Meperidine Hydrochloride and Oxymetazoline Hydrochloride

• Generic Name: meperidine
• Dosage Forms: n.a.
• Other Brand Names: Demerol, Demerol HCl, Meperitab

A strong analgesic used in the relief of moderate to severe pain.

Usually, temporary relief of moderate to severe pain such as that associated with acute and some chronic medical disorders including renal or biliary colic, acute trauma, postoperative pain, and cancer.

Used to provide analgesia during diagnostic and orthopedic procedures and during labor.

For preoperative sedation and as a supplement to anesthesia.

Use as first-line opiate therapy is discouraged because of central excitatory toxicity of metabolite (normeperidine).

Because of extensive first-pass metabolism in the liver to normeperidine, the risk of excitatory toxicity is increased with oral administration of meperidine; therefore, oral therapy is discouraged.

Has been used to relieve the pain of MI, although probably not as effective as morphine sulfate.

In symptomatic treatment of acute pain, reserve opiate analgesics for pain resulting from severe injuries, severe medical conditions, or surgical procedures, or when nonopiate alternatives for relieving pain and restoring function are expected to be ineffective or are contraindicated. Use smallest effective dosage for shortest possible duration since long-term opiate use often begins with treatment of acute pain. Optimize concomitant use of other appropriate therapies. (See Managing Opiate Therapy for Acute Pain under Dosage and Administration.)

Use for chronic pain is discouraged because of short duration of effect and risk of accumulation of normeperidine metabolite and resultant central excitatory toxicity with repeated or large doses.

Used parenterally for preoperative sedation and as a supplement to anesthesia.

Used in patients with acute pulmonary edema for its cardiovascular effects and to allay anxiety.

Do not use in the treatment of pulmonary edema resulting from a chemical respiratory irritant.

• Generic Name: oxymetazoline ophthalmic
• Dosage Forms: n.a.
• Other Brand Names: Visine LR, Visine Long Lasting, Ocuclear

Self-medication for temporary relief of nasal congestion associated with the common cold, hay fever, or other upper respiratory allergies.

As effective as other topical vasoconstrictors.

Labeled and has been used for self-medication for temporary relief of nasal congestion associated with sinusitis; however, efficacy data are lacking and/or controversial. In October 2005, FDA issued final rule to remove this indication from labeling of OTC nasal decongestants. Compliance date for preparations with annual sales <$25,000 is October 11, 2007; compliance date for all other preparations is April 11, 2007.

Self-medication for temporary relief of ocular redness due to minor irritation.

Has been used for self-medication for symptomatic prevention of otitic barotrauma (aerotitis [barotitis] media); however, no more effective than placebo.