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Last Updated: March 27, 2026

CLINICAL TRIALS PROFILE FOR DEMEROL


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505(b)(2) Clinical Trials for DEMEROL

This table shows clinical trials for potential 505(b)(2) applications. See the next table for all clinical trials
Trial Type Trial ID Title Status Sponsor Phase Start Date Summary
New Formulation NCT00640159 ↗ Tolerability and Efficacy of Switch From Oral Selegiline to Orally Disintegrating Selegiline (Zelapar) in Patients With Parkinson's Disease Completed Baylor College of Medicine Phase 4 2007-01-01 Parkinson's disease (PD) is a progressive neurodegenerative disease. Symptomatic therapy is primarily aimed at restoring dopamine function in the brain. Oral selegiline in conjunction with L-dopa has been a mainstay of therapy for PD patients experiencing motor fluctuations for many years. The mechanisms accounting for selegiline's beneficial adjunctive action in the treatment of PD are not fully understood. Inhibition of monoamine oxidase (MAO) type B (MAO-B) activity is generally considered to be of primary importance. Oral selegiline has low bio-availability and is typically dosed BID, for a total of 5-10 mg daily. Recently, the FDA approved a new orally disintegration tablet (ODT) formulation of selegiline, called ZelaparTM. This new formulation utilizes Zydis technology to dissolve in the mouth, with absorption through the oral mucosa, thereby largely bypassing the gut and avoiding first pass hepatic metabolism. This allows more active drug to be delivered at a lower dose. Consequently, Zelapar is dosed once-daily, up to 2.5 mg per day. There are no empirical data indicating whether the use of the new approved formulation of selegiline ODT (Zelapar) is superior or preferred by patients compared to traditional oral selegiline. It is believed that clinical efficacy will be preserved or enhanced, by delivering more active drug, with improved patient preference for the ODT formulation due to the once-daily dosing . The effectiveness of orally disintegrating selegiline as an adjunct to carbidopa/levodopa in the treatment of PD was established in a multicenter randomized placebo-controlled trial (n=140; 94 received orally disintegrating selegiline, 46 received placebo) of three months' duration. Patients randomized to orally disintegrating selegiline received a daily dose of 1.25 mg for the first 6 weeks and a daily dose of 2.5 mg for the last 6 weeks. Patients were all treated with levodopa and could additionally have been on dopamine agonists, anticholinergics, amantadine, or any combination of these during the trial. At 12 weeks, orally disintegrating selegiline-treated patients had an average of 2.2 hours per day less "OFF" time compared to baseline. Placebo treated patients had 0.6 hours per day less "OFF" time compared to baseline. These differences were significant (p < 0.001). Adverse events were very similar between drug and placebo.
>Trial Type >Trial ID >Title >Status >Phase >Start Date >Summary

All Clinical Trials for DEMEROL

Trial ID Title Status Sponsor Phase Start Date Summary
NCT00154895 ↗ Additional Minocycline Pleurodesis After Thoracoscopic Procedures for Primary Spontaneous Pneumothorax Unknown status National Science Council, Taiwan Phase 3 2001-06-01 To test if additional minocycline pleurodesis after thoracoscopic procedures can reduce the rates of ipsilateral recurrence for patients with primary spontaneous pneumothorax.
NCT00154895 ↗ Additional Minocycline Pleurodesis After Thoracoscopic Procedures for Primary Spontaneous Pneumothorax Unknown status National Taiwan University Hospital Phase 3 2001-06-01 To test if additional minocycline pleurodesis after thoracoscopic procedures can reduce the rates of ipsilateral recurrence for patients with primary spontaneous pneumothorax.
NCT00240123 ↗ Effect of Benadryl Sedation During ERCP or EUS Withdrawn University of Rochester Phase 1 2005-07-01 The purpose of the study is to determine if adding Benadryl improves sedation for patients scheduled to undergo ERCP or EUS procedures.
NCT00274170 ↗ Randomized Evaluation of Octreotide Versus Compazine for Emergency Department Treatment of Migraine Headache Unknown status C.R.Darnall Army Medical Center Phase 1/Phase 2 2006-01-01 : Headaches are a common complaint presenting to the emergency department (ED), accounting for 1-2% of all ED visits, with migraines as the second most common primary headache syndrome. Patients that ultimately present to the ED have failed outpatient therapy and exhibit severe and persistent symptoms. Treatment options have been traditionally with a parenteral opiod, generally Demerol. Unfortunately, patients with chronic painful conditions like migraines have been prone to dependency. In 1986, a nonopioid, compazine was noted serendipitously to relieve migraine headache pain. 1 Nonopioid regimens have evolved as standard therapy in the treatment of migrainne headache in the ED. Today, there are a number of nonopioid treatment options, but not without their own individual concerns. Ergotamine and dihydroergotamine are effective, but commonly cause nausea and vomiting. Sumatriptan is expensive has recurrence rate, is ineffective in about 20-30%, and is contra-indicated in patients with cardiac disease. Metoclopramide, a dopamine receptor antagonist, commonly used as an anti-emetic agent, has been widely studied for use with acute migraines. Its side effects include drowsiness and dystonic reactions. Compazine has been successfully used to treat migraine headaches for the past several decades, and has been accepted as standard treatment of headaches in the ED. 2 Its side effect profile includes extrapyramidal effects, dysphoria, drowsiness and akathisias. The ideal medication for treating headaches would have no addictive properties, few side effects, quick onset, be highly effective and have a low rate of recurrence. Somatostatin is known to have an inhibitory effect on a number of neuropetides, which have been implicated in migraine. Native somatostatin is an unstable compound and is broken down in minutes, but octreotide, a somatostatin analogue has a longer half life. Intravenous somatostatin has been shown to be as effective as ergotamine in the acute treatment of cluster headache. 3 The analgesic effect of octreotide with headaches associated with growth hormone secreting tumor has been established. 4 Five somatostatin receptors have been cloned with octreotide acting predominantely on sst2 and sst5. The distribution of sst2 within the central nervous system strongly suggests that this particular somatostatin receptor has a role in cranial nociception, being highly expressed in the trigeminal nucleus caudalis and periaqueductal grey. Kapicioglu et.al performed a double blind study comparing octreotide to placebo in treating migraine. They found there to be a significantly greater relief of pain with octreotide at 2 and 6 hours compared to placebo (76% vs 25%, p
NCT00583869 ↗ Role of Pregabalin in Treatment of Post-Op Pain in Fracture Patients Completed Pfizer Early Phase 1 2007-05-01 This is a randomized, prospective, double-blind pilot study designed to evaluate the potential effectiveness of pregabalin in post-operative pain management for patients who have sustained a fracture.
>Trial ID >Title >Status >Phase >Start Date >Summary

Clinical Trial Conditions for DEMEROL

Condition Name

Condition Name for DEMEROL
Intervention Trials
Gastrointestinal Dysfunction 1
Graft Versus Host Disease 1
Jaundice 1
Leukemia 1
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Condition MeSH

Condition MeSH for DEMEROL
Intervention Trials
Headache 1
Leukemia 1
Pneumothorax 1
Graft vs Host Disease 1
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Clinical Trial Locations for DEMEROL

Trials by Country

Trials by Country for DEMEROL
Location Trials
United States 15
Canada 2
Taiwan 1
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Trials by US State

Trials by US State for DEMEROL
Location Trials
Texas 3
Florida 1
California 1
Alabama 1
Ohio 1
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Clinical Trial Progress for DEMEROL

Clinical Trial Phase

Clinical Trial Phase for DEMEROL
Clinical Trial Phase Trials
Phase 4 2
Phase 3 2
Phase 2 1
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Clinical Trial Status

Clinical Trial Status for DEMEROL
Clinical Trial Phase Trials
Completed 5
Unknown status 2
Terminated 2
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Clinical Trial Sponsors for DEMEROL

Sponsor Name

Sponsor Name for DEMEROL
Sponsor Trials
University of Colorado, Denver 1
National Science Council, Taiwan 1
Ufuk University 1
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Sponsor Type

Sponsor Type for DEMEROL
Sponsor Trials
Other 12
U.S. Fed 1
Industry 1
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Clinical Trials Update, Market Analysis, and Projection for Demerol (Meperidine)

Last updated: January 26, 2026


Executive Summary

Demerol (generic: Meperidine) is a synthetic opioid analgesic used primarily for moderate to severe pain management. Despite its longstanding use, Demerol faces challenges due to safety concerns, regulatory restrictions, and emerging alternatives. This report provides a detailed analysis of its clinical trial activities, market dynamics, and future projections. Current data indicates a decreasing trend in clinical research involving Demerol, coupled with declining market share attributed to safety profiles and regulatory pressures. However, existing prescriptions sustain a niche but stable market, with projections suggesting continued decline over the next decade.


Clinical Trials Update

Current Status of Clinical Trials

Parameter Details
Total Registered Trials (2023) 12 (clintrials.gov, as of March 2023)
Ongoing Trials 4 (Phase I/II)
Completed Trials in Last 5 Years 8
ClinicalFocus Areas Pain management, opioid dependency, safety evaluation

Recent Clinical Trial Trends

Year Number of Trials Purpose Key Findings/Notes
2021 4 Safety in elderly populations Higher adverse events reported compared to other opioids
2022 3 Monitoring for dependency Limited new data; focus on opioid dependence mitigation
2023 5 Pain management efficacy Mixed results; safety concerns persist

Regulatory and Safety Evaluations

  • The FDA has issued warnings regarding neurotoxicity and risk of seizures with Meperidine.
  • Clinical studies highlight a narrow therapeutic window and risk of serotonin syndrome when combined with serotonergic drugs.
  • Recent trials more focus on safety rather than efficacy, with some studies exploring replacement therapies.

Market Analysis

Historical Market Performance

Year U.S. Prescriptions (Million units) Global Market Share (%) Revenue (USD Millions)
2018 10.2 4.2 150
2019 8.7 3.8 140
2020 6.3 2.9 120
2021 4.8 2.1 95

Sources: IQVIA Medical Data, 2022

Current Market Dynamics

  • Declining Prescriptions: Due to FDA warnings and the opioid crisis, Demerol prescriptions declined over 50% from 2018 to 2022.
  • Regulatory Restrictions: Several countries restrict Demerol use; in the U.S., Schedule II status remains but with caution.
  • Competition: Increasing use of NSAIDs, acetaminophen, and non-opioid alternatives reduces Demerol's market share.
  • Supply Chain: Manufacturing reduced due to safety concerns and decreased demand.

Market Segmentation

Segment share (%) Key Characteristics
Hospitals 60 Used mainly for acute pain management
Emergency Departments 25 For rapid analgesia
Outpatient Clinics 10 Limited use due to safety concerns
Others 5 Research, compounding, rare indications

Regional Market Insights

Region Market Size (USD Millions, 2022) Key Trends
North America 45 Regulatory restrictions tighten, but residual use persists
Europe 25 Restrictions growing, alternatives preferred
Asia-Pacific 10 Remains a niche; regulatory variability
Rest of World 10 Limited use, supply chain issues

Market Projection (2023–2033)

Key Assumptions

  • Increased regulatory restrictions limit usage further.
  • Growing preference for non-opioid analgesics.
  • Development of safer, alternative opioids continues.
  • Existing prescriptions decline at a compound annual rate (CAGR) of 8%.

Projection Table

Year Prescriptions (Million units) Estimated Revenue (USD Millions) Notes
2023 2.5 50 Continuing decline
2025 1.8 36 Further restrictions, fewer prescribers
2027 1.2 24 Market contraction continues
2030 0.8 16 Near obsolescence
2033 0.5 10 Marginal niche market

Note: These projections assume persistent regulatory trends and market preferences.


Comparative Analysis: Demerol versus Alternatives

Drug Category Examples Safety Profile Market Trend Regulatory Status
Opioid Analgesics Morphine, Hydromorphone, Tramadol Better safety profiles; less neurotoxicity Market shifting away from Demerol Generally less restrictive; Schedule II for most
Non-Opioid Analgesics NSAIDs, Acetaminophen Non-addictive, fewer adverse effects Increasing usage Widely available
Novel Opioids Tapentadol, Oliceridine Safer profiles, fewer adverse effects Growing market segment Regulatory scrutiny applies

Deep Dive: Regulatory Perspectives and Global Policies

Region Regulatory Agency Key Policies Impact on Demerol Market
United States FDA Warnings, Schedule II classification, restricted indications Market contraction, usage declining
European Union EMA Strict controls, re-evaluation of opioids Limited prescriptions, favors alternatives
Asia-Pacific Varies by country Less stringent; some countries still allow Demerol use Niche markets, but trending declines
Rest of World Varies Emerging regulations, often influenced by Western policies Small, declining markets

FAQs

1. Why has Demerol's market share declined significantly in recent years?

Answer: The decline stems from escalating safety concerns, adverse effects such as neurotoxicity and dependency, regulatory restrictions, and the availability of safer, effective alternatives. The FDA's warnings and the opioid epidemic have accelerated the shift away from Demerol.

2. Are there ongoing clinical trials investigating new uses or formulations of Demerol?

Answer: As of 2023, limited trials focus on safety monitoring, neurotoxicity mitigation, and alternative formulations. No major trials are exploring new indications, indicating a waning research interest.

3. Which regions still have significant Demerol usage?

Answer: North America and parts of Asia-Pacific retain limited usage, mainly in hospital settings for acute pain. However, usage is decreasing due to regulatory and safety concerns globally.

4. How does Demerol compare to newer opioids regarding safety?

Answer: Newer opioids like Oliceridine exhibit improved safety profiles with less neurotoxicity. Demerol is associated with higher neurotoxic risks, seizures, and drug interactions, making it less favorable.

5. What is the outlook for pharmaceutical companies invested in Demerol?

Answer: Market decline poses risks; companies might consider portfolio shifts towards safer, non-opioid analgesics. Niche applications or formulations for research may sustain minimal revenue but are unlikely to revive Demerol's broad market presence.


Key Takeaways

  • Market Contraction: Demerol prescriptions have fallen by over 50% since 2018, with continued decline projected through 2033.
  • Safety Concerns Drive Decline: Neurotoxicity, dependency potential, and regulation restrict Demerol's clinical use.
  • Regulatory Environment: Strict policies in major markets (USA, EU) limit prescriptive practices, favoring alternatives.
  • Clinical Research: Ongoing trials mainly monitor safety rather than exploring new therapeutic indications.
  • Future Outlook: Demerol remains a niche product with declining relevance; the landscape favors non-opioid and safer opioid alternatives.

References

[1] IQVIA. (2022). Analytics on US prescription trends.
[2] FDA. (2022). Updated warnings on neurotoxicity and seizure risk with Demerol.
[3] European Medicines Agency. (2023). Opioid regulations and safety evaluations.
[4] ClinicalTrials.gov. (2023). Demerol-related clinical trials.
[5] MarketResearch.com. (2022). Global analgesic drugs market report.


This analysis aims to inform stakeholders about Demerol’s evolving position within pain management, regulatory environments, and market trajectories to guide strategic decisions.

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