Last Updated: August 14, 2026

CLINICAL TRIALS PROFILE FOR MEPERIDINE HYDROCHLORIDE


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505(b)(2) Clinical Trials for meperidine hydrochloride

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 meperidine hydrochloride

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.
NCT00286052 ↗ Impact of Low Dose Naloxone on Fentanyl Requirements in Pediatric ICU Patients Completed University of Texas Southwestern Medical Center Phase 3 2002-12-01 Recently there has been an increased awareness in the need for adequate sedation and pain control for Pediatric Intensive Care Unit (ICU) patients. Fentanyl is an opioid commonly used in Pediatric ICU patients to decrease pain and increase sedation. Although opioids (e.g. morphine and fentanyl) provide excellent pain relief, they have many side effects including dependence, tolerance and withdrawal. These side effects lead to increased doses in order to maintain pain control and/or sedation. There have been a few adult studies pointing to some possible treatments. For example, giving low dose naloxone along with opioids. Adult studies show that this combination not only decreases the frequency of opioid side effects, but also improves pain control and prevents the development of tolerance. We propose that children who receive low dose naloxone infusions along with fentanyl infusions will demonstrate: 1) decreased total daily doses of Fentanyl, 2) decreased frequency of withdrawal and 3) increased pain and sedation control. In this randomized, blinded prospective trial we will enroll 168 Pediatric ICU patients. Patients will receive either low dose naloxone or placebo simultaneously with their fentanyl infusion. Pain and sedation will be assessed using the Modified Motor Activity Assessment Scale (MMAAS). The fentanyl infusion will be increased to provide adequate pain control and/or sedation. Naloxone infusion will not be adjusted. Approximately 48 hours prior to removal from the ventilator, patients will have their fentanyl infusions decreased while being monitored for withdrawal. Patients showing signs of withdrawal will receive methadone, an opioid taken by mouth. Once off fentanyl, naloxone will be stopped. Patients will continue to be monitored for withdrawal for 4 days or until ICU discharge. If this study works, patients who receive low dose naloxone along with opioid infusions will have less tolerance and dependence and demonstrate less withdrawal. This may cause shorter Intensive Care Unit stays.
NCT00296751 ↗ Epidural Analgesia Versus IV Meperidine for Labor Pain Control Completed Rambam Health Care Campus N/A 2006-03-01 60 female that care for pain control during second stage of delivery, will choose between epidural or systemic analgesia. Continuous ECG (3 lead)monitoring will be recorded during the second stage for 10 minutes. 30 minutes after administration of either pain relief, a second recording of maternal ECG will take place for 10 minutes.
NCT00305058 ↗ Trial Comparing Morphine to Hydromorphone in Elderly Patients With Severe Pain Completed Montefiore Medical Center Phase 2/Phase 3 2005-07-01 The purpose of this research study is to determine which opiate pain medication (morphine or hydromorphone (Dilaudid)) is more effective in the treatment of acute pain in patients presenting to the emergency department.
>Trial ID >Title >Status >Phase >Start Date >Summary

Clinical Trial Conditions for meperidine hydrochloride

Condition Name

Condition Name for meperidine hydrochloride
Intervention Trials
Labor Pain 5
Pain 5
Shivering 4
Analgesia 3
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Condition MeSH

Condition MeSH for meperidine hydrochloride
Intervention Trials
Labor Pain 5
Gallbladder Diseases 3
Leukemia 2
Coronary Artery Disease 2
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Clinical Trial Locations for meperidine hydrochloride

Trials by Country

Trials by Country for meperidine hydrochloride
Location Trials
United States 24
Egypt 12
Korea, Republic of 6
Canada 6
Thailand 4
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Trials by US State

Trials by US State for meperidine hydrochloride
Location Trials
Texas 6
California 2
New York 2
Massachusetts 1
Illinois 1
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Clinical Trial Progress for meperidine hydrochloride

Clinical Trial Phase

Clinical Trial Phase for meperidine hydrochloride
Clinical Trial Phase Trials
PHASE4 2
PHASE2 1
Phase 4 29
[disabled in preview] 16
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Clinical Trial Status

Clinical Trial Status for meperidine hydrochloride
Clinical Trial Phase Trials
Completed 50
Unknown status 10
Active, not recruiting 4
[disabled in preview] 8
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Clinical Trial Sponsors for meperidine hydrochloride

Sponsor Name

Sponsor Name for meperidine hydrochloride
Sponsor Trials
University of Texas Southwestern Medical Center 3
Assiut University 3
University of Alberta 2
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Sponsor Type

Sponsor Type for meperidine hydrochloride
Sponsor Trials
Other 101
Industry 5
OTHER_GOV 1
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Last updated: July 27, 2026

Meperidine Hydrochloride Clinical Trials Update, Market Analysis, and Market Projection

Executive summary: Public, decision-grade clinical-trials and market-exposure intelligence for meperidine hydrochloride (pethidine) is limited because the drug is widely marketed as an older generic opioid with no ongoing, easily indexed late-stage development programs in current major public registries. For market planning, the product should be treated as a mature, low-innovation, mostly generic supply chain with pricing tied to opioid market dynamics, substitution pressures from other opioids, and regulatory tightening on opioid prescribing and safety labeling.


What clinical trials exist for meperidine hydrochloride right now?

Featured snippet answer: Meperidine hydrochloride currently has minimal visible late-stage (Phase 3) development activity in major global trial registries. Existing evidence is largely historical (older analgesia and perioperative studies), while present-day activity tends to show up as small pharmacokinetic, safety, abuse-deterrence formulations, or observational studies rather than large pivotal trials.

Which phases show up in public registries

  • Phase 1: occasional PK or formulation studies (often small cohorts, single-dose or short multi-dose designs).
  • Phase 2/3: rare for the active ingredient itself; most “meperidine studies” in modern time are comparative analgesia, perioperative protocols, or special populations that are not necessarily drug-development pivots.
  • Observational/post-marketing: frequent, but these generally do not create new exclusivity value.

What endpoints dominate

  • Pain scores in perioperative or emergency settings
  • Safety endpoints (respiratory depression, sedation, delirium, seizure risk)
  • Abuse-related endpoints when products are reformulated (less common for classic meperidine HCl)

What matters for R&D decisions

  • If the commercial goal is new exclusivity, meperidine HCl is a high-friction target because the active ingredient is off-patent in most jurisdictions.
  • If the goal is life-cycle extension, development usually concentrates on:
    • new formulations (controlled release, abuse-deterrent concepts)
    • alternative delivery (less common)
    • new combinations (rare for pethidine)
    • protocol-specific indications (still hard to monetize without strong patent coverage)

No decision-grade, current late-stage trial dataset can be stated as facts from the provided prompt.


How big is the meperidine hydrochloride market today and who buys it?

Featured snippet answer: Meperidine hydrochloride is a mature, low-cost generic opioid. Demand is driven by hospital and emergency use, with procurement decisions shaped by:

  • formulary preferences and opioid stewardship policies
  • availability and supply stability
  • substitution by other opioids (morphine, hydromorphone, fentanyl, oxycodone in some settings)
  • local regulatory and payer scrutiny

Where it is used

  • Emergency departments
  • Inpatient analgesia and perioperative settings
  • Oncology pain protocols in certain systems where it remains part of standard formularies

What buyers care about

  • Acquisition cost and total cost of inventory
  • Stability and handling characteristics
  • Labeling constraints and nursing safety workflows
  • Supply continuity for parenteral vials/ampoules

Competitive set for procurement

  • Other short-acting opioids:
    • morphine (IV/PO)
    • hydromorphone
    • fentanyl (IV and transdermal in some pathways)
    • oxycodone (institutional protocols depending on jurisdiction)
  • For emerging “replacement” demand, the substitutes often come from better tolerated profiles, easier dosing, or tighter stewardship alignment.

No quantified market-size inputs are provided in the prompt, so numeric revenue estimates cannot be stated as facts.


When does meperidine hydrochloride lose exclusivity, and what does that mean commercially?

Featured snippet answer: Meperidine hydrochloride is generally treated as off-patent. Commercially, exclusivity loss is less relevant than generic supply and regulatory/policy constraints. Market share is primarily governed by procurement and prescribing behaviors.

What “exclusivity” looks like in practice for old generics

  • Orphan/drug development exclusivity: not a typical feature for meperidine HCl
  • New-use exclusivity: unlikely to be achieved for a widely used opioid
  • Formulation patents (if any, product-specific): can protect certain presentations, but these do not usually create large, durable monetizable monopolies for the active ingredient overall.

Commercial implication

  • New entrants can compete quickly after regulatory approvals.
  • Differentiation shifts toward:
    • packaging (single-dose vials)
    • manufacturing reliability
    • institutional contracting terms

What patents protect meperidine hydrochloride and its formulations?

Featured snippet answer: The active ingredient meperidine hydrochloride is widely generic. Patent coverage, where it exists, usually sits at the presentation level (specific salts, formulations, manufacturing processes) rather than the core API.

Likely patent clusters in practice

  • Manufacturing process patents (sterility, impurity control, crystallization)
  • Formulation patents:
    • concentration-specific compositions
    • stabilizer systems
    • packaging-related claims
  • Use/pain-protocol patents:
    • uncommon for meperidine given established standard practice and prior art density

Why this matters for R&D

  • If no patent estate supports exclusivity, late-stage investment is constrained.
  • Business cases usually depend on:
    • procurement differentiation
    • cost-down manufacturing
    • regulatory cleanliness and supply assurance
    • potential product improvements that survive bioequivalence standards without generating new clinical exclusivity

No patent numbers, assignees, or jurisdictions were included in the prompt, so a protected-patent map cannot be produced as facts.


What FDA and regulatory status applies to meperidine hydrochloride?

Featured snippet answer: Meperidine hydrochloride is an approved opioid drug with broad historical labeling. Current regulatory activity typically concerns:

  • opioid safety communications
  • boxed warnings and controlled-substance scheduling controls
  • label updates related to metabolite toxicity risk (notably normeperidine, associated with neurotoxicity and seizures)

Key regulatory drivers for market access

  • Controlled substance regulations (DEA scheduling and dispensing controls)
  • Labeling and risk mitigation requirements
  • Narcs substitution patterns driven by stewardship and payer policy

No Orange Book identifiers or current FDA regulatory milestone data were provided in the prompt, so they cannot be stated as facts.


What Paragraph IV generic entry risks exist for meperidine hydrochloride?

Featured snippet answer: Paragraph IV is typically relevant only where a listed drug has Orange Book-listed patents. For meperidine HCl, most competition is expected to come through normal generic pathways rather than patent-abstraction litigation, unless a particular specific presentation has unexpired listed patents.

Where generic litigation would concentrate (if any)

  • Sterile injectable presentations with unexpired formulation/process listings
  • Any brand-specific re-formulation or combination product with active listed patents

No Orange Book patent listings were provided in the prompt, so specific Paragraph IV litigation risks cannot be enumerated.


What biosimilar risk exists for meperidine hydrochloride?

Featured snippet answer: None. Meperidine hydrochloride is a small-molecule opioid, so it is not a biologic and does not have biosimilar pathways.


How does meperidine hydrochloride compare with competing opioids in clinical and commercial use?

Featured snippet answer: In modern formularies, meperidine is commonly less preferred than alternatives due to safety considerations tied to its metabolite profile and evolving stewardship. Procurement decisions favor agents with:

  • more favorable adverse-event tradeoffs
  • dosing convenience and protocol fit
  • stronger institutional preferences

Clinical differentiators (practical)

  • Higher concern for metabolite accumulation with repeated dosing in some contexts
  • Safety risk profile affects prescriber comfort and institutional adoption

Commercial differentiators

  • Pricing pressure from multi-supplier generics
  • Contracting and supply continuity in hospital systems

No head-to-head trial effect sizes or national formulary share data were included in the prompt, so comparative performance can’t be quantified here as facts.


Market projection for meperidine hydrochloride: what direction does demand take?

Featured snippet answer: Demand is projected to remain stable-to-declining in countries with tightening opioid stewardship and substitution toward preferred short-acting opioids. Growth, where it exists, is likely driven by:

  • transient supply shortages of alternatives
  • institutional inertia in formularies
  • pricing-driven adoption by lower-cost procurement policies

Key projection drivers

  • Opioid policy and prescribing restrictions
  • Hospital formulary changes and opioid committee decisions
  • Relative safety labeling and guideline alignment
  • Supply chain resilience for injectable sterile products
  • Competitive price erosion typical of mature generics

Scenario framework (qualitative)

  • Base case: flat to modest decline driven by substitution and safety-driven prescribing patterns.
  • Down case: faster decline due to stronger stewardship restrictions or formulary exclusion.
  • Up case: temporary stabilization from competitor shortages or contracting shifts.

No numeric assumptions or historical market-size/revenue series were provided in the prompt, so numeric projections cannot be stated as facts.


Key timelines and business checkpoints for a meperidine hydrochloride portfolio

Featured snippet answer: For meperidine HCl, the most important “timelines” are not patent cliffs but regulatory label updates, DEA/controlled-substance policy changes, and formulary renewal cycles at hospital systems.

Operational checkpoints

  • Label update compliance (pharmacovigilance and distribution)
  • Controlled-substance dispensing and inventory controls audits
  • Hospital committee review cycles (typically annual or semi-annual)

Key Takeaways

  1. Meperidine hydrochloride is a mature, predominantly generic opioid; current value creation is more tied to supply, contracting, and formulation/presentation quality than to late-stage clinical breakthroughs.
  2. Visible late-stage clinical development activity is minimal; modern studies are likely safety/PK/observational rather than pivotal new-efficacy programs.
  3. Market outlook is driven by opioid stewardship and substitution by other short-acting opioids, creating a stable-to-declining demand profile in many markets.
  4. Patent and Paragraph IV dynamics depend on specific product presentations with Orange Book-listed patents; without those listings in the prompt, a litigation map cannot be stated as facts.

FAQs

  1. Is meperidine hydrochloride still used for procedural sedation or perioperative pain in major hospital formularies?
  2. What is the normeperidine toxicity risk and how does it affect prescribing restrictions and label language?
  3. Which countries have the strongest opioid stewardship pressures that reduce meperidine use?
  4. Do any sustained-release or reformulated meperidine products have meaningful exclusivity over standard generics?
  5. How do hospital procurement decisions for injectable opioids typically weight acquisition price versus safety labeling and nursing workload?

References (APA)

  1. Not provided.

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