Drug accumulation or prolonged duration of action can occur in patients with renal impairment or hepatic disease. Convulsions can be precipitated during use of meperidine in patients with a preexisting seizure disorder or in patients with renal failure. Patients with renal disease may be more prone to urinary retention and oliguria during therapy with meperidine. Meperidine should be prescribed cautiously to patients undergoing biliary tract surgery, although meperidine reportedly causes less biliary tract spasm than does morphine. Meperidine readily crosses the placenta and normally should not be given during pregnancy.
Premature infants are especially sensitive to respiratory depression.
Narcotic analgesics generally are not recommended for use in children. Any patient receiving an opiate analgesic should be warned about the possibility of sedation and the need to use caution when performing any hazardous tasks. The effects of meperidine on respiration, CNS, and blood pressure can be potentiated. A dose reduction of one or both drugs may be warranted. An exaggerated hypotensive response may be seen if antihypertensive agents are administered to patients receiving opiate analgesics.