taking or have taken within the past 2 weeks a Monoamine Oxidase inhibitor (MAOi) (such as phenelzine sulphate, tranylcypromine sulphate, moclobemide or selegiline)
  • you are going to have, or recently had, a planned surgery

To help avoid side effects and ensure proper use, talk to your healthcare professional before you take DEMEROL. Talk about any health conditions or problems you may have, including if you:

  • have a history of illicit or prescription drug or alcohol abuse
  • have severe kidney, liver or lung disease
  • have heart disease
  • have low blood pressure
  • have tachycardias (a heart rhythm disorder)
  • convulsive disorders
  • have past or current depression
  • suffer from chronic or severe constipation
  • have problems with your thyroid, adrenal or prostate gland
  • have, or had in the past hallucinations or other severe mental problems
  • you are pregnant or planning to become pregnant or you are in labour
  • suffer from migraines
  • are planning to become pregnant

Other warnings you should know about:

Opioid dependence and addiction: There are important differences between physical dependence and addiction. It is important that you talk to your doctor if you have questions or concerns about abuse, addiction or physical dependence.

Pregnancy, nursing, labour and delivery: Opioids can be transferred to your baby through breast milk, or while still in the womb. DEMEROL can then cause life-threatening breathing problems in your unborn baby or nursing infant. Your doctor will determine if the benefits of using DEMEROL outweigh the risks to your unborn baby or nursing infant.

If you are pregnant and are taking DEMEROL, it is important that you don’t stop taking your medication all of a sudden. If you do, it can cause a miscarriage or a still-birth. Your doctor will monitor and guide you on how to slowly stop taking DEMEROL. This may help avoid serious harm to your unborn baby.

Driving and using machines: Before you do tasks which may require special attention, you should wait until you know how you react to DEMEROL. DEMEROL can cause:

  • drowsiness
  • dizziness or
  • lightheadedness

This can usually occur after you take your first dose and when your dose is increased.

Disorder of the adrenal gland: You may develop a disorder of the adrenal gland called adrenal insufficiency. This means that your adrenal gland is not making enough of certain hormones. You may experience symptoms such as:

  • nausea, vomiting
  • feeling tired, weak or dizzy
  • decreased appetite

You may be more likely to have problems with your adrenal gland if you have been taking opioids for longer than one month. Your doctor may do tests, give you another medication, and slowly take you off DEMEROL.

Serotonin Syndrome: DEMEROL can cause Serotonin Syndrome, a rare but potentially life-threatening condition. It can cause serious changes in how your brain, muscles and digestive system work. You may develop Serotonin Syndrome if you take DEMEROL with certain anti-depressants or migraine medications.

Serotonin Syndrome symptoms include:

  • fever, sweating, shivering, diarrhea, nausea, vomiting;
  • muscle shakes, jerks, twitches or stiffness, overactive reflexes, loss of coordination;
  • fast heartbeat, changes in blood pressure;
  • confusion, agitation, restlessness, hallucinations, mood changes, unconsciousness, and coma.

Sexual Function/Reproduction: Long term use of opioids may lead to a decrease in sex hormone levels. It may also lead to low libido (desire to have sex), erectile dysfunction or being infertile.

Tell your healthcare professional about all the medicines you take, including any drugs, vitamins, minerals, natural supplements or alternative medicines.

The following may interact with DEMEROL:

  • Alcohol. This includes prescription and non-prescription medications that contain alcohol. Do not drink alcohol while you are taking DEMEROL. It can lead to:

    • drowsiness
    • unusually slow or weak breathing
    • serious side effects or
    • a fatal overdose
  • other sedative drugs which may enhance the drowsiness caused by DEMEROL
  • other opioid analgesics (drugs used to treat pain)
  • skeletal muscle relaxants
  • general anesthetics (drugs used during surgery)
  • benzodiazepines (drugs used to help you sleep or that help reduce anxiety)
  • antidepressants (for depression and mood disorders). Do not take DEMEROL with MAO inhibitors (MAOi) or if you have taken MAOi’s in the last 14 days.
  • drugs used to treat serious mental or emotional disorders (such as schizophrenia)
  • antihistamines (drugs used to treat allergies)
  • anti-emetics (drugs used for the prevention of vomiting)
  • drugs used to treat muscle spasms and back pain
  • anti-retroviral drugs (used to treat viral infections e.g. ritonavir, acyclovir)
  • anti-epileptic drugs (used to treat epilepsy e.g. phenytoin)
  • histamine H2 receptor antagonist drugs (used in the treatment of heartburn and peptic ulcers e.g. cimetidine)
  • drugs such as buprenorphine, nalbuphine, pentazocine may decreased analgesic effect of DEMEROL.
  • some heart medication (such as beta blockers)
  • drugs used to treat migraines (e.g. triptans)
  • St John’s Wort

How to take DEMEROL:

Swallow whole. Do not cut, break, crush, chew or dissolve the tablet. This can be dangerous and can lead to death or seriously harm you.

Usual Adult Starting Dose:

Your dose is tailored/personalized just for you. Be sure to follow your doctor’s dosing instructions exactly. Do not increase or decrease your dose without consulting your doctor.

Your doctor will prescribe the lowest dose that works to control your pain. If you need to take DEMEROL for longer, your doctor will determine the best dose for you to lower the risk of side effects and overdose. Higher doses can lead to more side effects and a greater chance of overdose.

Review your pain regularly with your doctor to determine if you still need DEMEROL. Be sure to use DEMEROL only for the condition for which it was prescribed.

If your pain increases or you develop any side effect as a result of taking DEMEROL, tell your doctor immediately.

Stopping your Medication

If you have been taking DEMEROL for more than a few days you should not stop taking it all of a sudden. Your doctor will monitor and guide you on how to slowly stop taking DEMEROL. You should do it slowly to avoid uncomfortable symptoms such as having:

  • body aches
  • diarrhea
  • goosebumps
  • loss of appetite
  • nausea
  • feeling nervous or restless
  • runny nose
  • sneezing
  • tremors or shivering
  • stomach cramps
  • rapid heart rate (tachycardia)
  • having trouble sleeping
  • an unusual increase in sweating
  • heart palpitations
  • an unexplained fever
  • weakness
  • yawning

By reducing or stopping your opioid treatment, your body will become less used to opioids. If you start treatment again, you will need to start at the lowest dose. You may overdose if you restart at the last dose you took before you slowly stopped taking DEMEROL.

Refilling your Prescription for DEMEROL:

A new written prescription is required from your doctor each time you need more DEMEROL. Therefore, it is important that you contact your doctor before your current supply runs out.

Only obtain prescriptions for this medicine from the doctor in charge of your treatment. Do not seek prescriptions from other doctors unless you switch to another doctor for your pain management.

Overdose:

If you think you have taken too much DEMEROL, contact your healthcare professional, hospital emergency department or regional Poison Control Centre immediately, even if there are no symptoms.

Signs of overdose may include:

  • unusually slow or weak breathing
  • dizziness
  • confusion
  • extreme drowsiness

Missed Dose:

If you miss one dose, take it as soon as possible. However, if it is almost time for your next dose, then skip the missed dose. Do not take two doses at once. If you miss several doses in a row, talk to your doctor before restarting your medication.

What are possible side effects from using DEMEROL?

These are not all the possible side effects you may feel when taking DEMEROL. If you experience any side effects not listed here, contact your healthcare professional.

Side effects may include:

  • Drowsiness
  • Insomnia
  • Dizziness
  • Fainting
  • Nausea, vomiting, or a poor appetite
  • Dry mouth
  • Headache
  • Problems with vision
  • Weakness, uncoordinated muscle movement
  • Itching
  • Sweating
  • Constipation
  • Low sex drive, impotence (erectile dysfunction), infertility

Talk with your doctor or pharmacist about ways to prevent constipation when you start using DEMEROL.

Serious side effects and what to do about them

Symptom / effectTalk to your healthcare professionalStop taking drug and get immediate medical help
Only if severeIn all cases

RARE

Overdose: hallucinations, confusion, inability to walk normally, slow or weak breathing, extreme sleepiness, sedation, or dizziness, floppy muscles/low muscle tone cold and clammy skin.

✓
Respiratory Depression: slow, shallow or weak breathing.✓
Allergic Reaction: rash, hives, swelling of the face, lips, tongue or throat, difficulty swallowing or breathing.✓
Bowel Blockage (impaction): abdominal pain, severe constipation, nausea.✓
Withdrawal: nausea, vomiting, diarrhea, anxiety, shivering, cold and clammy skin, body aches, loss of appetite, sweating.✓
Fast, Slow or Irregular Heartbeat: heart palpitations.✓
Low Blood Pressure: dizziness, fainting, light-headedness.✓
Serotonin Syndrome: agitation or restlessness, loss of muscle control or muscle twitching, tremor, diarrhea✓

Serious side effects and what to do about them

Symptom / effectTalk to your healthcare professionalStop taking drug and get immediate medical help
Only if severeIn all cases

UNKNOWN FREQUENCY

Heart: heart attack (in the context of Kounis syndrome), with symptoms such as: tightness, pain, or a squeezing or aching sensation in your chest or arms that may spread to your neck, jaw or back; nausea, heartburn or abdominal pain; shortness of breath; cold sweat; fatigue; sudden dizziness.

✓

If you have a troublesome symptom or side effect that is not listed here or becomes bad enough to interfere with your daily activities, talk to your healthcare professional.

Reporting Side Effects

You can report any suspected side effects associated with the use of health products to Health Canada by:

  • Visiting the Web page on Adverse Reaction Reporting (https://www.canada.ca/en/health-canada/services/drugs-health-products/medeffect-canada.html) for information on how to report online, by mail or by fax; or
  • Calling toll-free at 1-866-234-2345.

NOTE: Contact your health professional if you need information about how to manage your side effects. The Canada Vigilance Program does not provide medical advice.

Storage:

  • Keep unused or expired DEMEROL in a secure place to prevent theft, misuse or accidental exposure.
  • Store between 15 and 30°C.
  • Keep DEMEROL under lock, out of sight and reach of children and pets.
  • Never take medicine in front of small children as they will want to copy you. Accidental ingestion by a child is dangerous and may result in death. If a child accidentally takes DEMEROL, get emergency help right away.

Disposal:

DEMEROL should never be thrown into household trash, where children and pets may find it. It should be returned to a pharmacy for proper disposal.

If you want more information about DEMEROL:

  • Talk to your healthcare professional
  • Find the full product monograph that is prepared for healthcare professionals and includes this consumer medication information by visiting the Health Canada website (https://www.canada.ca/en/health-canada/services/drugs-health-products/drug-products/drug-product-database.html); the manufacturer’s website www.sanofi.ca, or by calling 1-800-265-7927.

Last Revised: March 16, 2018

About this document

Source: Health Canada – Drug Product Database (DPD) and product monographs · DIN (Drug Identification Number): 02138018

Revision date stated in the text: March 16, 2018

Found a mistake? Write to us via the contact page.

The information on this site does not replace the advice of a doctor or pharmacist.

Drug information for Demerol

Rx or OTC
Prescription (Rx)?
DIN 02138018
Schedule(s) NARCOTICS (CDSA I)
Risk Management Plans A Canadian Specific Opioid targeted Risk Management Plan (CSO-tRMP) for this product was submitted.
Active ingredient(s) Meperidine hydrochloride 50 MG
Dosage form(s) Tablet
Route(s) of administration Oral
Drug class (WHO ATC)
  1. N Nervous system drugs
    1. N02 Analgesics
      1. N02A Opioid analgesics
        1. N02AB Phenylpiperidine derivatives, opioid analgesics
          1. N02AB02 Pethidine
Company SANOFI-AVENTIS CANADA INC
Current status Cancelled Post Market
Current status date July 2, 2020

Source: Health Canada – Drug Product Database (DPD) and product monographs, data as of November 1, 2026. Data from the Health Canada Drug Product Database, as published there. Not a substitute for the advice of a doctor or pharmacist.