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
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.