Demerol is used for

Treating moderate to severe pain. It may also be used before or during surgery (eg, to support anesthesia), for pain relief during labor and delivery, or for other conditions as determined by your doctor.

Demerol is a narcotic analgesic. It works by dulling the pain perception center in the brain.

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Do NOT use if...

• you are allergic to any ingredient in Demerol
• you have a certain type of intestinal inflammation (pseudomembranous colitis) or diarrhea due to poisoning
• you have taken a monoamine oxidase (MAO) inhibitor (eg, phenelzine) within the last 14 days
• you are taking ritonavir, sibutramine, or sodium oxybate (GHB)

Contact your doctor or health care provider right away if any of these apply to you.

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Before using

Some medical conditions may interact with Demerol . Tell your doctor or pharmacist if you have any medical conditions, especially if any of the following apply to you:

• if you are pregnant, planning to become pregnant, or are breast-feeding
• if you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement
• if you have allergies to medicines, foods, or other substances
• if you have a history of breathing problems (eg, asthma, chronic obstructive pulmonary disease, cor pulmonale); low levels of oxygen or high levels of carbon dioxide in the blood; sickle cell anemia; low blood pressure; an enlarged prostate; urinary blockage; lung, liver, or kidney problems; heart problems (eg, irregular heartbeat); seizures; or stomach or intestine problems (eg, inflammatory bowel disease)
• if you have a history of head injury, brain tumor or other growths, increased pressure in the brain, adrenal tumor or other problems (eg, Addison disease, pheochromocytoma), curved spine, or an underactive thyroid
• if you have a history of alcohol or substance abuse/dependence, delirium tremens, mental or mood changes caused by a medicine or other substance, or suicidal thoughts or attempts
• if you are dehydrated, have been severely weakened, or have had recent surgery

Some MEDICINES MAY INTERACT with Demerol . Tell your health care provider if you are taking any other medicines, especially any of the following:

• Agonist/antagonist analgesics (eg, butorphanol, pentazocine) or naltrexone because effectiveness of Demerol may be decreased
• MAO inhibitors (eg, phenelzine) because the risk of serious side effects, including coma, difficulty breathing, low blood pressure, seizures, and irregular heartbeat, may be increased
• Acyclovir, cimetidine, HIV protease inhibitors (eg, ritonavir), phenothiazines (eg, chlorpromazine), phenytoin, or tricyclic antidepressants (eg, amitriptyline) because the risk of side effects of Demerol may be increased
• Sibutramine because the risk of side effects, including increased body temperature, mental or mood changes, muscle twitching, or severe drowsiness, may be increased
• Barbiturate anesthetics (eg, thiopental), neuromuscular blockers (eg, pancuronium), or sodium oxybate (GHB) because actions and side effects may be increased by Demerol

This may not be a complete list of all interactions that may occur. Ask your health care provider if Demerol may interact with other medicines that you take. Check with your health care provider before you start, stop, or change the dose of any medicine.

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How to use

Use Demerol as directed by your doctor. Check the label on the medicine for exact dosing instructions.

• Demerol is usually administered as an injection at your doctor's office, hospital, or clinic. If you are using Demerol at home, carefully follow the injection procedures taught to you by your health care provider.
• If Demerol contains particles or is discolored, or if the vial is cracked or damaged in any way, do not use it.
• Keep this product, as well as syringes and needles, out of the reach of children and away from pets. Do not reuse needles, syringes, or other materials. Dispose of properly after use. Ask your doctor or pharmacist to explain local regulations for proper disposal.
• If you miss a dose of Demerol , take it as soon as possible. If it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not take 2 doses at once.

Ask your health care provider any questions you may have about how to use Demerol .

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Important safety information

• Demerol may cause drowsiness, dizziness, or lightheadedness. Do not drive, operate machinery, or do anything else that could be dangerous until you know how you react to Demerol . Using Demerol alone, with certain other medicines, or with alcohol may lessen your ability to drive or perform other potentially dangerous tasks.
• Avoid drinking alcohol or taking other medications that cause drowsiness (eg, sedatives, tranquilizers) while taking Demerol . Demerol will add to the effects of alcohol and other depressants. Ask your pharmacist if you have questions about which medicines are depressants.
• Demerol may cause dizziness, lightheadedness, or fainting. Alcohol, hot weather, exercise, and fever can increase these effects. To prevent them, sit up or stand slowly, especially in the morning. Also, sit or lie down at the first sign of dizziness, lightheadedness, or weakness.
• Do not exceed the recommended dose or take Demerol for longer than recommended by your doctor. Exceeding the recommended dose or taking Demerol for longer than prescribed may be habit-forming.
• Do not suddenly stop taking Demerol without first checking with your doctor.
• Before you have any medical or dental treatments, emergency care, or surgery, tell the doctor or dentist that you are using Demerol .
• Use Demerol with caution in the ELDERLY because they may be more sensitive to its effects.
• Use Demerol with extreme caution in CHILDREN because they may be more sensitive to its effects, especially slowed or difficult breathing.
• PREGNANCY and BREAST-FEEDING: If you become pregnant while taking Demerol , discuss with your doctor the benefits and risks of using Demerol during pregnancy. Demerol should not be used prior to the labor period because it may cause harmful side effects in the baby. Demerol is excreted in breast milk. Do not breast-feed while using Demerol .

When used for long periods of time or at high doses, Demerol may not work as well and may require higher doses to obtain the same effect as when originally taken. This is known as TOLERANCE. Talk with your doctor if Demerol stops working well. Do not take more than prescribed.

When used for long periods of time or at high doses, some people develop a need to continue taking Demerol . This is known as DEPENDENCE or addiction.

If you suddenly stop taking Demerol , you may experience WITHDRAWAL symptoms, including anxiety; appetite loss; backache; chills; diarrhea; enlarged pupils; fast heartbeat or breathing rate; increased tears; irritability; muscle or joint pain; nausea; restlessness; runny nose; severe or persistent dizziness; sleeplessness; stomach cramps; sweating; vomiting; weakness; yawning.

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Possible side effects

All medicines may cause side effects, but many people have no, or minor, side effects. Check with your doctor if any of these most COMMON side effects persist or become bothersome:

Constipation; dizziness; drowsiness; lightheadedness; loss of appetite; nausea; sweating; vomiting.

Seek medical attention right away if any of these SEVERE side effects occur:

Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); chest pain; difficulty urinating; fainting; fast, slow, or irregular heartbeat; mental or mood changes; numbness of an arm or a leg; seizure; severe or persistent dizziness; slowed or difficult breathing; sudden severe headache, nausea, vomiting, or stomach pain; tremor; vision changes.

This is not a complete list of all side effects that may occur. If you have questions about side effects, contact your health care provider. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088. You may also report side effects at http://www.fda.gov/medwatch.

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If OVERDOSE is suspected

Contact 1-800-222-1222 (the American Association of Poison Control Centers), your local poison control center (http://www.aapcc.org), or emergency room immediately. Symptoms may include chest pain; cold and clammy skin; lightheadedness; limp muscles; loss of consciousness; low body temperature; seizures; severe dizziness; severe drowsiness; slowed heartbeat; slowed or difficult breathing; small pupils.

Proper storage of Demerol :

Demerol is usually handled and stored by a health care provider. If you are using Demerol at home, store Demerol as directed by your pharmacist or health care provider. Keep Demerol out of the reach of children and away from pets.

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Disclaimer

The information in this monograph is not intended to cover all possible uses, directions, precautions, drug interactions or adverse effects. This information is generalized and is not intended as specific medical advice.

If you have questions about the medicines you are taking or would like more information, check with your doctor, pharmacist, or nurse.

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