Observations placeholder

Pethidine or meperidine  - commonly referred to as Demerol is also referred to as: isonipecaine; lidol; pethanol; piridosal; Algil; Alodan; Centralgin; Dispadol; Dolantin; Mialgin; Petidin Dolargan;Dolestine; Dolosal; Dolsin; Mefedina.  It  is a fast-acting analgesic.

Most common Meperidine hydrochloride side effects

• Nausea - (44 reports)
• Pain - (42 reports)
• Weakness - (29 reports)
• Fatigue - (27 reports)
• Abdominal pain - (25 reports)
• Stress and anxiety - (24 reports)
• Hypotension - (23 reports)
• Osteonecrosis of jaw - (21 reports)
• Constipation - (19 reports)
• Diarrhea - (19 reports)

Compared to morphine, pethidine was supposed to be safer, carry less risk of addiction, and to be superior in treating pain. In fact, pethidine is no more effective than morphine and its low potency, short duration of action, and unique toxicity have seen it fall out of favor in recent years. Several countries, including Australia, have put strict limits on its use.

Unlike morphine, pethidine exerts its analgesic effects by acting as an agonist at the kappa opioid receptor.  Pethidine also has stimulant effects mediated by its inhibition of the dopamine transporter (DAT) and norepinephrine transporter (NAT).  Pethidine has the potential to cause physical dependence or addiction.

Pethidine has serious interactions that can be dangerous with MAOIs.  Fatalities have occurred following both oral and intravenous pethidine overdosage. 

Derivatives,  analogues or related chemically

The following are either derivatives,  analogues or related chemically 

• 4-Fluoromeperidine - is a derivative of pethidine, which combines pethidine's opioid analgesic effects with monoamine reuptake inhibition, and dopamine reuptake inhibition, it still acts as an opioid analgesic drug in practice
• Allylnorpethidine (WIN-7681) is an analogue of pethidine and an active analgesic and has no antagonistic properties. 
• Anileridine is a synthetic opioid and strong analgesic medication.  It is an analog of pethidine. It is used as an analgesic adjunct in general anesthesia to facilitate relaxation.  .
• Benzethidine is related to pethidine (meperidine). It is not used in medicine and is a Class A/Schedule I drug which is controlled under UN drug conventions
• Carperidine is related to pethidine (meperidine).  It  is not used in medicine. Unlike most opioid derivatives it is not specifically listed as an illegal drug.
• Etoxeridine (Carbetidine, Atenos) was developed in the 1950s and investigated for use in surgical anesthesia, however it was never commercialised and is not currently used in medicine
• Furethidine is also related to pethidine.  It too is not used in medicine and is a Class A/Schedule I drug which is controlled under UN drug conventions
• Hydroxymethoxypethidine 
• Hydroxypethidine (Bemidone) is an analogue of pethidine (meperidine) that is significantly less potent than meperidine as an analgesic.  It is also an NMDA antagonist
• Meprodine
• Morpheridine (Morpholinoethylnorpethidine) is related to pethidine (meperidine). It is a strong analgesic with around 4 times the potency of pethidine.   It is not used in medicine and is a Class A/Schedule I drug which is controlled under UN drug conventions
• MPPP (1-methyl-4-phenyl-4-propionoxypiperidine, Desmethylprodine) is not used in clinical practice, but has been illegally manufactured for recreational drug use. It is an analog of meperidine (Demerol), but since it is not used in medicine, the DEA has labeled it a Schedule I drug in the United States. It is the reversed ester of pethidine and is listed as having 70% of the potency of morphine.
• Oxpheneridine (Carbamethidine) is related to pethidine (meperidine).  It is not used in medicine. It is not specifically listed as an illegal drug. In the UNODC narcotics report of 1958, they state that it was not possible to administer oxpheneridine in high doses as it is ‘poorly soluble and highly irritating’.  This appears to be the only time oxpheneridine has been investigated, and so its pharmacological properties have not been well established.
• PEPAP is an analogue of pethidine (meperidine), related to the drug MPPP.
• Pheneridine is related to pethidine (meperidine).  It  is not currently used in medicine
• Phenoperidine, marketed as its hydrochloride as Operidine or Lealgin, is not used today in clinical practise.  In humans 1 milligram is equipotent with 10 mg morphine.
• Piminodine (Alvodine) is an analogue of pethidine (meperidine). It was used in medicine briefly during the 1960s and 70s, but has largely fallen out of clinical use. It was used particularly for obstetric analgesia and in dental work.   Side effects can serious respiratory depression which can be life-threatening
• Prodine (trade names Prisilidine, Nisentil) is an analogue of pethidine
• Prodilidine is a ring-contracted analogue of prodine
• Properidine is an isopropyl analog of pethidine.
• Prosidol is an analogue of prodine. It was developed in Russia in the 1990s during research into the related drug pethidine
• Sameridine is related to pethidine (meperidine).  It is used as a local anaesthetic.   It is currently under development for use in surgical anasthesia.
• Trimeperidine is an  analgesic that is an analogue of prodine. It was developed in or around 1954 in the USSR during research into the related drug pethidine