Meptazinol

How it works

It acts as a partial agonist at opioid receptors, with relative selectivity for a subtype, and also has central cholinergic activity, producing analgesia with a lower reported propensity for respiratory depression than full opioid agonists.

Prescribing in practice

• As an opioid it can still cause respiratory depression, sedation, and dependence, and its partial-agonist action may precipitate withdrawal in patients dependent on full opioid agonists.
• Nausea and vomiting are common adverse effects; an antiemetic may be required, particularly in obstetric use.
• Use with caution in respiratory impairment, head injury, and hepatic or renal impairment; consult the SPC.

Monitoring

Monitor pain relief, level of sedation, respiratory rate, and for nausea, especially when combined with other central nervous system depressants.

Counselling the patient

• This is a strong painkiller that may cause drowsiness, nausea, or dizziness.
• Avoid alcohol and tell staff if you feel very sleepy or short of breath.
• It is intended for short-term pain relief only.

Evidence & guidelines

Meptazinol is a long-established opioid analgesic for moderate pain, with its use and cautions described in standard UK prescribing references.