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 its use is decreasing because safer opioid medicines are now available.

What is pethidine used for?

Pethidine is no longer commonly prescribed, and its use is discouraged. This is because it has a higher risk of side effects than other opioids.

Sometimes, pethidine is still used to help relieve labour pain during childbirth. In recent years, pethidine has been used less often in labour wards, as morphine has been shown to give longer-lasting pain relief with fewer side effects.

How does pethidine work?

Pethidine works to reduce feelings of pain by interrupting the way nerves signal pain between the brain and the body.

What are the possible side effects of taking pethidine?

All medicines, including pethidine, can have side effects.

Like all opioid medicines, pethidine can cause life-threatening breathing difficulties. The risk 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 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 pharmacy.

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 dosage, you may be at higher risk of having an accident.

If you have kidney problems or your kidney function is impaired, your doctor will need to adjust your dosage of pethidine.

There are other factors that may limit your use of pethidine — for example, if you drink alcohol or take other medicines that can cause drowsiness.

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 dependence

Like all opioid medicines, if you take pethidine there is a risk you may become dependent on this medicine, even if you take it for a short time only. Your doctor will monitor how you use pethidine to reduce your risk of harm, including through misuse, abuse and addiction.

You can also develop tolerance when you take pethidine. This means you may need to take larger amounts of the opioid to get the same effect. As the dosage increases, so does the risk of side effects.

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

This is why doctors don’t usually prescribe pethidine for chronic (long term) pain.

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 risks 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 medicine 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 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 prescribed pethidine, but your pain is not well controlled, or you have any unexpected side effects, speak with your doctor.

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.

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 website.