How Genes Influence Meperidine Allergy?

What is Meperidine?

Meperidine is a synthetic opioid pain killer (analgesic) used to treat moderate to severe pain.

It is similar to morphine and is commonly used to relieve post-operative pain.

Since this drug can cause dependence and withdrawal symptoms, it requires a prescription.

Meperidine is available as a syrup, tablet, and injection and is used as a second line of treatment for acute pain.

This drug has a chemical structure similar to anesthetics, and so it has been used for regional anesthesia, peripheral nerve blocks, intraarticular, epidural, and spinal anesthesia.

Meperidine is metabolized in the liver and excreted in the urine.

Is Meperidine An Opioid?

Meperidine is a synthetic drug belonging to the class of opioid analgesics.

It is not recommended for long-term use or for treating chronic ongoing pain.

Is Demerol The Same As Meperidine?

Demerol is the brand name for meperidine hydrochloride.

It is a prescription drug and may be used alone or with other medications.

What Is Meperidine Used For?

Meperidine is used to treat sudden or acute episodes of moderate to severe pain.

The dosage and form of meperidine prescribed for you will depend on the cause and intensity of your pain, risk of addiction, and medical history.

Some uses of this drug are:

Preoperative anesthetic
Obstetric analgesia

Meperidine is not used in the geriatric population (elderly patients) as it may have central nervous system effects due to the drug by-products like normeperidine.

How Does Meperidine Work?

Meperidine binds to kappa-opiate receptors and brings about anesthetic effects.

When meperidine binds to the kappa-opiate receptors, it prevents the production of neurotransmitters like substance P, GABA, dopamine, acetylcholine, and noradrenaline, which cause pain sensation.

Meperidine is also known to prevent the release of vasopressin, somatostatin, insulin, and glucagon, which further reduce neuron excitability and reduce pain.

The onset of meperidine effects is more rapid than with morphine, and the duration of action of this drug is shorter.

Side Effects of Meperidine

Though meperidine is safe to consume, it may cause side effects in some individuals.

Common side effects of meperidine are:

Nausea
Vomiting
Constipation
Sweating
Lightheadedness or dizziness
Pain or swelling at the injection site when meperidine is injected

Some severe side effects of meperidine that require immediate medical attention include

Dry mouth
Shortness of breath
Rapid heart rate
Sleep apnea
Painful or difficult in urinating
Vision changes
Mood changes
Fainting
Severe drowsiness
Seizures
Twitching of muscles
Unexplained fever, tiredness, or fatigue
Severe allergic reaction or anaphylaxis

Meperidine: Interactions With Other Drugs

When two or more drugs are taken together, they can interact with each other, resulting in a change in the mechanism of action of one or all the drugs and an increased risk for side effects.

You must, therefore, inform your doctor about any medications or supplements you are taking before consuming meperidine.

Some drugs that may interact with meperidine are:

Other opioid medications

Taking other opioid medications or morphine derivatives may lead to nervous system depression, respiratory distress, coma, or other side effects.

MAO inhibitors

Taking MAO inhibitors like isocarboxazid, linezolid, metaxalone, etc., may result in serious drug interaction.

For this reason, you must not take MAO inhibitors for at least two weeks before treatment with meperidine.

Discuss with your doctor when you can stop these drugs.

Drugs that increase serotonin

When meperidine is taken with other drugs that increase serotonin, the risk of developing serotonin syndrome or toxicity increases.

Drugs that affect the elimination of meperidine

Drugs like azole antifungals (ketoconazole), macrolide antibiotics (erythromycin), mifepristone, and antiseizure drugs (carbamazepine, phenytoin) reduce the elimination of meperidine, increasing the risk of side effects.

Avoid taking these drugs with meperidine.

Can You Be Allergic To Meperidine?

Opioid allergy is common, and some people may be allergic to meperidine.

However, less than 2% of opioid allergies are true allergies?

Pseudo allergy is a side effect of opioid drugs like meperidine that resemble true allergies but is caused by histamine release from a specific type of cells called mast cells in the skin.

True allergic reactions to opioids like meperidine may include symptoms like

Hives
Maculopapular rash
Erythema multiforme
Pustular rash

If you have a known allergy to other opioids, inform your doctor about the same before taking meperidine.

Genetics of Meperidine Allergy

The PTHLH Gene and Mepredidine Allergy

rs11049274 is a single nucleotide polymorphism or SNP located at LOC7292 on the PTHLH gene.

People with the A allele are at an increased risk of developing adverse drug reactions on taking meperidine than those with the G allele.

The FIP1L1 Gene and Mepredidine Allergy

rs113100019 is an SNP in the FIP1L1 gene.

People with the G allele are at an increased risk of developing adverse drug reactions on taking meperidine than those with the T allele.

The SERINC5 Gene and Mepredidine Allergy

rs185462714 is an SNP located on the SERINC5 gene on chromosome 5.

People with the C allele are at a greater risk of developing adverse drug reactions on taking meperidine than those with the A allele.

Gene	SNP	Risk Allele	Effect
PTHLH	rs11049274	A	Increased risk for adverse drug reactions
FIP1L1	rs113100019	G	Increased risk for adverse drug reactions
SERINC5	rs185462714	C	Increased risk for adverse drug reactions

Analyze Your Genetic Response to Meperidine

Recommendations To Use Meperidine

Pregnancy and Lactation

Meperidine has not been adequately assessed and evaluated in pregnant women.

However, it is advised to avoid it during pregnancy as it is known to cross the placenta.

Meperidine gets distributed into breast milk, and its effects on infants are unknown.

Hence, it must be avoided by lactating and breastfeeding women.

This drug is also habit-forming and must be avoided by pregnant women or who are planning to conceive in the near future.

Diet and Nutrition

Meperidine is known to cause constipation, so you must eat plenty of dietary fiber, drink lots of water, and exercise regularly while taking the drug.

If you are experiencing chronic constipation due to the medication, your doctor may prescribe a laxative to help clear your bowels.

For people experiencing dizziness or lightheadedness on taking the medication, getting up slowly when changing posture is advisable.

Alcohol Consumption

Meperidine may interact with alcohol and cause adverse reactions.

So, avoid alcohol consumption if you are taking this drug.

Current Medications

Meperidine interacts with a wide range of drugs, including pain-relieving medicines, sedatives, muscle relaxants, pentazocine, phenytoin, and other drugs that make you drowsy or slow down your breathing.

To avoid adverse reactions due to the interactions of meperidine with other drugs, you must inform your doctor about all medications you are currently taking.

Summary

Meperidine is a synthetic opioid analgesic used to treat acute, moderate to severe pain.
Since the chemical structure of meperidine is similar to anesthetics, it may be used for regional anesthesia and peripheral nerve blocks.
Demerol or meperidine hydrochloride is the most commonly available meperidine formulation.
Meperidine is used preoperatively to control pain in adults and children and obstetric analgesia.
Meperidine works by binding to receptors and preventing the production of chemical substances that elicit pain.
Meperidine may cause side effects like constipation, nausea, sweating, and vomiting in some individuals.
Inform your doctor about medications you are currently taking, as meperidine is known to interact with several drugs.
Allergy to meperidine is possible, but your doctor will evaluate your symptoms to understand if it is a true or pseudo allergy.
Certain genes like PTHLH, FIP1L1, and SERINC5 are associated with meperidine allergy.
Inform your doctor if you are pregnant, planning to conceive, or are lactating before taking meperidine.
Eat a healthy diet, drink plenty of fluids and avoid alcohol when taking meperidine.

References

A Sneak Peek Into The Gene Allergy Report

Get Insights On Common Allergies From Your 23andMe, AncestryDNA Raw Data!