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Meperidine - Demerol ® - Renal Dosing

Usual Dosing (Adults)

Oral: Initial: Opiate-naive: 50 mg q 3-4 hours prn. Usual range: 50-150 mg q2-4 hours prn.  
IM, SC: Initial: Opiate-naive: 50-75 mg q 3-4 hours prn.

Renal Dosing

dialysis Meperidine is not recommended for the management of chronic pain. When used for acute pain (in patients without renal or CNS disease), treatment should be limited to 48 hours and doses should not exceed 600 mg/24 hours. 
 
[CRCL >50 ml/min]: Usual doses. Limit therapy to 48hr and do not exceed 600 mg/24 hours.

[10-50 ml/min]:   Avoid use.  Note: Repeated use in renal impairment should be avoided due to potential accumulation of neuroexcitatory metabolite normeperidine.  Alternatively, cautiously administer 75% of normal dose and limit therapy to 24-48hr. Also, daily dose should not exceed 400-450 mg/24 hours. 

[<10 ]:  Avoid use. Note: Repeated use in renal impairment should be avoided due to potential accumulation of neuroexcitatory metabolite normeperidine.  Alternatively, cautiously administer 50% of normal dose and limit therapy to 24hr.  Also, daily dose should not exceed 200-300 mg/24 hours. 

Hemodialysis

dialysis Avoid use.

Reference(s)

National Institutes of Health, U.S. National Library of Medicine, DailyMed Database.
Provides access to the latest drug monographs submitted to the Food and Drug Administration (FDA). Please review the latest applicable package insert for additional information and possible updates.  A local search option of this data can be found here.

Disclaimer

The authors make no claims of the accuracy of the information contained herein; and these suggested doses are not a substitute for clinical judgment. Neither GlobalRPh Inc. nor any other party involved in the preparation of this program shall be liable for any special, consequential, or exemplary damages resulting in whole or part from any user's use of or reliance upon this material.PLEASE READ THE DISCLAIMER CAREFULLY BEFORE ACCESSING OR USING THIS SITE. BY ACCESSING OR USING THIS SITE, YOU AGREE TO BE BOUND BY THE TERMS AND CONDITIONS SET FORTH IN THE DISCLAIMER.   Read the disclaimer
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