Log in
Pharmacology · Drugs and Prescriptions

Trimeperidine hydrochloride

Promedolum

Trimeperidine is a synthetic narcotic analgesic, a full opioid receptor agonist. The drug is inferior to morphine in analgesic potency, but possesses a unique spasmolytic effect and causes less respiratory depression, making it the drug of choice in obstetrics and for colic.

Test your knowledge on this topicAsk the AI
Pharmacological groupSynthetic narcotic analgesics (full agonists)
Chemical classN-methylpiperidine (phenylpiperidine) derivative
Key featureCauses less respiratory center depression compared to morphine
Smooth muscleExerts a spasmolytic effect on the bronchi and ureters
How to write a prescription
Rp.: Tab. Promedoli 0,025
D.t.d. N 10
S. Внутрь по 1-2 таблетки при болях

Alternative prescription formats: Tabulettas Promedoli 0.025; Sol. Promedoli 1% - 1 ml; Sol. Promedoli 2% - 1 ml

Dosage form
Tab. 0.025 g; sol. in amp. 1% and 2% - 1 ml
Administration
Orally 1–2 tab. (Maximal Single Dose [MSD] 0.05 g; Maximal Daily Dose [MDD] 0.16 g); s.c. 10–20 mg (MSD 0.04 g)
Group
Agents affecting the central nervous system
3 min readFor medical studentsUpdated 09/24/2026
Material prepared by WhiteCoat Pro editorial team based on platform study guidesReviewed by medical editor: Aulov A. A., general practitioner · 09/24/2026

Mechanism of action and pharmacodynamics

Trimeperidine (Promedolum) is an original domestic drug developed by pharmacologists M.D. Mashkovsky and V.I. Ishchenko. It belongs to the group of full agonists of opioid receptors. In its pharmacokinetic parameters, the drug is similar to morphine, yet it has a number of fundamental differences in pharmacodynamics that determine its clinical value.

  • Analgesia: The analgesic effect of trimeperidine is 2–4 times weaker than that of morphine.
  • Effect on respiration: The drug depresses the respiratory center to a significantly lesser degree. This is a critically important property that allows its use in pediatrics and obstetric practice without a high risk of fetal or neonatal asphyxia.
  • Effect on smooth muscle: This is the most crucial difference from classical opiates. While morphine causes spasm, trimeperidine exhibits a pronounced spasmolytic effect on the bronchi and ureters. Its spasmogenic action on the intestine and biliary tract is also significantly less pronounced.
  • Effect on the uterus: The drug stimulates the myometrium, increasing its tone and contractile activity.

Indications for use

Due to the favorable combination of analgesic and spasmolytic effects, the spectrum of trimeperidine applications has strict indications:

  • Severe pain syndrome: used for severe injuries, oncological diseases, and in the postoperative period to relieve acute pain.
  • Premedication: used for medicinal sleep and preparing patients for surgical interventions.
  • Obstetric analgesia: is the drug of choice in obstetrics. This is due to the fact that it is relatively safe for fetal respiration while simultaneously stimulating labor activity by increasing myometrial tone.
  • Colic (renal, hepatic): effective pain relief is achieved through the relaxation of the smooth muscles of the ureters and biliary tract (spasmolytic component).
Test your knowledge on the topicTasks from the «Pharmacology» course bank — instant answers and explanations.

Side effects and contraindications

Like other narcotic analgesic drugs, trimeperidine requires the strictest control in prescription and accounting.

  • Adverse reactions: dyspeptic disorders (nausea, vomiting caused by the effect on the vomiting center), general weakness, and dizziness are possible during administration.
  • Risk of dependence: with systematic use, drug dependence inevitably develops (both psychological and physical craving for the drug is formed).
  • Contraindications: the main limitation for administration is respiratory failure. Although the risk of respiratory center depression is reduced compared to morphine, it still persists and can be fatal if respiratory function is initially compromised.

Dosage forms and dosing

The drug is available in enteral and parenteral dosage forms. It is prescribed strictly by prescription.

  • Tablets: available in 0.025 g. Prescribed orally, 1–2 tablets per dose. The maximal single dose (MSD) for oral administration is 0.05 g, and the maximal daily dose (MDD) is 0.16 g.
  • Solution for injection: available in 1% and 2% concentration ampoules of 1 ml. Administered subcutaneously (s.c.) at a dose of 10–20 mg. The maximal single dose (MSD) for subcutaneous administration is 0.04 g.

Briefly: answers to topical questions

What are the contraindications for prescribing trimeperidine?

A contraindication for prescribing trimeperidine is respiratory failure. Trimeperidine is contraindicated in children under 2 years of age.

How to memorize

PROMEDOL: Renal colic, Labor, Analgesia, Less respiratory depression, Excellent Lytic (spasmolytic).

Class and exam questions

Why is trimeperidine preferred over morphine for renal colic?

Morphine has a spasmogenic action and can increase ureteral spasm, worsening colic. Trimeperidine, conversely, exerts a spasmolytic effect on the smooth muscles of the ureters while simultaneously relieving pain.

Can trimeperidine be used for obstetric analgesia?

Yes, this is one of the main indications. It depresses the respiratory center less (which is safer for the fetus) and increases myometrial tone and contractile activity.

Which chemical group does the drug belong to?

It is a synthetic drug, a derivative of N-methylpiperidine (phenylpiperidine). Developed by domestic pharmacologists.

Something unclear? Ask the AIThe AI tutor has reviewed the material on "Trimeperidine hydrochloride" and will explain it in simple terms.

What else to study on this topic

  • Comparative characteristics of full opioid receptor agonists (morphine, fentanyl, methadone).
  • The mechanism of development of physical and psychological opioid dependence.
  • Analgesics with a mixed mechanism of action (tramadol) and their advantages over classical opioids.
  • Transdermal therapeutic systems (TTS) in the treatment of chronic pain (using fentanyl as an example).
  • Opioid receptor antagonists and principles of care for narcotic analgesic overdose.

Master the entire topic in the «Pharmacology» course

This is a summary. The course covers everything tested in classes and exams.

  • Complete study guide on "Trimeperidine hydrochloride" and 5,304 other subject pages
  • Assignments and quizzes after every topic — just like in a colloquium
  • AI tutor answers questions on the topic anytime
  • 116 video lessons on the subject
Open full reviewSubject curriculumfrom 599 ₽ per month

Other topics in the «Drugs and Prescriptions» section

Atropine sulfateAceclidineAeronHexoprenalinePirenzepineIpratropium bromideXylometazolineMetocinium iodideNaphazolineNeostigmineNorepinephrinePipecuronium bromidePlatyphyllineSalmeterolSuxamethoniumTropicamideFenoterolEpinephrineEphedrine hydrochlorideAcetaminophenBromocriptineSodium valproateDiazepamZolpidem
The entire "Drugs and Prescription" section

Free video lessons: pharmacologyShort lessons with study notes — no registration required.

Watch lessons

Prepared by WhiteCoat Pro faculty in accordance with the medical school curriculum. For educational purposes only.