How do you administer this medicine?
What happens if I overdose Petidina-Labesfal?
Contact 1-800-222-1222 (the American Association of Poison Control Centers), your local, or emergency room immediately. Symptoms may include chest pain; cold and clammy skin; fainting; limp muscles; loss of consciousness; low body temperature; seizures; severe dizziness or light-headedness; severe drowsiness; slowed heartbeat; slowed, shallow, or difficult breathing; small pupils.
Proper storage of Petidina-Labesfal:
Petidina-Labesfal is usually handled and stored by a health care provider. If you are using Petidina-Labesfal at home, store Petidina-Labesfal as directed by your pharmacist or health care provider. Keep Petidina-Labesfal out of the reach of children and away from pets.
Overdose of Petidina-Labesfal in details
Symptoms: Serious overdosage with Petidina-Labesfal is characterized by respiratory depression (a decrease in respiratory rate and/or tidal volume, Cheyne-Stokes respiration, cyanosis), extreme somnolence progressing to stupor or coma, skeletal muscle flaccidity, cold and clammy skin and sometimes bradycardia and hypotension. In severe overdosage, particularly by IV route, apnea, circulatory collapse, cardiac arrest and death may occur.
Treatment: Primary attention should be given to the re-establishment of adequate respiratory exchange through provision of a patient airway and institution of assisted or controlled ventilation. The narcotic antagonist, naloxone HCl, is a specific antidote against respiratory depression which may result from overdosage or unusual sensitivity to narcotics, including Petidina-Labesfal. Therefore, an appropriate dose of this antagonist should be administered, preferably by IV route, simultaneously with efforts at respiratory resuscitation.
An antagonist should not be administered in the absence of clinically significant respiratory or cardiovascular depression.
Oxygen, IV fluids, vasopressors and other supportive measures should be employed as indicated.
Note: In an individual physically dependent on narcotics, the administration of the usual dose of a narcotic antagonist will precipitate an acute withdrawal syndrome. The severity of this syndrome will depend on the degree of physical dependence and the dose of antagonist administered. The use of narcotics antagonist in such individual should be avoided if possible. If a narcotic antagonist must be used to treat serious respiratory depression in the physically dependent patient, the antagonist should be administered with extreme care and only 1/5 to 1/10 the usual initial dose administered.
What should I avoid while taking Petidina-Labesfal?
Do not drink alcohol. Dangerous side effects or death can occur when alcohol is combined with Petidina-Labesfal.
This medication may impair your thinking or reactions. Avoid driving or operating machinery until you know how this medicine will affect you. Dizziness or severe drowsiness can cause falls or other accidents.
Meperidine should not be used for treatment of chronic pain. Meperidine should only be used in the treatment of acute episodes of moderate to severe pain. Prolonged meperidine use may increase the risk of toxicity (e.g. seizures) from the accumulation of the meperidine metabolite, normeperidine.
Petidina-Labesfal is an opioid agonist and a Schedule II controlled substance with an abuse liability similar to morphine.
Petidina-Labesfal can be abused in a manner similar to other opioid agonists, legal or illicit. This should be considered when prescribing or dispensing Petidina-Labesfal in situations where the physician or pharmacist is concerned about an increased risk of misuse, abuse, or diversion.
Misuse, Abuse, and Diversion of Opioids
Meperidine is an opioid agonist of the morphine-type. Such drugs are sought by drug abusers and people with addiction disorders and are subject to criminal diversion.
Meperidine can be abused in a manner similar to other opioid agonists, legal or illicit. This should be considered when prescribing or dispensing Petidina-Labesfal in situations where the physician or pharmacist is concerned about an increased risk of misuse, abuse, or diversion.
Petidina-Labesfal has been reported as being abused by crushing, chewing, snorting, or injecting the dissolved product. These practices will result in the uncontrolled delivery of the opioid and pose a significant risk to the abuser that could result in overdose or death.
Concerns about abuse, addiction, and diversion should not prevent the proper management of pain.
Healthcare professionals should contact their State Professional Licensing Board or State Controlled Substances Authority for information on how to prevent and detect abuse or diversion of this product.
Interactions with Alcohol and Drugs of Abuse
Meperidine may be expected to have additive effects when used in conjunction with alcohol, other opioids, or illicit drugs that cause central nervous system depression.
Head Injury and Increased Intracranial Pressure
The respiratory depressant effects of meperidine and its capacity to elevate cerebrospinal fluid pressure may be markedly exaggerated in the presence of head injury, other intracranial lesions, or a preexisting increase in intracranial pressure. Furthermore, narcotics produce adverse reactions which may obscure the clinical course of patients with head injuries. In such patients, meperidine must be used with extreme caution and only if its use is deemed essential.
Meperidine should be used with extreme caution in patients having an acute asthmatic attack, patients with chronic obstructive pulmonary disease or cor pulmonale, patients having a substantially decreased respiratory reserve, and patients with preexisting respiratory depression, hypoxia, or hypercapnia. In such patients, even usual therapeutic doses of narcotics may decrease respiratory drive while simultaneously increasing airway resistance to the point of apnea.
The administration of meperidine may result in severe hypotension in the postoperative patient or any individual whose ability to maintain blood pressure has been compromised by a depleted blood volume or the administration of drugs such as the phenothiazines or certain anesthetics.
Due to the risk of serotonin syndrome, meperidine should not be used in combination with serotoninergic products.
Usage in Ambulatory Patients
Meperidine may impair the mental and/or physical abilities required for the performance of potentially hazardous tasks such as driving a car or operating machinery. The patient should be cautioned accordingly.
Meperidine, like other narcotics, may produce orthostatic hypotension in ambulatory patients.
Usage in Pregnancy
Meperidine should not be used in pregnant women prior to the labor period, unless in the judgment of the physician the potential benefits outweigh the possible risks, because safe use in pregnancy prior to labor has not been established relative to possible adverse effects on fetal development.
Labor and Delivery
Meperidine crosses the placental barrier and can produce depression of respiration and psychophysiologic functions in the newborn. Resuscitation may be required. Therefore meperidine is not recommended during labor.
Meperidine appears in the milk of nursing mothers receiving the drug. Due to the potential for serious adverse reactions in nursing infants, a decision should be made whether to discontinue nursing or to discontinue the drug, taking into account the potential benefits of the drug to the nursing woman.
What should I discuss with my healthcare provider before taking Petidina-Labesfal?
Some medical conditions may interact with Petidina-Labesfal. Tell your doctor or pharmacist if you have any medical conditions, especially if any of the following apply to you:
- if you are pregnant, planning to become pregnant, or are breast-feeding
- if you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement
- if you have allergies to medicines, foods, or other substances
- if you have had an allergic reaction to any codeine- or morphine-related medicine (eg, hydrocodone, oxycodone, dihydrocodeine, hydromorphone)
- if you have a history of lung or breathing problems (eg, asthma, chronic obstructive pulmonary disease [COPD], cor pulmonale); low levels of oxygen or high levels of carbon dioxide in the blood; sickle cell anemia; adrenal gland problems (eg, Addison disease, pheochromocytoma); curvature of the spine (scoliosis); thyroid problems; low blood pressure; an enlarged prostate; urinary blockage or trouble urinating; lung, liver, or kidney problems; heart problems (eg, fast or irregular heartbeat); seizures; or stomach or bowels problems (eg, inflammatory bowel disease)
- if you have or have recently had any head injury, brain tumor or other growths, or increased pressure in the brain
- if you drink alcohol; are going through withdrawal from alcohol or other substances; or have a history of alcohol or substance abuse or dependence, mental or mood problems, or suicidal thoughts or attempts
- if you have severe diarrhea due to taking an antibiotic (pseudomembranous colitis), constipation, stomach pain, low blood volume, dehydration, drowsiness, or severe weakness, or have had recent surgery
Some MEDICINES MAY INTERACT with Petidina-Labesfal. Tell your health care provider if you are taking any other medicines, especially any of the following:
- Mixed narcotic agonist/antagonists (eg, butorphanol, pentazocine), naltrexone, or rifamycins (eg, rifampin) because they may decrease Petidina-Labesfal's effectiveness
- Furazolidone or MAOIs (eg, phenelzine) because the risk of serious side effects, including coma, difficulty breathing, low blood pressure, seizures, and irregular heartbeat, may be increased
- Selective serotonin reuptake inhibitors (SSRIs) (eg, fluoxetine) or sibutramine because the risk of side effects, including increased body temperature, mental or mood changes, muscle twitching, or severe drowsiness, may be increased
- Acyclovir, cimetidine, phenothiazines (eg, chlorpromazine), phenytoin, or ritonavir because the risk of side effects of Petidina-Labesfal may be increased
- Muscle relaxers (eg, cyclobenzaprine) or sodium oxybate (GHB) because actions and side effects may be increased by Petidina-Labesfal
This may not be a complete list of all interactions that may occur. Ask your health care provider if Petidina-Labesfal may interact with other medicines that you take. Check with your health care provider before you start, stop, or change the dose of any medicine.
As with all IM preparation, Petidina-Labesfal IM injection should be injected well within the body of a large muscle.
Supraventricular Tachycardias: Petidina-Labesfal should be used with caution in patients with atrial flutter and other supraventricular tachycardias because of a possible vagolytic action which may produce a significant increase in the ventricular response rate.
Convulsions: Petidina-Labesfal may aggravate preexisting convulsion in patients with convulsive disorders, if dosage is escalated substantially above recommended levels because of tolerance development, convulsion may occur in individuals without a history of convulsive disorders.
Acute Abdominal Conditions: The administration of Petidina-Labesfal or other narcotics may obscure the diagnosis or clinical course in patients with acute abdominal conditions.
Special Risk Patients: Petidina-Labesfal should be given with caution and the initial dose should be reduced in certain patients eg, the elderly or debilitated, and those with severe impairment of hepatic or renal functions, hypothyroidism, Addison's disease, and prostatic hypertrophy or urethral stricture.
Effects on the Ability to Drive or Operate Machinery: Petidina-Labesfal may impair the mental and/or physical abilities required for the performance of potentially hazardous tasks eg, driving a car or operating machinery. The patients should be cautioned accordingly.
Petidina-Labesfal, like other narcotics, may produce orthostatic hypotension in ambulatory patients.
Use in pregnancy & lactation: Petidina-Labesfal should not be used in pregnant women prior to the labor period, unless in the judgement of the physician the potential benefits outweigh the possible hazards, because safe use in pregnancy prior to labor has not been established relative to possible adverse effects on the fetal development.
When used as an obstetrical analgesic, Petidina-Labesfal crosses the placental barrier and can produce depression of respiration and psychophysiologic functions in the newborn. Resuscitation may be required.
Petidina-Labesfal appears in the milk of nursing mothers receiving Petidina-Labesfal.
What happens if I miss a dose of Petidina-Labesfal?
Since Petidina-Labesfal is used for pain, you are not likely to miss a dose. Skip any missed dose if it is almost time for your next scheduled dose. Do not use extra medicine to make up the missed dose.
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Information checked by Dr. Sachin Kumar, MD Pharmacology