Narcotic analgesics (opioids, opiates) / antihistamines (sedating)

Pethidine, promethazine

Solution for injection in ampoules.

Injection, pethidine hydrochloride 100 mg, promethazine hydrochloride 50 mg/ 2 mL.

Pre-anaesthetic medication. Obstetric analgesia and amnesia. The management of severe pain.

Not recommended.

Severe liver disease, cholecystectomy, biliary colic, increased intracranial pressure, respiratory depression, obstructive airways disease. MAOIs or within two weeks of their use.

Repeated use may result in dependence of the morphine type. Administration during labour. Elderly or debilitated or those with head injuries, severe with head injuries, severe hepatic or renal impairment, biliary tract disorders, hypothyroidism, adreno-cortical insufficiency, shock, prostatic hypertrophy, and supra- ventricular tachycardia.

Caution is also required in patients with acute alcoholism, raised intracranial pressure or convulsive disorders. Pethidine neurotoxicity may be seen in patients with renal failure, cancer or sickle cell anaemia, during concomitant administration with anticholinergics or during prolonged administration of increasing pethidine doses. Pregnancy and lactation.

CNS depressants or anaesthetics. Alcohol. MAOIs. Cimetidine. Hypnotics and anxiolytics. Mexiletine. Domperidone and Metaclopramide.

Dizziness, nausea, vomiting, hypertension and respiratory depression. Mild euphoria may occur and CNS excitation has been reported in certain patient groups.

Other side effects include dryness of the mouth and blurred vision. Occasionally patients may develop a feeling of weakness or syncope accompanied by profuse perspiration.

Martindale

(CD)

22 June 2009