- Drugs List
- Therapeutic Indications
- Precautions and Warnings
- Pregnancy and Lactation
- Side Effects
Oral formulations of meptazinol
Pain - moderate
200 mg every 3 to 6 hours as required.
The usual dose is 200 mg every 4 hours.
200 mg every 3 to 6 hours as required.
The usual dose is 200 mg every 4 hours.
Patients with Renal Impairment
The Renal Handbook suggests patients with a GFR (ml/min) of 10 and above should receive the same dose as patients with normal renal function. Patients with a GFR (ml/min) of less than 10 should receive doses equivalent to patients with normal renal function but should be started on low doses.
Acute alcohol intoxication
Children under 18 years
Predisposition to paralytic ileus
Within 2 weeks of discontinuing MAOIs
Acute respiratory depression
Chronic obstructive pulmonary disease
Raised intracranial pressure
Precautions and Warnings
Biliary tract disorder
Inflammatory bowel disease
Moderate renal impairment
Consider dose modification in patients with respiratory depression
Reduce dose in hypothyroidism
Reduce dose in patients with hepatic impairment
Reduce dose in patients with moderate renal impairment
Advise patient ability to drive or operate machinery may be impaired
Advise patient not to drive until they know how the medicine affects them
Advise patient this medicine may be subject to driving restrictions
Contains sunset yellow (E110) - may cause allergic reaction
Tolerance and dependence may occur
Potential for withdrawal symptoms
Avoid abrupt withdrawal
Reduce dose in debilitated patients
Only recommended for short term use
Pregnancy and Lactation
Use meptazinol with caution in pregnancy.
Manufacturer advises that meptazinol tablets should only be given in pregnancy if clearly necessary.
As meptazinol is less tried than other opioid analgesics, if an opioid is warranted, other established agents e.g. tramadol or pethidine, should be used instead. The use of meptazinol in the first trimester is not seen as a valid reason for the termination of a pregnancy or for the deployment of invasive diagnostic procedures (Schaefer, 2007).
When tested on pregnant animals, meptazinol did not show any evidence of teratogenic effects. Likewise, no congenital anomaly is known from the anecdotal human experience with opioid analgesics, and Lee (2000) even conclude that opioids are fully compatible with pregnancy as therapeutic doses are unlikely to have any adverse effect on foetal development (Lee, 2000). It should be noted, however, that no adequate and well-controlled clinical studies in humans were available for meptazinol at the time of writing.
Therapy with opioid analgesics during pregnancy is generally associated with the following risks to mother and foetus: pregnant women taking opiates during labour may suffer such adverse reactions as gastric stasis and inhalation pneumonia, while the baby may develop withdrawal symptoms if the mother uses opiates regularly throughout the pregnancy (Lee, 2000). These withdrawal symptoms will typically include: feeding intolerance, diarrhoea, vomiting, tachypnoea, hypertonia, hyperexcitability, high-pitched cry, tremor and, in severe cases, convulsions (Lee, 2000; Schaefer, 2007). The newborn may also be exposed to respiratory depression if the mother receives doses within days of delivery (Schaefer, 2007).
Meptazinol crosses the placenta.
The use of all medication in pregnancy should be avoided whenever possible; particularly in the first trimester. Non-drug treatments should also be considered. When essential, a medication with the best safety record over time should be chosen, employing the lowest effective dose for the shortest possible time. Polypharmacy should be avoided. Teratogens taken in the pre-embryonic period, often quoted as lasting until 14 to 17 days post-conception, are believed to have an all-or-nothing effect. Where drugs have a short half-life, and when the date of conception is certain, this may allow women to be reassured where drug exposure has occurred within this time frame. Further advice may be available from the UK National Teratology Information Service (NTIS) and through ToxBase, available via password on the internet ( www.toxbase.org ) or if this is unavailable at the backup site ( www.toxbasebackup.org ).
Use Meptazinol with caution in breastfeeding.
Manufacturer recommends that meptazinol should only be administered during lactation with caution. There is effectively very limited information on the use of meptazinol during lactation and other, more established opiates should probably be preferred (Schaefer, 2007).
Opiates may all be excreted into breast milk. No quantitative data are available for meptazinol as of the revision date, however given the slower metabolism of opioids in infants, it is very likely that accumulation will occur if the nursing infant is chronically exposed to even small amounts of drug (Lee, 2000).
Lee (2000) advise that mothers on opiate therapy should breastfeed immediately before taking a dose so as to avoid peak concentrations in milk.
LactMed suggests infants exposed to opiates via breast milk may generally experience the following side effects: cyanosis, breathing difficulty, increased sleepiness, limpness, difficulty breastfeeding.
LactMed indicates certain opioid agents may increase serum prolactin.
Neonates, infants born prematurely, those with low birth weight, those with an unstable gastrointestinal function or who have serious illnesses may require special consideration. For any infant, if a drug is prescribed to the nursing mother, it should be at the lowest practical dose and for the shortest time. When drug administration is unavoidable and breastfeeding is to continue, minimisation of exposure of the infant to the drug may sometimes be achieved by timing the maternal doses to just after a feeding episode. Infants exposed to drugs via breast milk should be monitored for unusual signs or symptoms. Interactions between the drug received by the infant from the mother's milk and medication prescribed for the infant should also be considered, for example, when the drug given to the infant may prevent metabolism of the drug received via breast milk.
Specialist advice is available from the UK Drugs in Lactation Advisory Service at https://www.midlandsmedicines.nhs.uk/content.asp?section=6&subsection=17&pageIdx=1
Effects on Ability to Drive and Operate Machinery
This class of medicine is in the list of drugs included in regulations under 5a of the Road Traffic Act 1988 (England and Wales). This medicine may be subject to police testing and has specified maximum blood levels for driving.
When prescribing this medicine: Advise patient the medicine can affect cognitive function and is likely to affect ability to drive. Advise patient not to drive until they know how the medicine affects them.
It is an offence to drive while under the influence of this medicine. However, a patient is not committing an offence (called 'statutory defence') if: 1. The medicine has been prescribed to treat a medical or dental problem and 2. The medicine has been taken according to the instructions given by the prescriber and/or in the information provided with the medicine, and 3. The medicine was not affecting the ability to drive safely. For further guidance see https://www.gov.uk
Difficulty in micturition
Reduction of male potency
It is strongly recommended that the UK National Poisons Information Service be consulted on cases of suspected or actual overdose where there is doubt over the degree of risk or about appropriate management.
The following number will direct the caller to the relevant local centre (0844) 892 0111
Information may be obtained if you have access to ToxBase the primary clinical toxicology database of the National Poisons Information Service. This is available via password on the internet ( www.toxbase.org ) or if this is unavailable at the backup site ( www.toxbasebackup.org ).
Last Full Review Date: August 2016
Drugs During Pregnancy and Lactation: Treatment Options and Risk Assessment, 2nd edition (2007) ed. Schaefer, C., Peters, P. and Miller, R. Elsevier, London.
Joint Formulary Committee. British National Formulary(online) London: BMJ Group and Pharmaceutical Press Accessed on 05 August 2016.
Summary of Product Characteristics: Meptid Tablets. Almirall Ltd. Revised June 2015.
Therapeutics in Pregnancy and Lactation (2000) Lee, A., Inch, S. and Finnigan, D. Radcliffe Medical Press, Abingdon.
Gov.uk. Government departments. Department for Transport. Publications. Drug driving and medicine: Advice for healthcare professionals. Drug driving: Guidance for healthcare professionals on drug driving. Available at: https://www.gov.uk/ Last accessed: 5 August 2016
New drug driving offence implications for medicines packaging. Medicines Regulatory News. 10 December 2013. Available at: https://www.mhra.gov.uk Last accessed: 5 August 2016
US National Library of Medicine. Toxicology Data Network. Drugs and Lactation Database (LactMed).
Available at: https://toxnet.nlm.nih.gov/cgi-bin/sis/htmlgen?LACT
Morphine Last revised: 04 February 2016
Last accessed: 05 August 2016
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Medscape UK | Univadis prescription drug monographs & interactions are based on FDB Multilex Content
FDB Disclaimer : FDB Multilex is intended for the use of healthcare professionals and is provided on the basis that the healthcare professionals will retain FULL and SOLE responsibility for deciding what treatment to prescribe or dispense for any particular patient or circumstance.