Meperidine manufacturers

In the early 1980s, a form of designer meperidine, known as MPPP, was being illegally manufactured. MPPP was also referred to as synthetic heroin. In some cases, the chemical technique was not precise, and a toxic chemical byproduct, MPTP, was produced. MPTP is a known industrial toxin that can destroy nerve cells in certain portions of the brain... 

As a Schedule II drug, meperidine is strictly controlled in the United States, as well as in other parts of the world. Its manufacture and distribution in the United States are controlled by the Food and Dmg Administration (FDA) and the Drug Enforcement Administration (DEA). International control is overseen by the International Narcotic Control Board (INCB). 

Autoxidation of an impurity of meperidine (XII) leads to the aroma-tization product (XIII) (57) (Fig. 10). Some time ago, this was the major feature in an important criminal case, because this impurity, found in a drug manufactured illicitly, produced a severe parkinsonian syndrome in men. The tetrahydropyridine ring, not uncommon in pharmaceuticals, easily gives aromatization. In fact, the allylic methylene group adjacent to the nitrogen atom is activated and two dihydropyridine molecules formed by this oxidation may disproportionate to the finally aromatized product and to the starting material (57). 

Because sibutramine inhibits serotonin uptake, and because the serious serotonin syndrome has been seen when serotonergic drugs were taken with SSRIs, the manufacturers say that sibutramine should not be taken with any serotonergic drugs. They name dextromethorphan, dihydroergot-amine, fentanyl, pentazocine, pethidine (meperidine), SSRIs, sumatriptan, and tryptophan. Possible cases have been reported for sibutramine and SSMs , (below).The US manufacturers also include lithium in their list. Note that this list is not exhaustive (see MAOIs under (d) above) and a case of the serotonin syndrome has been seen when venla-faxine was given with sibutramine. ... 

The UK manufacturer of linezolid (a drug with weak, reversible, non-selective MAOI activity) contraindicates its use with pethidine, unless facilities are available for close observation and monitoring of blood pressure, because of the possibility of serious reactions, as have occurred with classical MAOIs and pethidine, see MAOIs or RIMAs -I- Opioids Pethidine (Meperidine) , p.1140. 

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