Why Demerol is No Longer Routinely Used To Treat Pain

The Risks Often Outweigh Benefit When Taking Demerol

Prescription Pain Medications
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Demerol (meperidine) is a narcotic pain reliever that has fallen out of favor in recent years.  In the past, Demerol was used for a variety of painful conditions, including pain after surgery.  In recent years, the pain medication has largely been ignored as safer medications, such as morphine, Dilaudid and Fentanyl have become more commonly prescribed.

Risks of All Narcotic Pain Relievers

All narcotic pain medications, also known as opioid analgesics, have serious side effects.

Before taking these medications, you should be aware of the potential side effects and issues that can happen.

Sedation: The most serious complication of narcotic pain relievers is the fact that they can and often do sedate the patient.  This sedation can be minor and may allow the patient to sleep well despite pain.  However, sedation also makes it dangerous to drive a car while taking prescription pain relievers, as you may not be as alert as you should be to safely get behind the wheel.  In more serious cases, this sedation can be severe, and make it difficult for the patient to wake.  With high doses, these medications can cause a decrease in respiratory rate, or even cause an individual to stop breathing.

Constipation: If you are taking a narcotic pain reliever, plan to include high fiber foods and copious amounts of water in your daily diet.  You may also want to add a daily stool softening medication to help prevent constipation, as fiber rich foods may not be enough to prevent this very uncomfortable complication.

Itching: Narcotics are known to cause some very annoying itching.  For some, taking the medication with Benadryl can decrease the amount of itching, but be careful as Benadryl can also increase the sedating effects of medication.

Tolerance: This is the term for your body adjusting to a dose of medication over time and requiring a higher dose for the same effect.

  The more pain medication you take, the higher your risk of side effects, including sedation.

Nausea: For some, nausea is an unavoidable side effect of prescription pain relievers.  In many cases, taking an anti-nausea medication, such as Zofran or Phenergan, prior to taking pain medications can prevent or decrease nausea.

The Risks of Demerol

In addition to the risks associated with all narcotic medications, Demerol is known to have additional risks that you should be aware of:

Inadequate Pain Relief: The pain relieving qualities of Demerol do not last as long as other pain relieving agents, which may leave the patient in pain until their next dose.  Demerol also may not provide the same level of pain relief as similar medications.

Seizures: Demerol is known to lower the seizure threshold, which means patients who have a seizure disorder and even those who have never had a seizure, are more like to experience one while taking this medication.

Drug Interactions: Demerol is known to interact with MAOI inhibitors and Serotonin Reuptake Inhibitors (Tramadol, Zyvox), which can lead to a very serious condition called Serotonin Syndrome.


High Abuse Potential: When compared to other prescription pain medications, Demerol is considered to be more addictive and is not appropriate for individuals who are at risk for addiction.  Some patients report short episodes of euphoria when using Demerol, which is believed to increase the likelihood of abuse. 

Children: According to the American Academy of Pediatrics and the American Pain Society, Demerol is not appropriate for infants and children.  Some hospitals do allow for the use of Demerol during short procedures, but other medications, again, have been researched and proven more appropriate. 

When Demerol Should Be Used

In many facilities, Demerol is no longer used for the treatment of pain.  Other opioid medications are considered far superior for pain relief with less risk of complications.  

In most facilities, Demerol is reserved for one purpose: to stop or reduce shivering.  Shivering is the body’s way of increasing temperature, individuals with a high fever may be given Demerol to help decrease body temperature.  Demerol is also used during hypothermia treatments, a process where the body is intentionally cooled after a cardiac arrest to decrease the the risk of brain damage and death.


Is Meperdine the Drug That Just Won’t Die? Pediatric Journal of Pharmacologic Therapy.  Accessed June, 2015. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3292527

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