Beta-meprodine Stats & Data
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DrugBankDescription
Betameprodine is an opioid analgesic classified by the United States Drug Enforcement Administration under Schedule I of illegal substances. The stereoisomer alphameprodine is similarly classified, and was more widely used (both are referred to as Meprodine). Betameprodine is a structural analogue of meperidine. It exerts physiological effects characteristic of opioids, such as analgesia, euphoria and sedation, as well as itching, nausea, and respiratory depression.
Effect Profile
CuratedStrong euphoria with moderate itching/nausea, mild pain relief, low sedation
Tolerance & Pharmacokinetics
drugs.wikiNo tolerance chart. Our decay curves for opioids were estimates, and a curve can make tolerance look longer-lasting than it is, which is the dangerous direction.
Opioid tolerance drops fast when you stop, and even a few days off can be enough, so a dose that used to be normal can now stop your breathing. Overdose deaths rise sharply after prison, detox or leaving treatment, and tolerance also falls during a hospital stay. After any break, start with a much smaller amount, try a test dose first, don't use alone, and keep naloxone within reach. Alcohol, benzodiazepines, gabapentinoids and other sedatives make an opioid overdose much more likely.
Sources: FRANK: heroin · National Harm Reduction Coalition · WHO: opioid overdose · Merrall et al. 2010 · Binswanger et al. 2007 · Strang et al. 2003 · FDA 2019: gabapentinoids and breathing
Cross-Tolerances
Harm Reduction
drugs.wikiRationale addition 1 (MAOI/serotonergic risk): Meperidine (pethidine) and its congeners are specifically contraindicated with MAOIs due to severe and sometimes fatal reactions (e.g., hyperpyrexia, delirium, coma), and serotonergic combinations raise serotonin syndrome risk; this is extended by evidence that meperidine-class molecules can interact with SERT. Therefore, avoid betameprodine with MAOIs and serotonergic agents (SSRIs/SNRIs/TCAs, dextromethorphan). Sources: NCBI StatPearls entries for MAOIs, tranylcypromine, phenelzine; DrugBank data on meperidine derivatives binding SERT. Rationale addition 2 (seizure risk/renal impairment): Meperidine’s metabolite normeperidine accumulates and is pro-convulsant, especially in renal dysfunction; phenylpiperidine congeners share similar metabolic liabilities. Caution in renal/hepatic impairment; watch for tremor, agitation, myoclonus, or seizures. Source: StatPearls and LiverTox meperidine monographs. Rationale addition 3 (polysubstance overdose): Co-use of opioids with alcohol, benzodiazepines, GHB, ketamine, and other depressants markedly increases the risk of respiratory failure and aspiration; population data and harm-reduction resources highlight high co-implication of benzos and gabapentinoids in opioid deaths. Avoid combining; if used, halve doses and do not redose. Sources: Hi-Ground opioid guidance; DrugWise mortality summaries; systematic evidence linking gabapentinoids to increased overdose risk when combined with opioids. Rationale addition 4 (naloxone & observation): In suspected opioid toxicity, administer naloxone (IN/IM) and monitor breathing/consciousness; WHO/NCBI guidance supports at least 2 hours observation after reversal for short-acting opioids, longer if long-acting exposure is possible. Rebound respiratory depression can occur after naloxone wears off. Sources: WHO Community Management of Opioid Overdose; NCBI naloxone reviews. Rationale addition 5 (stimulant co-use): Stimulants can mask opioid sedation, increasing ‘speedball’ risk; when stimulant effects wane, unrecognized opioid burden can cause delayed overdose. Avoid this combination. Source: Hi-Ground heroin guidance. Rationale addition 6 (antihistamines and DXM): First-generation antihistamines and dextromethorphan add CNS/respiratory depression and serotonergic burden. Avoid concomitant use. Sources: Hi-Ground (antihistamines cautions), TripSit combinations (opioids + DXM dangerous). Rationale addition 7 (pregnancy/lactation): By class, opioids can cause neonatal respiratory depression and withdrawal; meperidine during breastfeeding has sedated infants. Avoid betameprodine in pregnancy/breastfeeding; if exposure occurs, monitor neonate. Source: LactMed meperidine. Rationale addition 8 (ROA hygiene): Rapid-acting IV/IM phenylpiperidines require conservative titration and sterile technique to reduce infection and overdose risk; harm-reduction services advise safer injecting practices and carrying naloxone. Source: Hi-Ground HR pages. Rationale addition 9 (uncertain human potency): Modern, peer-reviewed human potency data for betameprodine are sparse; historical reports vary across stereoisomers. Treat all dose ranges as provisional and start low. Source: DrugBank indicating experimental/illicit status and lack of approvals/trials.
References
Cited references
- Betameprodine – PubChem Compound (CID 12218309)
- Betameprodine – DrugBank (DB01552)
- Meperidine – StatPearls (NCBI Bookshelf)
- Meperidine – LiverTox (NCBI Bookshelf)
- MAOI overview – StatPearls (contraindications incl. meperidine)
- Phenelzine – StatPearls (meperidine contraindicated)
- Tranylcypromine – StatPearls (contraindications)
- Meperidine & SERT-binding derivatives – DrugBank article summary
- WHO Community Management of Opioid Overdose – NCBI Bookshelf
- Naloxone comparative routes – NCBI (AHRQ/WHO pages)
- Naloxone – StatPearls (NCBI Bookshelf)
- LactMed – Meperidine (NCBI Bookshelf)
- Hi-Ground – Opioids (HR guidance, combinations)
- Hi-Ground – Heroin (stimulant mixing risk)
- Hi-Ground – Nitazenes (safer injecting pointers/antihistamines caution)
- TripSit – Drug combinations (opioids & DXM dangerous)
- DrugWise – Deaths (co-implication of benzos/gabapentinoids)
- Opioid Treatments for Chronic Pain – NCBI (gabapentinoids + opioids risk)