Medicines & treatments centre

PETHIDINE WARNINGS

Pethidine should be used with caution in:

• Breathing difficulties
• Newborn babies
• Premature babies
• Elderly patients
• Debilitated patients
• Severe liver disease
• Severe kidney disease
• Biliary tract disorders
• Underactive thyroid gland
• Adrenocortical insufficiency (a condition in which the adrenal glands, located above the kidneys, do not produce adequate amounts of steroid hormones)
• Shock
• Enlarged prostate gland
• Rapid or erratic heartbeat
• Myasthenia gravis (a condition which causes muscles weakness)
• Acute alcoholism
• Convulsive disorders (fits)
• Severe continuing pain
• Cor pulmonale (a heart problem after long-term lung disease)

It should not be used in:

• History of allergies to pethidine
• Coma
• Raised intracranial pressure (increased pressure on the brain)
• Patients with head injuries
• A tumour on your adrenal gland called a phaeochromocytoma,
• Respiratory depression or obstructive airways disease
• Patients receiving monoamine oxidase inhibitors or within two weeks following their withdrawal

Also see list of precautions and interactions

STORAGE

Do not store above 25°C.

PETHIDINE USES

What is it used for?

• Pethidine is used to relieve pain.
• It is an analgesic, sometimes known as a pain killer.
• Pethidine hydrochloride may be used as an analgesic for the relief of moderate to severe pain including pain associated with childbirth, and pain before, during and after an operation.
• It is used to relieve moderate to severe pain.
• In general this drug is used to relieve pain in a variety of situations.

Listed below are the typical uses of pethidine.

• Pain relief during childbirth.
• Pain relief before, during and after an operation.

On occasion your doctor may prescribe this medicine to treat a condition not on the above list.

HOW TO USE/TAKE

How often do I take it?

• Your doctor or nurse will administer the correct dose for you by injection. If necessary, this dose may be repeated.
• Use this medication for the duration of the prescription in order to get the most benefit from it.
• Remember to use it at the same time each day - unless specifically told not to by your doctor.
• Certain medical conditions may require different dosage instructions as directed by your doctor.

What dose?

• Dosage is based on your age, gender, medical condition, response to therapy, and use of certain interacting medicines.

Do I need to avoid anything?

• Pethidine may impair the mental and/or physical abilities required for driving or for operating machinery; patients on this medicine should not drive or operate machinery. Consult your doctor or pharmacist for more details.

When can I stop?

• Your doctor will administer the correct amount of pethidine for you.

PETHIDINE SIDE EFFECTS

• lightheadedness
• dizziness
• sleepiness
• nausea (feeling sick)
• vomiting (being sick)
• sweating
• constipation
• dry mouth
• feeling restless or agitated

Tell your doctor immediately if you develop any of the following symptoms:

• difficulty breathing
• low blood pressure

Remember that your doctor has prescribed this medication because he or she has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.

A serious allergic reaction to this drug is unlikely, but seek immediate medical attention if it occurs. Symptoms of a serious allergic reaction include: rash, itching/swelling (especially of the face/tongue/throat), dizziness, trouble breathing.

This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.

The Yellow Card Scheme allows you to report suspected side effects from any type of medicine (which includes vaccines, herbals and over the counter medicines) that you are taking. It is run by the medicines safety watchdog called the Medicines and Healthcare products Regulatory agency (MHRA). Please report any suspected side effect on the Yellow Card Scheme website.

PETHIDINE PRECAUTIONS

Before taking pethidine, tell your doctor or pharmacist if you are allergic to it; or to other opioid analgesics; or if you have any other allergies.

This medication should not be used if you have certain medical conditions. Before using this medicine, consult your doctor or pharmacist in case of:

• History of allergies to pethidine
• Coma
• Raised intracranial pressure (increased pressure on the brain)
• Patients with head injuries
• A tumour on your adrenal gland called a phaeochromocytoma,
• Respiratory depression or obstructive airways disease
• Patients receiving monoamine oxidase inhibitors or within two weeks following their withdrawal

Before using this medication tell your doctor or pharmacist your medical history, especially any of the following:

• Breathing difficulties
• Newborn babies
• Premature babies
• Elderly patients
• Debilitated patients
• Severe liver disease
• Severe kidney disease
• Biliary tract disorders
• Underactive thyroid gland
• Adrenocortical insufficiency (a condition in which the adrenal glands, located above the kidneys, do not produce adequate amounts of steroid hormones)
• Shock
• Enlarged prostate gland
• Rapid or erratic heartbeat
• Myasthenia gravis (a condition which causes muscles weakness)
• Acute alcoholism
• Convulsive disorders (fits)
• Severe continuing pain
• Cor pulmonale (a heart problem after long-term lung disease)

Before having surgery, tell your doctor or dentist that you are taking this medication.

Does alcohol intake affect this drug?

• Alcohol should not be taken while using pethidine.

The elderly: pethidine should be used with caution in the elderly as these patients can be more sensitive to the unwanted effects of pethidine.

Pregnancy and breastfeeding - please ensure you read the detailed information below

PREGNANCY

Pethidine is not safe to take if you are, or are planning to become, pregnant.
Use during labour may cause breathing difficulties in the newborn baby.

It is sensible to limit use of medication during pregnancy whenever possible. However, your doctor may decide that the benefits outweigh the risks in individual circumstances and after a careful assessment of your specific health situation.

If you have any doubts or concerns you are advised to discuss the medicine with your doctor or pharmacist.

BREAST FEEDING

Pethidine is not safe to take if you are breastfeeding.

It is sensible to limit use of medication during breastfeeding whenever possible. However, your doctor may decide that the benefits outweigh the risks in individual circumstances and after a careful assessment of your specific health situation.

If you have any doubts or concerns you are advised to discuss the medicine with your doctor or pharmacist.

PETHIDINE INTERACTIONS

Your doctor or pharmacist may already be aware of any possible drug interactions and may be monitoring you for them. Do not start, stop, or change the dosage of any medicine before checking with them first.

This drug should not be used with the following medications because very serious, possibly fatal interactions may occur:

• monoamine oxidase inhibitors.

If you are currently using any such medicine, tell your doctor or pharmacist before starting pethidine.

Before using this medication, tell your doctor or pharmacist of all prescription and non-prescription/herbal products you may use, especially of:

• anxiolytics
• hypnotics
• antidepressants
• other analgesics
• alcohol
• general anaesthetics
• phenothiazine
• cimetidine
• anticholinergics

This information does not contain all possible interactions. Therefore, before using pethidine, tell your doctor or pharmacist of all the products you use.

PETHIDINE OVERDOSE

An overdose of pethidine may cause convulsions (fits), respiratory depression (breathing difficulties), hypotension, shock and coma.

If you think you, or someone you care for, might have accidentally taken more than the recommended dose of pethidine or intentional overdose is suspected, contact your local hospital, GP or if in the UK call NHS Direct on 0845 4647.

MISSED DOSE

Your doctor or nurse will administer your medication. Contact them if you think that a dose has been missed.