What is pethidine?

Pethidine is a strong opioid pain relief medicine. It was once widely used in Australia for pain caused by a range of different conditions, but it is now less frequently used because safer opioid medicines are available.

How does pethidine work?

Pethidine works to reduce feelings of pain by interrupting the way nerves signal pain between the brain and the body. It works directly on the central nervous system.

What is pethidine used for?

Pethidine is no longer commonly prescribed, and its use is discouraged. This is because it is more likely to cause side effects than other opioids.

Sometimes, pethidine is still used to help relieve labour pain during childbirth. In recent years, pethidine has been offered less often for labour pain, as other opioid medicines have been shown to give longer-lasting pain relief with fewer side effects.

What are the possible side effects of taking pethidine?

All medicines, including pethidine, can have side effects.

As with all opioid medicines, pethidine can cause life-threatening breathing difficulties. The likelihood of these is higher:

• when you first take pethidine
• after a dosage increase
• if you are older
• if you have an existing lung problem

The side effects of pethidine increase with repeated doses, and so the medicine is not often used to treat ongoing pain.

Repeated dosing, especially in people with poor kidney function, can also lead to nerve conditions such as tremors, muscle twitching and seizures.

Other side effects are similar to other opioids, and include:

• constipation
• headache or dizziness
• fatigue or drowsiness (especially soon after taking a dose)
• loss of appetite, nausea and vomiting

If you experience any of these side effects or other unwanted effects after taking pethidine, see your doctor. If your doctor is not available and you need urgent help, visit your nearest emergency department.

What are the risks associated with pethidine?

Pethidine is an opioid medicine and can cause life-threatening breathing problems.

Pethidine may make it difficult for you to drive or operate heavy machinery. If you have recently started taking an opioid medicine, or changed the dosage, you are more likely to have an accident. Ask your doctor whether it is legal for you to drive while taking pethidine. Also contact your car insurer, as you may not be covered for accidents that occur while you are taking pethidine.

If you have kidney or liver problems, your doctor may need to suggest a different medicine or adjust your dosage of pethidine.

There are other factors that may limit your use of pethidine — for example, if you:

• are an older adult
• drink alcohol
• take antidepressants
• take other medicines that can cause drowsiness, such as benzodiazepines

Your doctor is the best person to advise you on whether pethidine is the right medicine for you, how much you need and how long to take it for.

Opioid tolerance and dependence

If you use opioid medicines, you may develop tolerance. This means that you may need to take larger amounts of the opioid to get the same effect. The chance of side effects also increases with a higher dose.

It's also possible to become dependent on pethidine, even if you take it exactly as prescribed and only for a short time. Your doctor will monitor how you use pethidine to reduce your chance of harm, including through misuse, abuse and addiction.

If you are concerned that you are becoming addicted to or dependent on pethidine, let your doctor know so that you can get help. You can also call the National Alcohol and Other Drug Hotline (1800 250 015) for 24/7 support and treatment information.

If you take pethidine regularly and stop taking pethidine suddenly, you may experience withdrawal symptoms.

Opioid overdose

If you take too much pethidine (known as an overdose), it's important to get immediate medical attention. Overdose of opioid medicines can cause you to stop breathing.

Symptoms of overdose include:

• feeling sleepy
• difficulty breathing
• loss of consciousness
• pinpoint (very small) pupils

Access to overdose-reversing medication

Naloxone is a medicine that can temporarily reverse the effects of an opioid overdose. The Australian Government is offering this medication free of charge and without a prescription to people who may experience, or witness, an opioid overdose.

Learn more about the Take Home Naloxone program.

How do I take pethidine?

Pethidine is generally given in a healthcare setting by a registered professional. You are unlikely to receive more than one dose of pethidine, due to the increased chance of side effects with repeat dosing.

How do I dispose of medicines safely?

It's important you dispose of unwanted opioid medicines safely. Unused medicines can be returned to any pharmacy. Don't keep unused pethidine 'just in case', as this can lead to dangerous or inappropriate use.

Keep pethidine out of reach of children and pets. Never throw medicines into a garbage bin or flush them down the toilet, as this is dangerous to others and harmful to the environment.

Are there any alternatives to pethidine?

Everyone's pain is unique and different pain relief medicines will work in different circumstances. Some people's pain will respond well to non-opioid medicines, which are generally associated with fewer problems and side effects.

Pethidine is not usually recommended to treat pain, because there are other safer opioids available.

Your doctor is the best person to guide you on whether an opioid is the right medicine for you, how much you need and how long to take it for.

If you have chronic (long-term) pain, your doctor might suggest lifestyle changes to help manage the effects of pain. This is useful irrespective of opioid use and may include:

• improving your physical fitness
• activity pacing
• social activities
• relaxation techniques
• overall health management

Find out more about options for managing chronic pain.

When should I see my doctor?

If you have been given pethidine, but your pain is not well controlled, or you have any unexpected side effects, speak with your doctor.

Resources and support

Asking about your treatment or medicine is important to help you understand your options. Here's a guide to questions you should ask your pharmacist or doctor before taking any medicine.

You can also see the list of medicines that contain pethidine to read the Consumer Medicine Information (CMI) leaflet for the brand prescribed.

You can also:

• Call 1300 MEDICINE (1300 633 424) to talk about the medicines you are taking for your pain.
• Discuss your pain on the Pain Link helpline (1300 340 357) which is staffed by volunteers with personal experience of chronic pain.
• Go to Painaustralia to find pain services and programs in your area.
• Learn more about prescription opioids on the Choosing Wisely

Other languages

The Alcohol and Drug Foundation has translated their guide to using medicines safely into many community languages.

Information for Aboriginal and/or Torres Strait Islander peoples

Learn more about pain management on Pain Management Network.