Meperidine Hydrochloride (me-PER-i-deen hye-droe-KLOR-ide), Promethazine Hydrochloride (proe-METH-a-zeen hye-droe-KLOR-ide)

Treats pain during and after surgery or other medical procedure.

Brand Name(s):

When This Medicine Should Not Be Used:

How to Use This Medicine:

Injectable

• A doctor or other trained healthcare professional will give you this medicine in a hospital. This medicine is given as a shot into a muscle or into a vein.

Drugs and Foods to Avoid:

Ask your doctor or pharmacist before using any other medicine, including over-the-counter medicines, vitamins, and herbal products.

• Do not use this medicine if you are using or have used an MAO inhibitor within the past 14 days.
• Some medicines can affect how meperidine/promethazine works. Tell your doctor if you are using any of the following:
  • Acyclovir, carbamazepine, cimetidine, cyclobenzaprine, erythromycin, ketoconazole, metaxalone, phenytoin, rifampin, ritonavir, tramadol
  • Benzodiazepine medicine
  • Diuretic (water pill)
  • Medicine to treat depression (including mirtazapine, trazodone, SNRIs, SSRIs, TCAs)
  • Triptan medicine to treat migraine headaches
• Do not drink alcohol while you are using this medicine.
• Tell your doctor if you use anything else that makes you sleepy. Some examples are allergy medicine, narcotic pain medicine, and alcohol. Tell your doctor if you are also using buprenorphine, butorphanol, nalbuphine, pentazocine, or a muscle relaxer (including cyclobenzaprine, metaxalone).

Warnings While Using This Medicine:

• Tell your doctor if you are pregnant or breastfeeding, or if you have kidney disease, liver disease, breathing or lung problems (including sleep apnea), diabetes, heart rhythm problems, Addison disease, pheochromocytoma (an adrenal gland tumor), or stomach or bowel problems. Tell your doctor if you have had seizures, a head injury, a recent surgery, or have been addicted to alcohol or drugs.
• This medicine may cause the following problems:
  • High risk of overdose, which can lead to death
  • Respiratory depression (serious breathing problem that can be life-threatening)
  • Sleep-related breathing problems (including sleep apnea, sleep-related hypoxemia)
  • Worsening of pain
  • Serotonin syndrome, when used with certain medicines
  • Adrenal gland problem
  • Low blood pressure
  • Increased risk of seizures
• This medicine can be habit-forming. Do not use more than your prescribed dose. Call your doctor if you think your medicine is not working.
• This medicine may make you dizzy, lightheaded, faint, drowsy, or less alert. Do not drive or do anything else that could be dangerous until you know how this medicine affects you. Sit or lie down if you feel dizzy. Stand up carefully.
• Do not stop using this medicine suddenly. Your doctor will need to slowly decrease your dose before you stop it completely.
• This medicine could cause infertility. Talk with your doctor before using this medicine if you plan to have children.
• This medicine may cause constipation, especially with long-term use. Ask your doctor if you should use a laxative to prevent and treat constipation.

Possible Side Effects While Using This Medicine:

Call your doctor right away if you notice any of these side effects:

• Allergic reaction: Itching or hives, swelling in your face or hands, swelling or tingling in your mouth or throat, chest tightness, trouble breathing
• Anxiety, restlessness, muscle spasms, twitching, diarrhea, seeing or hearing things that are not there
• Blue lips, fingernails, or skin
• Changes in skin color, dark freckles, cold feeling, tiredness, weight loss
• Confusion, headache
• Extreme dizziness or weakness, shallow breathing, slow or uneven heartbeat, sweating, seizures, and cold, clammy skin
• Lightheadedness, dizziness, fainting
• Shaking, trembling, fast or pounding heartbeat, hunger
• Worsening of pain, increased sensitivity to pain

If you notice these less serious side effects, talk with your doctor:

• Nausea, vomiting
• Sleepiness

If you notice other side effects that you think are caused by this medicine, tell your doctor

Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088