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Promedol what group of drugs. Promedol is a real helper for severe pain of various origins

In this article you can read the instructions for use of the drug Promedol. Reviews of site visitors - consumers of this medicine, as well as the opinions of specialist doctors on the use of Promedol in their practice are presented. We kindly ask you to actively add your reviews about the drug: whether the medicine helped or did not help get rid of the disease, what complications and side effects were observed, perhaps not stated by the manufacturer in the annotation. Analogues of Promedol in the presence of existing structural analogues. Use for the treatment of pain, during childbirth for pain relief and stimulation in adults, children, as well as during pregnancy and lactation.

Promedol- refers to agonists of opioid receptors (mainly mu receptors). Activates the endogenous antinociceptive system and thus disrupts the interneuronal transmission of pain impulses at various levels of the central nervous system, and also changes the emotional coloring of pain, affecting the higher parts of the brain. In terms of pharmacological properties, trimeperidine is close to morphine: it increases the threshold of pain sensitivity to painful stimuli of various modalities, inhibits conditioned reflexes, and has a moderate hypnotic effect. Unlike morphine, it depresses the respiratory center to a lesser extent and is less likely to cause nausea and vomiting. It has a moderate antispasmodic and uterotonic effect. Promotes opening of the cervix during childbirth, increases the tone and contractile activity of the myometrium.

When administered parenterally, the analgesic effect develops after 10-20 minutes, reaches a maximum after 40 minutes and lasts 2-4 hours.

Compound

Trimeperidine + excipients.

Pharmacokinetics

Communication with plasma proteins - 40%. Metabolized by hydrolysis to form meperidic and normeperidic acids, followed by conjugation. Small amounts are excreted unchanged by the kidneys

Indications

pain syndrome of moderate and severe intensity (unstable angina, myocardial infarction, dissecting aortic aneurysm, renal artery thrombosis, thromboembolism of the arteries of the extremities or pulmonary artery, acute pericarditis, air embolism, pulmonary infarction, acute pleurisy, spontaneous pneumothorax, gastric ulcer and duodenal ulcer intestines, esophageal perforation, chronic pancreatitis, paranephritis, acute dysuria, paraphimosis, priapism, acute prostatitis, acute attack of glaucoma, causalgia, acute neuritis, lumbosacral radiculitis, acute vesiculitis, thalamic syndrome, burns, cancer, trauma, intervertebral disc protrusion ; foreign bodies of the bladder, rectum, urethra);
in combination with atropine-like and antispasmodics for pain caused by spasm of smooth muscles of internal organs (hepatic, renal, intestinal colic);
acute left ventricular failure, pulmonary edema, cardiogenic shock;
preoperative, operational and postoperative periods;
childbirth (pain relief and stimulation);
neuroleptanalgesia (in combination with antipsychotics).

Release forms

Solution for injections 1% and 2% (injections in injection ampoules).

Tablets 25 mg.

Instructions for use and dosage

Subcutaneously, intramuscularly or intravenously (only subcutaneously and intravenously for the drug in syringe tubes).

Adults: from 0.01 g to 0.04 g (from 1 ml of 1% solution to 2 ml of 2% solution). During anesthesia, the drug is administered intravenously in fractional doses of 0.003-0.01 g.

Children from two years old: 0.003-0.01 g depending on age.

For premedication before anesthesia, 0.02-0.03 g is administered subcutaneously or intramuscularly along with atropine (0.0005 g) 30-45 minutes before surgery.

Pain relief for labor: subcutaneously or intramuscularly in a dose of 0.02-0.04 g when the pharynx is dilated by 3-4 cm and if the condition of the fetus is satisfactory. The last dose of the drug is administered 30-60 minutes before delivery to avoid narcotic depression of the fetus and newborn.

Higher doses for adults: single - 0.04 g, daily - 0.16 g.

Side effect

constipation;
nausea, vomiting;
dry mouth;
anorexia;
spasm of the biliary tract;
paralytic ileus and toxic megacolon;
jaundice;
dizziness;
headache;
blurred visual perception;
tremor;
convulsions;
weakness;
drowsiness;
confusion;
euphoria;
nightmares or unusual dreams;
hallucinations;
depression;
paradoxical arousal;
anxiety;
tinnitus;
slowing down the speed of psychomotor reactions;
depression of the respiratory center;
decrease or increase in blood pressure;
arrhythmia;
decreased diuresis;
urinary retention;
bronchospasm;
laryngospasm;
angioedema;
skin rash;
skin itching;
swelling of the face;
hyperemia, swelling, “burning” at the injection site;
increased sweating;
addiction, drug dependence.

Contraindications

hypersensitivity;
conditions accompanied by respiratory depression;
simultaneous treatment with MAO inhibitors and for 3 weeks after their discontinuation;
children under 2 years of age.

Use during pregnancy and breastfeeding

Use with caution during pregnancy and lactation.

Use in elderly patients

Use with caution in old age.

Use in children

Contraindicated in children under 2 years of age. Use with caution in children over 2 years of age.

Special instructions

During the treatment period, it is necessary to refrain from driving vehicles and engaging in potentially hazardous activities that require increased concentration and speed of psychomotor reactions. Ethanol (alcohol) consumption is not allowed.

Dispensed by prescription. The dosage limit for the drug per prescription is 0.25 g.

Overdose

Symptoms: miosis, depression of consciousness (up to coma), increased severity of side effects.

Treatment: maintaining adequate pulmonary ventilation, symptomatic therapy. Intravenous administration of the specific opioid antagonist naloxone in a dose of 0.4-2 mg quickly restores breathing. If there is no effect, the administration of naloxone is repeated after 2-3 minutes. The starting dose of naloxone for children is 0.01 mg/kg.

Drug interactions

Strengthens the depression of the central nervous system and respiration caused by taking other narcotic analgesics, sedatives, hypnotics, antipsychotics (neuroleptics), anxiolytics, drugs for general anesthesia, ethanol (alcohol), muscle relaxants. Against the background of systematic use of barbiturates, especially phenobarbital, a decrease in the analgesic effect is possible.

Strengthens the hypotensive effect of drugs that lower blood pressure (including ganglion blockers, diuretics).

Medicines with anticholinergic activity and antidiarrheal drugs (including loperamide) increase the risk of constipation (including intestinal obstruction) and urinary retention.

Strengthens the effect of anticoagulants (plasma prothrombin should be monitored).

Buprenorphine (including previous therapy) reduces the effectiveness of Promedol. When used simultaneously with MAO inhibitors, severe reactions may develop due to overexcitation or inhibition of the central nervous system with the occurrence of hyper- or hypotensive crises.

Naloxone restores breathing, eliminates analgesia and reduces the depression of the central nervous system caused by taking Promedol. May accelerate the appearance of symptoms of “withdrawal syndrome” due to drug addiction.

Naltrexone accelerates the appearance of symptoms of “withdrawal syndrome” against the background of drug addiction (symptoms can appear as early as 5 minutes after administration of the drug, last for 48 hours, and are characterized by persistence and difficulty in eliminating them); reduces the effects of Promedol; does not affect symptoms caused by histamine reaction.

Reduces the effect of metoclopramide.

Analogues of the drug Promedol

The drug Promedol has no structural analogues for the active substance.

Analogs by pharmacological group (opioid narcotic analgesics):

Bupranal;
Buprenorphine hydrochloride;
DHA Continus;
Dipidolor;
Dolforin;
Durogesic;
Durogesic Matrix;
Codeine phosphate hemihydrate;
Codeine phosphate hemihydrate;
Lunaldin;
M Eslon;
Morphine;
MST Continus;
Nopan;
Nurofen Plus;
Omnopon;
Prosidol;
Sedalgin Neo;
Skenan;
Thebaine;
Transtek;
Ultiva;
Fendivia;
Fentadol;
Fentanyl.

If there are no analogues of the drug for the active substance, you can follow the links below to the diseases for which the corresponding drug helps, and look at the available analogues for the therapeutic effect.

Active ingredient

Trimeperidine

Release form, composition and packaging

1 ml - ampoules (5) - contour plastic packaging (1) - cardboard packs.
1 ml - ampoules (5) - contour plastic packaging (2) / with knife amp. or scarif. as required/ - cardboard packs.
1 ml - ampoules (5) (for hospitals) - contour plastic packaging (20) / with knife amp. or scarif. as required/ - cardboard boxes.
1 ml - ampoules (5) (for hospitals) - contour plastic packaging (30) / with knife amp. or scarif. as required/ - cardboard boxes.
1 ml - ampoules (5) (for hospitals) - contour plastic packaging (40) / with knife amp. or scarif. as required/ - cardboard boxes.
1 ml - ampoules (5) (for hospitals) - contour plastic packaging (50) / with knife amp. or scarif. as required/ - cardboard boxes.
1 ml - ampoules (5) (for hospitals) - contour plastic packaging (100) / with knife amp. or scarif. as required/ - cardboard boxes.

Pharmacological action

Refers to agonists of opioid receptors (mainly mu receptors). Activates the endogenous antinociceptive system and thus disrupts the interneuronal transmission of pain impulses at various levels of the central nervous system, and also changes the emotional coloring of pain, affecting the higher parts of the brain. In terms of pharmacological properties, trimeperidine is close to: it increases the threshold of pain sensitivity to painful stimuli of various modalities, inhibits conditioned reflexes, and has a moderate hypnotic effect. Unlike morphine, it depresses the respiratory center to a lesser extent and is less likely to cause nausea and vomiting. It has a moderate antispasmodic and uterotonic effect. Promotes opening of the cervix during childbirth, increases the tone and contractile activity of the myometrium.

When administered parenterally, the analgesic effect develops after 10-20 minutes, reaches a maximum after 40 minutes and lasts 2-4 hours.

Pharmacokinetics

Connection with proteins - 40%. Metabolized by hydrolysis to form meperidic and normeperidic acids, followed by conjugation. Small amounts are excreted unchanged by the kidneys

Indications

Pain syndrome of moderate and severe intensity (unstable angina, myocardial infarction, dissecting aortic aneurysm, renal artery thrombosis, thromboembolism of the arteries of the extremities or pulmonary artery, acute pericarditis, air embolism, pulmonary infarction, acute pleurisy, spontaneous pneumothorax, gastric ulcer and duodenal ulcer intestines, esophageal perforation, chronic pancreatitis, paranephritis, acute dysuria, paraphimosis, priapism, acute prostatitis, acute attack of glaucoma, causalgia, acute neuritis, lumbosacral radiculitis, acute vesiculitis, thalamic syndrome, burns, cancer, trauma, intervertebral disc protrusion ; foreign bodies of the bladder, rectum, urethra).

In combination with atropine-like and antispasmodics for pain caused by spasm of smooth muscles of internal organs (hepatic, renal, intestinal colic).

Acute left ventricular failure, pulmonary edema, cardiogenic shock.

Preoperative, operational and postoperative periods.

Childbirth (pain relief and stimulation).

Neuroleptanalgesia (in combination with antipsychotics).

Contraindications

Hypersensitivity; conditions accompanied by respiratory depression; simultaneous treatment with MAO inhibitors and for 3 weeks after their discontinuation; children under 2 years of age.

With caution: respiratory failure, hepatic and/or renal failure, adrenal insufficiency, chronic insufficiency, central nervous system depression, traumatic brain injury, intracranial hypertension, myxedema, hypothyroidism, prostatic hyperplasia, urethral stricture, gastrointestinal or urinary surgery system, bronchial asthma, chronic obstructive pulmonary disease, convulsions, arrhythmia, arterial hypotension, suicidality, emotional lability, alcoholism, drug addiction (including history), severe inflammatory bowel diseases, debilitated patients, cachexia, pregnancy, period lactation, childhood, old age.

Dosage

SC, IM or IV (only SC and IM for the drug in syringe tubes).

For adults: from 0.01 g to 0.04 g (from 1 ml of 1% solution to 2 ml of 2% solution). During anesthesia, the drug is administered intravenously in fractional doses of 0.003–0.01 g.

Children from two years old: 0.003-0.01 g depending on age.

For premedication before anesthesia, 0.02-0.03 g is administered subcutaneously or intramuscularly along with (0.0005 g) 30-45 minutes before surgery.

Pain relief for childbirth: subcutaneously or intramuscularly in a dose of 0.02-0.04 g when the pharynx is dilated by 3-4 cm and when the condition of the fetus is satisfactory. The last dose of the drug is administered 30-60 minutes before delivery to avoid narcotic depression of the fetus and newborn.

Higher doses for adults: one-time – 0.04 g, daily – 0.16 g.

Side effects

From the gastrointestinal tract: constipation, nausea, vomiting, dry mouth, anorexia, spasm of the biliary tract; for inflammatory bowel diseases - paralytic intestinal obstruction and toxic megacolon; jaundice.

From the nervous system and sensory organs: dizziness, headache, blurred vision, diplopia, tremors, involuntary muscle contractions, convulsions, weakness, drowsiness, confusion, disorientation, euphoria, nightmares or unusual dreams, hallucinations, depression, paradoxical arousal, anxiety, muscle stiffness (especially respiratory) , ringing in the ears, slowing down the speed of psychomotor reactions.

From the respiratory system: depression of the respiratory center.

From the cardiovascular system: decrease or increase in blood pressure, arrhythmia.

From the urinary system: decreased diuresis, urinary retention.

Allergic reactions: bronchospasm, laryngospasm, angioedema, skin rash, itching, facial swelling.

Local reactions: hyperemia, swelling, “burning” at the injection site.

Others: increased sweating, addiction, drug dependence.

Overdose

Symptoms: miosis, depression of consciousness (up to coma), increased severity of side effects.

Treatment: maintaining adequate pulmonary ventilation, symptomatic therapy. IV administration of a specific opioid antagonist at a dose of 0.4-2 mg quickly restores breathing. If there is no effect, the administration of naloxone is repeated after 2-3 minutes. The starting dose of naloxone for children is 0.01 mg/kg.

Drug interactions

Strengthens the depression of the central nervous system and respiration caused by taking other narcotic analgesics, sedatives, hypnotics, antipsychotics (neuroleptics), anxiolytics, drugs for general anesthesia, ethanol, muscle relaxants. Against the background of systematic use of barbiturates, especially phenobarbital, a decrease in the analgesic effect is possible.

Strengthens the hypotensive effect of drugs that lower blood pressure (including ganglion blockers, diuretics).

Medicines with anticholinergic activity and antidiarrheal drugs (including loperamide) increase the risk of constipation (including intestinal obstruction) and urinary retention.

Strengthens the effect of anticoagulants (plasma prothrombin should be monitored).

Promedol is a drug with an analgesic effect, a so-called opioid receptor agonist.

What is the composition and release form of Promedol?

The drug Promedol is produced in a 1% injection solution, where the active compound is represented by trimeperidine in an amount of 10 mg. The pharmaceutical product is sold in 1 milliliter ampoules, which are packaged in plastic boxes.

In addition, the opioid analgesic Promedol is available in a 2% solution, where the active compound is also trimeperidine in a dosage of 20 milligrams. The drug is sold by prescription. It should be stored in a dark place. The shelf life of ampoules is five years, after which the medicine becomes unusable.

What is the effect of Promedol?

Promedol activates the endogenous so-called antinociceptive system, thereby disrupting the transmission of pain impulses between neurons at different levels of the central nervous system, in addition, the drug changes the emotional coloring of the pain sensation, acting on the higher parts of the brain.

In terms of its properties, trimeperidine is close to morphine; it significantly increases the threshold of pain sensitivity, inhibits conditioned reflexes in humans, in addition, has a hypnotic effect, rarely provokes nausea and vomiting, and also during childbirth promotes dilatation of the cervix and increases the tone of the myometrium.

With parenteral administration of Promedol, the analgesic effect occurs after 10 minutes, reaching its maximum after forty minutes, the duration of the effect is 4 hours. Connection with proteins - 40%. The drug is metabolized by hydrolysis followed by conjugation. Excreted by the kidneys.

What are Promedol's indications for use?

Promedol solution instructions for use allow it to be used for medicinal purposes for pain in various conditions, some of which I will list: unstable angina, acute pericarditis, myocardial infarction, symptoms of aortic aneurysm, arterial thromboembolism, air embolism, radiculitis, acute pleurisy, esophageal perforation, spontaneous pneumothorax, chronic pancreatitis, peptic ulcer, paranephritis, dysuria, paraphimosis, burns, priapism, prostatitis, various colics, an attack of glaucoma, acute neuritis, thalamic syndrome, oncological diseases, in addition, injuries and other diseases.

In addition, Promedol is prescribed for pain relief during labor, the medication is used in the preoperative and postoperative periods, as well as for neuroleptanalgesia in conjunction with the use of antipsychotics.

What are Promedol's contraindications for use?

The instructions for use of the drug Promedol (solution) do not allow use for medicinal purposes in the following cases:

Hypersensitivity to the components of the drug;
If respiratory function is depressed, do not use the solution;
Until the age of two.

Promedol is used with caution in the following situations: hepatic, adrenal, renal and heart failure, convulsions, traumatic brain injury, alcoholism, myxedema, hypothyroidism, cachexia, bronchial asthma, symptoms of central nervous system depression, pregnancy, obstructive pulmonary disease, arrhythmia, myxedema, arterial hypotension, drug addiction, suicidality, intracranial hypertension, emotional lability, also in weakened patients, lactation period, old age.

What are Promedol's uses and dosage?

Promedol solution is used parenterally: subcutaneously, intravenously, intramuscularly. Typically, adults are prescribed from 0.01 g to 0.04 g. For premedication, before anesthesia, 0.02-0.03 grams of the drug is administered subcutaneously together with atropine.

Pain relief for labor involves prescribing from 0.02 to 0.04 grams of the drug when the throat is dilated by three centimeters and the condition of the fetus is satisfactory. The highest daily dose for adults is 0.16 grams.

Promedol - drug overdose

Symptoms of an overdose of Promedol: miosis, depression of consciousness occurs up to the development of coma. The patient is prescribed symptomatic treatment.

What are the side effects of Promedol?

The administration of the pharmaceutical drug Promedol causes the following side effects: constipation, depression of respiratory function, nausea, vomiting are characteristic, changes in blood pressure are observed, increased dry mouth, possible arrhythmia, anorexia, decreased diuresis, laryngospasm, in addition, spasm of the biliary tract, itching, not excluded urinary retention, paralytic intestinal obstruction, as well as bronchospasm, jaundice.

Other adverse reactions include: angioedema, characterized by increased sweating, possible dizziness, drug dependence develops, in addition, headache, convulsions, decreased visual acuity, weakness, diplopia, tremor, drowsiness, there may be involuntary muscle contractions, confusion, symptoms of disorientation, depression, as well as euphoria.

Other side effects: anxiety, nightmares are typical, tinnitus in the head is noted, hallucinations are observed, paradoxical arousal is noted, as well as muscle rigidity, and psychomotor reactions may slow down. In addition, local reactions in the form of skin hyperemia, swelling, and possibly a burning sensation.

Special instructions

During the period of treatment with Promedol, the patient must stop drinking alcohol and refrain from driving.

How to replace Promedol, what analogues should I use?

Trimeperidine (instructions for use of the drug must be read personally from the official leaflet included in the package before use!).

Conclusion

Promedol should be used strictly according to indications.

Instructions for medical use of the drug

Description of pharmacological action

Promedol is an opioid receptor agonist (mainly mu receptor). Activates the endogenous antinociceptive system and thus disrupts the interneuronal transmission of pain impulses at various levels of the central nervous system, and also changes the emotional coloring of pain, affecting the higher parts of the brain. In terms of pharmacological properties, trimeperidine is close to morphine: it increases the threshold of pain sensitivity to painful stimuli of various modalities, inhibits conditioned reflexes, and has a moderate hypnotic effect. Unlike morphine, it depresses the respiratory center to a lesser extent and is less likely to cause nausea and vomiting. It has a moderate antispasmodic and uterotonic effect. Promotes opening of the cervix during childbirth, increases the tone and contractile activity of the myometrium.

When administered parenterally, the analgesic effect develops after 10-20 minutes, reaches a maximum after 40 minutes and lasts 2-4 hours.

Indications for use

Severe pain syndrome (injuries, malignant neoplasms, postoperative period, etc.), preparation for surgery, childbirth (pain relief).

Release form

solution for injection 10 mg/ml; ampoule 1 ml contour cell packaging 5 cardboard pack 1;

Solution for injection 20 mg/ml; ampoule 1 ml contour cell packaging 5 cardboard pack 1;

Solution for injection 20 mg/ml; syringe tube 1 ml for hospitals cardboard box (box) 100;

Solution for injection 10 mg/ml; 1 ml ampoule with ampoule knife contour cell packaging 5 cardboard pack 2;

Solution for injection 20 mg/ml; 1 ml ampoule with ampoule knife contour cell packaging 5 cardboard pack 2;

Solution for injection 10 mg/ml; 1 ml ampoule with ampoule knife contour cell packaging 5 cardboard pack 1;

Solution for injection 20 mg/ml; ampoule 1 ml with ampoule knife cardboard pack 5 cardboard pack 1;

Solution for injection 10 mg/ml; ampoule 1 ml contour cell packaging 5 cardboard pack 2;

Solution for injection 20 mg/ml; ampoule 1 ml contour cell packaging 5 cardboard pack 2;

Solution for injection 10 mg/ml; ampoule 1 ml contour cell packaging 5 cardboard box (box) 100;

Solution for injection 10 mg/ml; syringe tube 1 ml for hospitals cardboard box (box) 100;

Solution for injection 20 mg/ml; ampoule 1 ml contour cell packaging 5 cardboard box (box) 100;

Solution for injection 10 mg/ml; ampoule 1 ml with ampoule knife contour packaging 5 cardboard box (box) 100;

Solution for injection 10 mg/ml; ampoule 1 ml with ampoule knife contour packaging 5 cardboard box (box) 20;

Solution for injection 10 mg/ml; ampoule 1 ml with ampoule knife contour packaging 5 cardboard box 30;

Solution for injection 10 mg/ml; ampoule 1 ml with ampoule knife contour packaging 5 cardboard box 40;

Solution for injection 10 mg/ml; ampoule 1 ml with ampoule knife contour packaging 5 cardboard box (box) 50;

Solution for injection 20 mg/ml; ampoule 1 ml with ampoule knife pack of cardboard 5 pack of cardboard 100;

Pharmacodynamics

Stimulates opiate receptors, relaxes smooth muscles.

Pharmacokinetics

With intravenous administration, Cmax (9 mcg/ml) is reached after 15 minutes, then a rapid decrease in plasma levels is observed and after 2 hours only trace concentrations are determined. Compared to morphine, it has a weaker and shorter analgesic effect, has less effect on the respiratory, vomiting and vagal centers, does not cause spasm of smooth muscles (except for the myometrium), and has a moderate antispasmodic and hypnotic effect. With subcutaneous and intramuscular administration, the effect begins within 10–20 minutes and lasts 3–4 hours or more.

Use during pregnancy

Use with caution during pregnancy and lactation.

Contraindications for use

Hypersensitivity; conditions accompanied by respiratory depression; simultaneous treatment with MAO inhibitors and for 3 weeks after their discontinuation; children under 2 years of age.

With caution: respiratory failure, hepatic and/or renal failure, adrenal failure, chronic heart failure, depression of the central nervous system, traumatic brain injury, intracranial hypertension, myxedema, hypothyroidism, prostatic hyperplasia, urethral stricture, gastrointestinal surgery intestinal tract or urinary system, bronchial asthma, chronic obstructive pulmonary disease, convulsions, arrhythmia, arterial hypotension, suicidality, emotional lability, alcoholism, drug addiction (including a history), severe inflammatory bowel diseases, debilitated patients, cachexia , pregnancy, lactation period, childhood, old age.

Side effects

From the gastrointestinal tract: constipation, nausea, vomiting, dry mouth, anorexia, spasm of the biliary tract; for inflammatory bowel diseases - paralytic intestinal obstruction and toxic megacolon; jaundice.

From the nervous system and sensory organs: dizziness, headache, blurred vision, diplopia, tremor, involuntary muscle contractions, convulsions, weakness, drowsiness, confusion, disorientation, euphoria, nightmares or unusual dreams, hallucinations, depression, paradoxical arousal, anxiety, muscle rigidity (especially respiratory), ringing in the ears, slowing of the speed of psychomotor reactions.

From the respiratory system: depression of the respiratory center.

From the cardiovascular system: decrease or increase in blood pressure, arrhythmia.

From the urinary system: decreased diuresis, urinary retention.

Allergic reactions: bronchospasm, laryngospasm, angioedema, skin rash, itching, facial swelling.

Local reactions: hyperemia, swelling, “burning” at the injection site.

Other: increased sweating, addiction, drug dependence.

Directions for use and doses

SC or IM, 1 ml; maximum doses for adults: single - 0.04 g, daily - 0.16 g.

Adults: from 0.01 g to 0.04 g (from 1 ml of 1% solution to 2 ml of 2% solution). During anesthesia, the drug is administered intravenously in fractional doses of 0.003–0.01 g.

Children from two years old: 0.003-0.01 g depending on age.

For premedication before anesthesia, 0.02-0.03 g is administered subcutaneously or intramuscularly along with atropine (0.0005 g) 30-45 minutes before surgery.

Pain relief for labor: subcutaneously or intramuscularly in a dose of 0.02-0.04 g when the pharynx is dilated by 3-4 cm and the condition of the fetus is satisfactory. The last dose of the drug is administered 30-60 minutes before delivery to avoid narcotic depression of the fetus and newborn.

Higher doses for adults: single – 0.04 g, daily – 0.16 g.

Overdose

Symptoms: miosis, depression of consciousness (up to coma), increased severity of side effects.

Treatment: maintaining adequate pulmonary ventilation, symptomatic therapy. IV administration of the specific opioid antagonist naloxone at a dose of 0.4-2 mg quickly restores breathing. If there is no effect, the administration of naloxone is repeated after 2-3 minutes. The starting dose of naloxone for children is 0.01 mg/kg.

Interactions with other drugs

Strengthens the depression of the central nervous system and respiration caused by taking other narcotic analgesics, sedatives, hypnotics, antipsychotics (neuroleptics), anxiolytics, drugs for general anesthesia, ethanol, muscle relaxants. Against the background of systematic use of barbiturates, especially phenobarbital, a decrease in the analgesic effect is possible.

Strengthens the hypotensive effect of drugs that lower blood pressure (including ganglion blockers, diuretics).

Medicines with anticholinergic activity and antidiarrheal drugs (including loperamide) increase the risk of constipation (including intestinal obstruction) and urinary retention.

Strengthens the effect of anticoagulants (plasma prothrombin should be monitored).

Reduces the effect of metoclopramide.

Special instructions for use

Storage conditions

List A.: In a place protected from light, at a temperature not exceeding 15 °C.

Best before date

ATX classification:

** The Drug Directory is intended for informational purposes only. For more complete information, please refer to the manufacturer's instructions. Do not self-medicate; Before starting to use the drug Promedol, you should consult a doctor. EUROLAB is not responsible for the consequences caused by the use of information posted on the portal. Any information on the site does not replace medical advice and cannot serve as a guarantee of the positive effect of the drug.

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Promedol is a narcotic pain reliever (opioid analgesic) with moderate uterotonic, antispasmodic and hypnotic effects.

Release form and composition

Dosage forms of Promedol:

Injection solution (1 ml per ampoule, 5 ampoules in a plastic package, 1 package in a cardboard box; 1 ml per ampoule, 5 ampoules in a plastic package, 2 packages in a cardboard box with an ampoule knife or scarifier, as needed; for hospitals: 1 ml in an ampoule, 5 ampoules in a contoured plastic package, 20, 30, 40, 50 or 100 packages in a cardboard box with an ampoule knife or scarifier, as needed; 1 ml in a syringe tube, 20 in a cardboard box. or 100 syringe tubes);
Tablets (10 pcs. in a blister pack, 1 or 2 packs in a cardboard box).

The active ingredient is trimeperidine, the content depends on the form of release:

Solution: 10 or 20 mg in 1 ml (in 1 ampoule – 10 or 20 mg; in 1 syringe tube – 20 mg);
Tablets: 25 mg/piece.

Indications for use

Pain syndrome of moderate and severe intensity, accompanying the following diseases and conditions: myocardial infarction, dissecting aortic aneurysm, unstable angina, thromboembolism of the arteries of the extremities or pulmonary artery, renal artery thrombosis, pulmonary infarction, air embolism, acute pericarditis, spontaneous pneumothorax, acute pleurisy, chronic pancreatitis, esophageal perforation, gastric and duodenal ulcers, priapism, paraphimosis, acute dysuria, paranephritis, acute prostatitis, lumbosacral radiculitis, acute neuritis, causalgia, acute attack of glaucoma, thalamic syndrome, acute vesiculitis, cancer, trauma , burns, intervertebral disc protrusion; the presence of foreign bodies in the urethra, rectum, bladder;
Pain caused by spasm of the smooth muscles of internal organs: renal, hepatic, intestinal colic (in combination with antispasmodic and atropine-like drugs);
Cardiogenic shock, pulmonary edema, acute left ventricular failure;
Childbirth (stimulation of labor and pain relief for women in labor);
Neuroleptanalgesia (in combination with antipsychotics).

Promedol is also used in preparation for surgery, to relieve postoperative pain, and, if necessary, as an analgesic component of general anesthesia.

Contraindications

Absolute for all forms of release:

Conditions accompanied by depression of the respiratory center;
Age up to 2 years (for solution);
Concomitant therapy with monoamine oxidase inhibitors and a period of 21 days after their discontinuation;
Hypersensitivity to the drug.

Additionally for tablets:

Infections (due to the risk of infection entering the central nervous system);
Blood coagulation disorders during spinal and epidural anesthesia (including against the background of anticoagulant therapy);
Diarrhea occurring with pseudomembranous colitis caused by taking penicillins, lincosamides, cephalosporins;
Toxic dyspepsia (due to exacerbation and prolongation of diarrhea associated with delayed elimination of toxins).

Relative (must be used with extreme caution due to the increased risk of complications): central nervous system depression, chronic heart failure, adrenal insufficiency, hepatic and/or renal failure, respiratory failure, hypothyroidism, myxedema, intracranial hypertension, traumatic brain injury, surgical interventions on the gastrointestinal tract or urinary tract, urethral stricture, prostatic hyperplasia, arterial hypotension, arrhythmia, seizures, chronic obstructive pulmonary disease, bronchial asthma, drug addiction (including history), emotional lability, suicidality, alcoholism , severe inflammatory bowel lesions, abdominal pain of unknown origin (for tablets), cachexia, seriously ill or weakened patients, childhood, old age, breastfeeding, pregnancy.

Directions for use and dosage

The solution is administered intramuscularly, subcutaneously and, in emergency cases, intravenously.

Recommended doses for adults for intramuscular and subcutaneous injections are 10-40 mg (from 1 ml of 1% solution to 2 ml of 2% solution). When performing general anesthesia, the drug is administered in divided intravenous doses of 3-10 mg.

For children over 2 years old, Promedol is prescribed 0.1-0.5 mg/kg (depending on age) taken orally, or administered intramuscularly, subcutaneously or, if necessary, intravenously. To relieve pain, repeated administration of the drug is allowed 4-6 hours after the first dose. For children from birth to 2 years of age, the drug is administered parenterally at a dose of 0.05-0.25 mg/kg.

For pain caused by spasm of smooth muscles (renal, hepatic, intestinal colic), the drug is combined with antispasmodics and atropine-like drugs with careful monitoring of the patient's condition.

Before administering anesthesia for the purpose of premedication, intramuscular or subcutaneous injections of trimeperidine solution are made 30-40 minutes before surgery at a dose of 20-30 mg together with atropine (0.5 mg).

For pain relief during labor, with a positive assessment of the condition of the fetus and dilation of the uterine pharynx by 3-4 cm, Promedol is administered subcutaneously or intramuscularly in doses of 20-40 mg. Trimeperidine helps to accelerate the dilatation of the cervix, having an antispasmodic effect on it. The last injection of the drug must be carried out no later than 30-60 minutes before delivery in order to avoid negative effects on the respiratory center of the fetus and newborn.

For parenteral administration, the maximum single dose for adults is 40 mg, the maximum daily dose is 160 mg.

As a component of general anesthesia, Promedol is administered intravenously at 0.5-2.0 mg/kg/hour, while the total dose should not exceed 2 mg/kg/hour.

With continuous intravenous infusion, the dose of the drug can vary from 0.01 to 0.05 mg/kg/hour.

It is recommended to administer the drug epidurally at 0.1-0.15 mg/kg, previously diluted in 2-4 ml of 0.9% sodium chloride solution. The analgesic effect of the drug develops 15-20 minutes after administration, and reaches a maximum after 40 minutes; the duration of pain relief can be 8 hours or more.

Side effects

Respiratory system: depression of the respiratory center;
Nervous system and sensory organs: headache, weakness, dizziness, diplopia, blurred vision, tremors, convulsions, involuntary muscle contractions, drowsiness, disorientation, confusion, euphoria, hallucinations, unusual or nightmares, depression, anxiety, nervousness, paradoxical agitation, ringing in the ears, muscle rigidity (mainly respiratory), slowing of the speed of psychomotor reactions;
Digestive system: constipation, dry mouth, vomiting, nausea, spasm of the biliary tract, anorexia; for inflammatory bowel diseases - toxic megacolon and paralytic intestinal obstruction; for solution – jaundice, for tablets – hepatotoxicity (icterus of the skin and sclera, pale stool, dark urine);
Cardiovascular system: arrhythmias, increased or decreased blood pressure;
Urinary system: urinary retention, decreased diuresis, for tablets - spasm of the ureters (frequent urge to urinate, difficulty and pain when urinating);
Local reactions: swelling, hyperemia, burning sensation at the injection site;
Allergic reactions: laryngospasm, bronchospasm, angioedema, skin itching, facial swelling, skin rash;
Other: addiction, increased sweating, drug dependence.

A sign of an overdose of Promedol is an increase in the severity of adverse reactions, miosis (in severe hypoxia, pupil dilation may be observed), respiratory depression, stuporous or comatose state (in severe cases).

In this condition, measures necessary to maintain systemic hemodynamics and sufficient pulmonary ventilation are carried out. The specific opioid antagonist naloxone is administered intravenously at a dose of 0.4-2 mg (in order to quickly restore breathing); if the desired effect is absent, the injection is repeated after 2-3 minutes. Intravenous or intramuscular administration of nalorphine every 15 minutes at a dose of 5-10 mg is also acceptable, with a total dose of no more than 40 mg.

For children, naloxone is administered at an initial dose of 0.01 mg/kg.

Special instructions

During therapy with Promedol, it is necessary to refrain from driving vehicles and performing potentially dangerous types of work that require concentration and speed of reactions.

Treatment with the drug must not be combined with the use of ethanol.

Drug interactions

Possible interaction reactions when combining Promedol with other drugs:

Muscle relaxants, ethanol, general anesthesia, anxiolytics, antipsychotics (neuroleptics), hypnotics and sedatives, other narcotic analgesics - aggravated respiratory and central nervous system depression;
Barbiturates (especially phenobarbital) – the analgesic effect decreases;
Drugs that lower blood pressure (including ganglion blockers, diuretics) - their hypotensive effect increases;
Antidiarrheals (including loperamide) and drugs with anticholinergic activity - the threat of urinary retention and constipation (up to the development of intestinal obstruction) is aggravated;
Anticoagulants – their effectiveness increases (it is necessary to control plasma prothrombin);
Buprenorphine (including previous treatment) - the effect of trimeperidine is reduced;
Naloxone – helps restore breathing, reduce depression of the central nervous system, eliminate analgesia, accelerate the development of “withdrawal syndrome” in drug addiction;
Monoamine oxidase inhibitors - severe reactions may occur due to overexcitation or inhibition of the central nervous system with the development of hypotensive or hypertensive crises;
Naltrexone – against the background of drug addiction, there is an acceleration in the appearance of symptoms of “withdrawal syndrome” (difficult to eliminate and persistent symptoms can appear within 5 minutes after using the drug and last for 48 hours); the effectiveness of trimeperidine decreases; symptoms associated with the histamine reaction do not change;
Metoclopramide – its effect decreases.