Excreted Unchanged %
Hepatic
Half-Life (Normalesrd) Hours
2-7/7-32
Plasma Protein Binding %
70
Volume Of Distribution L/Kg
4-5
Dose For Normal Renal Function
50-100 mg q3-4h
Adjustment For Renal Failure Method
D
Adjustment For Renal Failure Gfr, Ml/Min >50 [Recommended Level]
100% [D]
Adjustment For Renal Failure Gfr, Ml/Min 10-50 [Recommended Level]
75% [D]
Adjustment For Renal Failure Gfr, Ml/Min <10 [Recommended Level]
50% [D]
Supplement For Dialysis [Recommendation Level]: Ihd
IHD: Avoid
Supplement For Dialysis [Recommendation Level]: Pd
PD: Avoid
Supplement For Dialysis [Recommendation Level]: Crrt
CRRT: Avoid, [D]
References
Clark RF, Wei EM, Anderson PO. Meperidine: therapeutic use and toxicity. J Emerg Med. 1995; 13: 797-802. [PMID: 8747629] / Davies G, Kingswood C, Street M. Pharmacokinetics of opioids in renal dysfunction. Clin Pharmacokinet. 1996; 31: 410-22. [PMID: 8968655] / Sjö strö m S, Hartvig P, Persson MP, Tamsen A. Pharmacokinetics of epidural morphine and meperidine in humans. Anesthesiology. 1987; 67: 877-88. [PMID: 2891328] / Sjö strö m S, Tamsen A, Persson MP, Hartvig P. Pharmacokinetics of intrathecal morphine and meperidine in humans. Anesthesiology. 1987; 67: 889-95. [PMID: 2891329]
Toxicity Notes
Normeperidine, an active metabolite, accumulates in ESRD and may cause seizures. Protein binding is reduced in ESRD. 20-25% excreted unchanged in acidic urine.