Prescription medicine
Meperidine Brand names: Demerol
Meperidine (Demerol) is a prescription medicine with an FDA approval on record since 1942. FDA's NDC Directory lists it from 3 generic labelers, and pharmacies paid $0.157 per mL (Meperidine 50 mg/5 mL solution) in the October 7, 2026 NADAC survey.
- Generic listed
- Boxed warning
- DEA Schedule II
Check it at the source: the meperidine FDA label on DailyMed (effective November 29, 2025, EPIC PHARMA, LLC); the NDA 5010 record on Drugs@FDA; every meperidine label on DailyMed.
Highlights of the record
FDA label of November 29, 2025; NDC Directory, Drugs@FDA and Orange Book, October 8, 2026; NADAC October 7, 2026
SERIOUS AND LIFE-THREATENING RISKS FROM USE OF MEPERIDINE HYDROCHLORIDE TABLETS.
Addiction, Abuse, and Misuse Because the use of Meperidine hydrochloride tablets exposes patients and other users to the risks of opioid addiction, abuse, and misuse, which can lead to overdose and death, assess each patient’s risk prior to prescribing and reassess all patients regularly for the development of these behaviors and conditions [see Warnings and Precautions (5.2) ]. Life-Threatening Respiratory Depression Serious, life-threatening, or fatal respiratory depression may occur with use of meperidine hydrochloride tablets, especially during initiation or following a dosage increase. To reduce the risk of respiratory depression, proper dosing and titration of meperidine hydrochloride tablets are essential [see Warnings and Precautions (5.3 )]. Accidental Ingestion Accidental ingestion of meperidine hydrochloride tablets, especially by children, can result in a fatal overdose of meperidine [see Warnings and Precautions (5.3) ]. Risks From Concomitant Use With Benzodiazepines Or Other CNS Depressants Concomitant use of opioids with benzodiazepines or other central nervous system (CNS) depressants, including alcohol, may result in profound sedation, respiratory depression, coma, and death. […]
Used for
From the label: indications and usageMeperidine hydrochloride tablets are indicated for the management of acute pain severe enough to require an opioid analgesic and for which alternative treatments are inadequate.
Forms and strengths
- 50 mg
- 100 mg
- 25 mg/ml
- 50 mg/ml
- 50 mg/5ml
- 100 mg/ml
Injection; injection (solution); tablet; solution.
On the market
- Earliest approval on file
- November 10, 1942 Demerol, Quagen; Drugs@FDA’s file, where older or withdrawn approvals can be missing
- Generic approvals
- 28 first April 26, 1972; 6 with a marketed status in Drugs@FDA
- Labelers listed (NDC)
- 4 of which 3 under generic applications, 1 under brand applications, repackagers included
Supply and safety
- Pharmacy cost (NADAC)
- $0.157 per mL Meperidine 50 mg/5 mL solution
- Shortage (FDA)
- None current 6 past records
- Recalls by its makers (FDA)
- 0 since 2013 0 Class I among all firms' recalls; 1 more by firms not listed as its makers
- FAERS reports
- 9,161 through July 30, 2026
What is meperidine used for?
From the label: indications and usageMeperidine hydrochloride tablets are indicated for the management of acute pain severe enough to require an opioid analgesic and for which alternative treatments are inadequate. Limitations of Use Because of the risks of addiction, abuse, misuse, overdose, and death, which can occur at any dosage or duration and persist over the course of therapy [see Warnings and Precautions (5.2) ], reserve opioid analgesics, including meperidine hydrochloride tablets for use in patients for whom alternative treatment options are ineffective, not tolerated, or would be otherwise inadequate to provide sufficient management of pain. […]
Conditions named in the indications of meperidine's FDA labels, with every medicine labeled for each:
FDA pharmacologic class: Opioid Agonist.
Source: FDA drug label (Meperidine Hydrochloride), EPIC PHARMA, LLC, effective November 29, 2025 (SPL set fae5cc34-5917-4445-9516-25f97ffca8db), via openFDA; the full label on DailyMed
Is there a generic for meperidine (Demerol)?
The FDA approved the first generic meperidine on April 26, 1972. 28 generic applications are approved; 6 of them carry a current (not discontinued) marketing status in Drugs@FDA; that status is not evidence that the generic is on sale.
FDA's NDC Directory lists meperidine from 3 labelers under a generic (ANDA) application and from 1 brand labeler. A listing means the company has registered the product for sale; it does not show that every pharmacy stocks it.
- 1942 earliest approval on file
- 1972 first generic approved
- red ticks recalls
Source: Drugs@FDA, FDA NDC Directory and the Orange Book (openFDA bulk files, October 8, 2026)
What do pharmacies pay for meperidine (Demerol)?
In CMS's NADAC survey of October 7, 2026, pharmacies paid $0.157 per mL (Meperidine 50 mg/5 mL solution), down 2% from $0.159 on October 8, 2025. The chart's scale runs from the lowest to the highest price shown, not from zero. NADAC is what retail pharmacies paid their wholesalers, per unit, in CMS's monthly survey; what a patient pays depends on insurance and the pharmacy.
- Meperidine 50 mg/5 mL solution (generic)
| Strength and form | Brand or generic | Pharmacy cost | 30 tablets, or one pen or vial | 12-month change |
|---|---|---|---|---|
| Meperidine 50 mg/5 mL solution | Generic | $0.157 per mL | n/a | -2% |
Source: CMS National Average Drug Acquisition Cost (NADAC) survey, October 7, 2026: what retail pharmacies paid per unit; not a counter price
Is meperidine in shortage?
No meperidine presentation is listed as limited or unavailable in the FDA Drug Shortage Database (read October 8, 2026); it keeps 6 current entries listed as available (updated September 22, 2026). ASHP keeps a separate shortage list, which can differ.
| Presentation | Company | Status | Updated |
|---|---|---|---|
| Demerol, Injection, 25 mg/1 mL (NDC 0409-1176-30) | Hospira, Inc., a Pfizer Company | Current | September 22, 2026 |
| Demerol, Injection, 50 mg/1 mL (NDC 0409-1178-30) | Hospira, Inc., a Pfizer Company | Current | September 22, 2026 |
| Demerol, Injection, 50 mg/1 mL (NDC 0409-1181-30) | Hospira, Inc., a Pfizer Company | Current | September 22, 2026 |
| Meperidine Hydrochloride, Injection, 100 mg/1 mL (NDC 0641-6054-25) | Hikma Pharmaceuticals USA, Inc. | Current | September 18, 2026 |
| Meperidine Hydrochloride, Injection, 25 mg/1 mL (NDC 0641-6052-25) | Hikma Pharmaceuticals USA, Inc. | Current | September 18, 2026 |
| Meperidine Hydrochloride, Injection, 50 mg/1 mL (NDC 0641-6053-25) | Hikma Pharmaceuticals USA, Inc. | Current | September 18, 2026 |
Source: FDA Drug Shortage Database via openFDA, updated October 8, 2026
Has meperidine been recalled?
The FDA's Enforcement Report lists 1 recall naming meperidine since 2013: 0 Class I (the most serious), 1 Class II, 0 Class III; 0 still ongoing. 1 of them is by a firm that FDA's NDC Directory does not list as a maker of meperidine and that holds no application for it in Drugs@FDA, such as compounding pharmacies or bulk-ingredient suppliers; the recall notice names the product recalled. A recall names products and lots, not every product of the medicine.
| Started | Class | Company | Reason |
|---|---|---|---|
| April 22, 2013 | Class II | Nora Apothecary and Alternative Therapies, Inc. not a listed maker | Lack of Assurance of Sterility: FDA inspection findings resulted in concerns regarding quality control processes. |
Source: FDA Enforcement Report (drug recalls) via openFDA, through October 8, 2026
What does the meperidine label say about other medicines?
The meperidine label names 27 other medicines in its interaction, contraindication or warning sections. The labels of 34 other medicines name meperidine. The sentences are the labels' own; a label lists what its studies and reports found, not every interaction.
| Medicine named | Section | What the label says |
|---|---|---|
| Acyclovir | drug interactions | Clinical Impact: The concomitant use of acyclovir may increase the plasma concentrations of meperidine and its metabolite, normeperidine. Intervention: If concomitant use of acyclovir and meperidine hydrochloride tablets is necessary, evaluate patients for respiratory depression and sedation at frequent intervals. |
| Buprenorphine | drug interactions | Clinical Impact: May reduce the analgesic effect of meperidine hydrochloride tablets and/or precipitate withdrawal symptoms. Intervention: Avoid concomitant use. Examples: butorphanol, nalbuphine, pentazocine, buprenorphine Muscle Relaxants |
| Butorphanol | drug interactions | Clinical Impact: May reduce the analgesic effect of meperidine hydrochloride tablets and/or precipitate withdrawal symptoms. Intervention: Avoid concomitant use. Examples: butorphanol, nalbuphine, pentazocine, buprenorphine Muscle Relaxants |
| Carbamazepine | drug interactions | CYP3A4 and CYP2B6 Inducers Clinical Impact: The concomitant use of meperidine hydrochloride tablets and CYP3A4 or CYP2B6 inducers can decrease the plasma concentration of meperidine, resulting in decreased efficacy or onset of a withdrawal syndrome in patients who have developed … intervals for signs of respiratory depression and sedation. Examples: Rifampin, carbamazepine, phenytoin |
| Chlorpromazine | drug interactions | Monoamine Oxidase Inhibitors (MAOIs) Clinical Impact: Meperidine is contraindicated in patients who are receiving monoamine oxidase (MAOIs) or those who have recently received such agents. Therapeutic doses of meperidine have occasionally precipitated unpredictable, severe, and occasionally … have been used to treat severe reactions, with the addition of intravenous chlorpromazine in those cases exhibiting hypertension and hyperpyrexia. … |
| Cimetidine | drug interactions | Cimetidine Clinical Impact: The concomitant use of cimetidine may reduce the clearance and volume of distribution of meperidine also the formation of the metabolite, normeperidine, in healthy subjects. Intervention: If concomitant use of cimetidine and meperidine hydrochloride tablets is necessary, evaluate patients for respiratory depression and sedation at frequent intervals. |
| Cyclobenzaprine | drug interactions | Serotonergic Drugs Clinical Impact: The concomitant use of opioids with other drugs that affect the serotonergic neurotransmitter system has resulted in serotonin syndrome. … (e.g., mirtazapine, trazodone, tramadol), certain muscle relaxants (i.e., cyclobenzaprine, metaxalone), monoamine oxidase inhibitors (MAOIs) (those intended to treat psychiatric disorders and also others, such as … |
| Erythromycin | drug interactions | Inhibitors of CYP3A4 and CYP2B6 Clinical Impact: The concomitant use of meperidine hydrochloride tablets and CYP3A4 or CYP2B6 inhibitors can increase the plasma concentration of meperidine, resulting in increased or prolonged opioid effects. … Evaluate for signs of opioid withdrawal. Examples: Macrolide antibiotics (e.g., erythromycin), azole-antifungal agents (e.g., ketoconazole), protease inhibitors (e.g., ritonavir) |
| Gabapentin | drug interactions | Benzodiazepines and Other Central Nervous System (CNS) Depressants Clinical Impact: Due to additive pharmacologic effect, the concomitant use of benzodiazepines or other CNS depressants, including alcohol, can increase the risk of hypotension, respiratory depression, profound sedation, coma, and death. … anxiolytics, tranquilizers, muscle relaxants, general anesthetics, antipsychotics, gabapentinoids (gabapentin or pregabalin), other opioids, alcohol. |
| Hydrocortisone | drug interactions | Monoamine Oxidase Inhibitors (MAOIs) Clinical Impact: Meperidine is contraindicated in patients who are receiving monoamine oxidase (MAOIs) or those who have recently received such agents. Therapeutic doses of meperidine have occasionally precipitated unpredictable, severe, and occasionally … Intervention: Do not use meperidine hydrochloride tablets in patients taking MAOIs or within 14 days of stopping such treatment. Intravenous hydrocortisone or prednisolone have been used to treat severe reactions, with … |
| Ketoconazole | drug interactions | Inhibitors of CYP3A4 and CYP2B6 Clinical Impact: The concomitant use of meperidine hydrochloride tablets and CYP3A4 or CYP2B6 inhibitors can increase the plasma concentration of meperidine, resulting in increased or prolonged opioid effects. … Macrolide antibiotics (e.g., erythromycin), azole-antifungal agents (e.g., ketoconazole), protease inhibitors (e.g., ritonavir) |
| Linezolid | drug interactions | Monoamine Oxidase Inhibitors (MAOIs) Clinical Impact: Meperidine is contraindicated in patients who are receiving monoamine oxidase (MAOIs) or those who have recently received such agents. Therapeutic doses of meperidine have occasionally precipitated unpredictable, severe, and occasionally … treatment of these reactions is unknown.) Examples: phenelzine, tranylcypromine, linezolid |
| Metaxalone | drug interactions | Serotonergic Drugs Clinical Impact: The concomitant use of opioids with other drugs that affect the serotonergic neurotransmitter system has resulted in serotonin syndrome. … mirtazapine, trazodone, tramadol), certain muscle relaxants (i.e., cyclobenzaprine, metaxalone), monoamine oxidase inhibitors (MAOIs) (those intended to treat psychiatric disorders and also others, such as linezolid and … |
| Methylene blue | drug interactions | Serotonergic Drugs Clinical Impact: The concomitant use of opioids with other drugs that affect the serotonergic neurotransmitter system has resulted in serotonin syndrome. … psychiatric disorders and also others, such as linezolid and intravenous methylene blue) |
Every other medicine the meperidine label names
| Medicine named | Section | What the label says |
|---|---|---|
| Mirtazapine | drug interactions | Serotonergic Drugs Clinical Impact: The concomitant use of opioids with other drugs that affect the serotonergic neurotransmitter system has resulted in serotonin syndrome. … antagonists, drugs that effect the serotonin neurotransmitter system (e.g., mirtazapine, trazodone, tramadol), certain muscle relaxants (i.e., cyclobenzaprine, metaxalone), monoamine oxidase inhibitors (MAOIs) (those … |
| Nalbuphine | drug interactions | Clinical Impact: May reduce the analgesic effect of meperidine hydrochloride tablets and/or precipitate withdrawal symptoms. Intervention: Avoid concomitant use. Examples: butorphanol, nalbuphine, pentazocine, buprenorphine Muscle Relaxants |
| Nalmefene | warnings and precautions | Management of respiratory depression may include close observation, supportive measures, and use of opioid overdose reversal agents (e.g., naloxone, nalmefene), depending on the patient’s clinical … |
| Naloxone | warnings and precautions | Management of respiratory depression may include close observation, supportive measures, and use of opioid overdose reversal agents (e.g., naloxone, nalmefene), depending on the patient’s clinical … |
| Phenelzine | drug interactions | Monoamine Oxidase Inhibitors (MAOIs) Clinical Impact: Meperidine is contraindicated in patients who are receiving monoamine oxidase (MAOIs) or those who have recently received such agents. Therapeutic doses of meperidine have occasionally precipitated unpredictable, severe, and occasionally … narcotic antagonists in the treatment of these reactions is unknown.) Examples: phenelzine, tranylcypromine, linezolid |
| Phenytoin | drug interactions | CYP3A4 and CYP2B6 Inducers Clinical Impact: The concomitant use of meperidine hydrochloride tablets and CYP3A4 or CYP2B6 inducers can decrease the plasma concentration of meperidine, resulting in decreased efficacy or onset of a withdrawal syndrome in patients who have developed … of respiratory depression and sedation. Examples: Rifampin, carbamazepine, phenytoin |
| Prednisolone | drug interactions | Monoamine Oxidase Inhibitors (MAOIs) Clinical Impact: Meperidine is contraindicated in patients who are receiving monoamine oxidase (MAOIs) or those who have recently received such agents. Therapeutic doses of meperidine have occasionally precipitated unpredictable, severe, and occasionally … Intervention: Do not use meperidine hydrochloride tablets in patients taking MAOIs or within 14 days of stopping such treatment. Intravenous hydrocortisone or prednisolone have been used to treat severe reactions, with … |
| Pregabalin | drug interactions | Benzodiazepines and Other Central Nervous System (CNS) Depressants Clinical Impact: Due to additive pharmacologic effect, the concomitant use of benzodiazepines or other CNS depressants, including alcohol, can increase the risk of hypotension, respiratory depression, profound sedation, coma, and death. … relaxants, general anesthetics, antipsychotics, gabapentinoids (gabapentin or pregabalin), other opioids, alcohol. |
| Rifampin | drug interactions | CYP3A4 and CYP2B6 Inducers Clinical Impact: The concomitant use of meperidine hydrochloride tablets and CYP3A4 or CYP2B6 inducers can decrease the plasma concentration of meperidine, resulting in decreased efficacy or onset of a withdrawal syndrome in patients who have developed … frequent intervals for signs of respiratory depression and sedation. Examples: Rifampin, carbamazepine, phenytoin |
| Ritonavir | drug interactions | Inhibitors of CYP3A4 and CYP2B6 Clinical Impact: The concomitant use of meperidine hydrochloride tablets and CYP3A4 or CYP2B6 inhibitors can increase the plasma concentration of meperidine, resulting in increased or prolonged opioid effects. … azole-antifungal agents (e.g., ketoconazole), protease inhibitors (e.g., ritonavir) |
| Tramadol | drug interactions | Serotonergic Drugs Clinical Impact: The concomitant use of opioids with other drugs that affect the serotonergic neurotransmitter system has resulted in serotonin syndrome. … effect the serotonin neurotransmitter system (e.g., mirtazapine, trazodone, tramadol), certain muscle relaxants (i.e., cyclobenzaprine, metaxalone), monoamine oxidase inhibitors (MAOIs) (those intended to treat … |
| Tranylcypromine | drug interactions | Monoamine Oxidase Inhibitors (MAOIs) Clinical Impact: Meperidine is contraindicated in patients who are receiving monoamine oxidase (MAOIs) or those who have recently received such agents. Therapeutic doses of meperidine have occasionally precipitated unpredictable, severe, and occasionally … antagonists in the treatment of these reactions is unknown.) Examples: phenelzine, tranylcypromine, linezolid |
| Trazodone | drug interactions | Serotonergic Drugs Clinical Impact: The concomitant use of opioids with other drugs that affect the serotonergic neurotransmitter system has resulted in serotonin syndrome. … drugs that effect the serotonin neurotransmitter system (e.g., mirtazapine, trazodone, tramadol), certain muscle relaxants (i.e., cyclobenzaprine, metaxalone), monoamine oxidase inhibitors (MAOIs) (those intended to … |
Other labels that name meperidine
- Amphetamine
- Atropine and difenoxin
- Atropine and diphenoxylate
- Citalopram
- Desvenlafaxine
- Dextroamphetamine
- Dicyclomine
- Duloxetine
- Escitalopram
- Fluoxetine
- Fluvoxamine
- Isocarboxazid
- Levomilnacipran
- Milnacipran
- Nirmatrelvir and ritonavir
- Paroxetine
- Rasagiline
- Safinamide
- Selegiline
- Sertraline
- Venlafaxine
- Vilazodone
- Vortioxetine
- Ziprasidone
Source: FDA drug label (Meperidine Hydrochloride), EPIC PHARMA, LLC, effective November 29, 2025 (SPL set fae5cc34-5917-4445-9516-25f97ffca8db), via openFDA; the full label on DailyMed
What do FAERS reports show for meperidine?
The FDA Adverse Event Reporting System holds 9,161 reports that list meperidine among the medicines taken, through July 30, 2026, each a report of something that happened, not proof the medicine caused it; 746 are coded as a death and 1,775 as a hospital stay. Counts follow how widely a medicine is used and watched, and they are not a measure of how risky it is.
Reports received each year
The most reported reactions
Source: FDA Adverse Event Reporting System (FAERS) via openFDA, reports through July 30, 2026
What else is labeled for the same conditions as meperidine?
36 other medicines are given the same way (oral) and in the same FDA class as meperidine or labeled mainly for the same use (pain), the same class first. Pain lists all 80 medicines labeled for it, by any route. The first 8 are below. They are listed as records, not as substitutes: whether one can replace another is a prescriber's decision.
| Medicine | Shared indication | Generic labelers (oral) | Pharmacy cost | Shortage |
|---|---|---|---|---|
| Acetaminophen and hydrocodone | Pain | 38 labelers | $0.152 per tablet 10-325 mg tablet | No current entry |
| Oxycodone | Pain | 34 labelers | $0.0884 per tablet 5 mg tablet | No current entry |
| Acetaminophen and oxycodone | Pain | 30 labelers | $0.183 per tablet 7.5-325 mg tablet | A presentation being discontinued |
| Tramadol | Pain | 40 labelers | $0.0248 per tablet 50 mg tablet | No current entry |
| Morphine | Pain | 17 labelers | $0.226 per tablet 15 mg tablet | In shortage |
| Acetaminophen and codeine | Pain | 25 labelers | $0.256 per tablet 3 tablet | No current entry |
| Hydromorphone | Pain | 11 labelers | $0.219 per tablet 4 mg tablet | In shortage |
| Methadone | Pain | 17 labelers | $0.177 per tablet 10 mg tablet | No current entry |
Every medicine labeled for the same conditions as meperidine
Source: FDA drug labels (indications), NDC Directory, NADAC of October 7, 2026, FDA shortages (October 8, 2026)
How does meperidine compare with medicines for the same use?
5 side-by-side pages set meperidine beside a medicine whose label shares a use: approvals, generics, pharmacy cost, warnings and supply.
What next?
- Alternatives to meperidine
- 36 medicines for the same use
- Other opioids
- the pharmacologic class, with prices and generics
- Meperidine side effects
- the label's list beside FAERS reports
- Meperidine shortage record
- every presentation, company and date
- Check an interaction
- what two or more labels say about each other