Drug/Small Molecule:
meperidine

2D structure

Overview

Trade Names: Centralgin; Demarol; Demerol; Dispadol; Dolantin; Dolcontral; Dolosal; Dolsin; Isonipecaine; Lidol; Lydol; Meperidine Hcl; Meperidol; Methyl phenylpiperidine carbonic acid ethyl ester; Nemerol; Operidine; Petantin; Pethanol; Pethidin; Pethidine; Pethidineter; Petydyna; Phetidine; Piperosal; Pipersal; Piridosal
PharmGKB Accession Id: PA450369

Description

A narcotic analgesic that can be used for the relief of most types of moderate to severe pain, including postoperative pain and the pain of labor. Prolonged use may lead to dependence of the morphine type; withdrawal symptoms appear more rapidly than with morphine and are of shorter duration. PubChem (source: Drug Bank)

Indication

Used to control moderate to severe pain. (source: Drug Bank)

ATC Therapeutic Category

  • N02AB:Phenylpiperidine derivatives

Pharmacology, Interactions, and Contraindications

Mechanism Of Action

Meperidine is primarily a kappa-opiate receptor agonist and also has local anesthetic effects. Meperidine has more affinity for the kappa-receptor than morphine. Opiate receptors are coupled with G-protein receptors and function as both positive and negative regulators of synaptic transmission via G-proteins that activate effector proteins. Binding of the opiate stimulates the exchange of GTP for GDP on the G-protein complex. As the effector system is adenylate cyclase and cAMP located at the inner surface of the plasma membrane, opioids decrease intracellular cAMP by inhibiting adenylate cyclase. Subsequently, the release of nociceptive neurotransmitters such as substance P, GABA, dopamine, acetylcholine and noradrenaline is inhibited. Opioids also inhibit the release of vasopressin, somatostatin, insulin and glucagon. Meperidine's analgesic activity is, most likely, due to its conversion to morphine. Opioids close N-type voltage-operated calcium channels (OP2-receptor agonist) and open calcium-dependent inwardly rectifying potassium channels (OP3 and OP1 receptor agonist). This results in hyperpolarization and reduced neuronal excitability. (source: Drug Bank)

Pharmacology

Meperidine is a synthetic opiate agonist belonging to the phenylpiperidine class. Meperidine may produce less smooth muscle spasm, constipation, and depression of the cough reflex than equivalent doses of morphine. The onset of action is lightly more rapid than with morphine, and the duration of action is slightly shorter. The chemical structure of meperidine is similar to local anesthetics. Meperidine is recommended for relief of moderate to severe acute pain and has the unique ability to interrupt postoperative shivering and shaking chills induced by amphotericin B. Meperidine has also been used for intravenous regional anesthesia, peripheral nerve blocks and intraarticular, epidural and spinal analgesia. Meperidine is considered a second-line agent for the treatment of acute pain. (source: Drug Bank)

Food Interactions

Take without regard to meals. Avoid alcohol. (source: Drug Bank)

Absorption, Distribution, Metabolism, Elimination & Toxicity

Biotransformation

Meperidine is metabolized in the liver by hydrolysis to meperidinic acid followed by partial conjugation with glucuronic acid. Meperidine also undergoes N-demethylation to normeperidine, which then undergoes hydrolysis and partial conjugation. Normeperidine is about half as potent as meperidine, but it has twice the CNS stimulation effects. (source: Drug Bank)

Protein Binding

65-75% (source: Drug Bank)

Absorption

Oral bioavailability is 50-60% in patients with normal hepatic function. (source: Drug Bank)

Isomeric SMILES Code:

CCOC(=O)C1(CCN(CC1)C)C2=CC=CC=C2 (source: Drug Bank)

The following genes are in curated knowledge about this drug.

  Gene Relationship Evidence
Phenotype data available Genotype Data Available Literature annotations available Has annotations
CYP2B6
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  • PK
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Publications
Phenotype data available Genotype Data Available Literature annotations available Has annotations
CYP2C19
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  • PK
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Publications
Phenotype data available Genotype Data Available Literature annotations available Not annotated
CYP3A
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  • PK
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Publications
Phenotype data available Genotype Data Available Literature annotations available Has annotations
CYP3A4
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  • PK
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Publications
Phenotype data available Genotype Data Available Literature annotations available Has annotations
CYP3A5
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  • PK
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Publications
No phenotype data Genotype Data Available Literature annotations available Not annotated
UGT1A4
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  • PK
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Publications

A list of non-curated publications that mention this drug along with other genes is available.

Drug Targets

Gene Description
GRIN3A Uncurated Annotation (source: Drug Bank)
OPRK1 Uncurated Annotation (source: Drug Bank)

A list of non-curated publications that mention this drug along with other drugs is available.

Drug Interactions

Drug Description
chlorpromazine Uncurated Annotation Increased sedation and hypotension (source: Drug Bank)
cimetidine Uncurated Annotation Cimetidine increases the effect of the narcotic (source: Drug Bank)
donepezil Uncurated Annotation Possible antagonism of action (source: Drug Bank)
galantamine Uncurated Annotation Possible antagonism of action (source: Drug Bank)
isocarboxazid Uncurated Annotation Potentially fatal adverse effects (source: Drug Bank)
isoniazid Uncurated Annotation Possible episodes of hypotension (source: Drug Bank)
moclobemide Uncurated Annotation Increased CNS toxicity (can cause death) (source: Drug Bank)
naltrexone Uncurated Annotation Naltrexone may precipitate a withdrawal syndrome in opioid-dependent individual (source: Drug Bank)
phenelzine Uncurated Annotation Potentially fatal adverse effects (source: Drug Bank)
ritonavir Uncurated Annotation Ritonavir increases the levels of analgesic (source: Drug Bank)
rivastigmine Uncurated Annotation Possible antagonism of action (source: Drug Bank)
selegiline Uncurated Annotation Potentially fatal adverse effects (source: Drug Bank)
sibutramine Uncurated Annotation Possible serotoninergic syndrome (source: Drug Bank)
tranylcypromine Uncurated Annotation Potentially fatal adverse effects (source: Drug Bank)

Curated Information

The following diseases are in curated knowledge about this drug.

  Disease Relationship Evidence
No phenotype data No genotype data Literature annotations available Not annotated
Hallucinations
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  • PD
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Publications
No phenotype data No genotype data Literature annotations available Not annotated
Seizures
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  • PD
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Publications
No phenotype data No genotype data Literature annotations available Not annotated
Serotonin Syndrome
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  • PD
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Publications

Non-Curated Information

A list of non-curated publications that mention this drug along with other diseases is available.

Curated Phenotype Datasets

These datasets are sorted alphabetically by title.

Additional Datasets

These datasets are minimally curated and are sorted alphabetically by title.

  1. Physicochemical determinants of human renal clearance

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LinkOuts

Web Resource:
Wikipedia
DrugBank:
DB00454
KEGG Compound ID:
C07128
PubChem Compound ID:
4058
PubChem Substance ID:
148822

Common Searches

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Non-Curated Publications

A list of non-curated publications that mention this drug is available.

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