Which medication is not widely available and is no longer recommended as an analgesic?

Meperidine, commonly known by the brand name Demerol, is considered to be less favorable as an analgesic due to several key factors. Although it was once a popular choice for treating pain, it has fallen out of favor in clinical practice. This shift is primarily due to its side effect profile, including the risk of producing a neurotoxic metabolite, normeperidine, which can lead to seizures and other central nervous system complications, particularly in patients with renal impairment or in the elderly.

Additionally, there are now safer and more effective alternatives to meperidine available for pain management, such as methadone, fentanyl, and hydromorphone. These alternatives tend to have a more favorable safety and efficacy profile, making them preferable choices in both acute and chronic pain management scenarios. As a result of these considerations, meperidine is not widely available and is no longer recommended as an analgesic in most clinical settings.