Pharmaniaga Pethidine HCl Caution For Usage

Incompatibilities: Solutions of pethidine hydrochloride are acidic. Pethidine is incompatible with barbiturate salts and with other drugs including aminophylline, amobarbital, floxacillin, furosemide, amylobarbitone sodium, ephedrine sulphate, heparin sodium, hydrocortisone sodium succinate (in a ratio of 2 parts of hydrocortisone sodium succinate to 1 part of pethidine hydrochloride), methicillin sodium, methylprednisolone sodium succinate, morphine sulphate, nitrofurantoin sodium, pentobarbitone sodium, phenobarbitone sodium, phenytoin sodium, oxytetracycline hydrochloride, thiamylal sodium, thiopental sodium, sodium bicarbonate, sulphadiazine sodium, sodium iodide, sulphafurazole diethanolamine or thiopentone sodium. Incompatibility has also been observed between pethidine hydrochloride and acyclovir sodium, imipenem, frusemide, idarubicin, allopurinol, amphotericin B cholesteryl sulphate complex and cefepime.
Colour changes or precipitation have been observed on mixing pethidine with the following drugs: minocycline hydrochloride, tetracycline hydrochloride, cefoperazone sodium, mezlocillin sodium, nafcillin sodium and liposomal doxorubicin hydrochloride.
Pethidine hydrochloride also has been reported to be incompatible with solutions containing potassium iodide, aminosalicylic acid, and salicylamide.