Classes
DEA Class; Rx
Common Brand Names; Phenergan, Phenadoz
- Antiemetic Agents;
- Antihistamines, 1st Generation
Description
Phenothiazine derivative with primarily antihistaminic effects and also has antiemetic, anticholinergic, sedative actions
Not an effective neuroleptic; used in cough and cold products for antihistaminic actions; also commonly used for post-operative nausea/vomiting
Contraindicated in pediatric patients less than 2 years of age due to risk of fatal respiratory depression
Intravenous administration not recommended as it carries a risk of severe tissue damage
Indications
Indicated for the prevention of motion sickness.
Contraindications
Hypersensitivity
Newborn/premature infants <2 years old (risk of potentially fatal respiratory depression)
SC or intra-arterial administration
Coma
Treatment of lower respiratory tract symptoms, including asthma
Adverse Effects
- Sedation
- Confusion
- Disorientation
- Blurred vision
- Hallucinations
- Dystonias
- Catatonic states
- Euphoria
- Excitation
- Extrapyramidal symptoms
- Tachycardia
- Bradycardia
- Leukopenia (rare)
- Agranulocytosis (rare)
- Obstructive jaundice
- Photosensitivity
- Dry mouth
- Angioneurotic edema
- Tardive dyskinesia
- Urticaria
- Xerostomia
- Impotence
- Urinary retention
Warnings
Use caution in asthma, hepatic impairment, peptic ulcer disease, respiratory impairment, bone marrow suppression, anaphylaxis in susceptible individuals
May impair ability to drive or perform hazardous tasks
May impair core body temperature regulation; caution when taking medications with anticholinergic effects, heat exposure, or strenuous exercise
Depresses hypothalamic thermoregulatory mechanism; exposure to extreme temperatures may cause hypo- or hyperthermia
May alter cardiac conduction (life-threatening arrhythmias reported)
Antiemetic effect may obscure toxicity of chemotherapeutic drugs
Monitor closely in patients with cardiovascular disease, hepatic impairment, Reye syndrome, or history of sleep apnea
Has anticholinergic effects; use with caution in patients with decreased gastrointestinal motility or obstructions (partial or complete), urinary retention, urinary obstructions, xerostomia, BPH, or visual problems
May cause extrapyramidal symptoms including pseudoparkinsonism, acute dystonic reactions, tardive dyskinesia, and akathisia
Neuroleptic malignant syndrome reported with use; monitor for fever, muscle rigidity and/or autonomic instability, or mental status changes
May cause orthostatic hypotension; use caution in patients at risk of experiencing hypotensive episodes (cardiovascular disease, cerebrovascular disease, hypovolemia or taking medications that may predispose to bradycardia or hypotension)
May cause photosensitivity
Pyloroduodenal obstruction, stenosing peptic ulcer disease, bladder neck obstruction
Anticholinergic effects of promethazine may exacerbate condition in patients with narrow-angle glaucoma or myasthenia gravis
Pregnancy and Lactation
Pregnancy category: C
Lactation: Not known whether drug crosses into breast milk; discontinue drug, or do not nurse
Maximum Dosage
50 mg/dose; generally 100 mg/day. Dosage should not exceed maximum recommendations per indication.
50 mg/dose; generally 100 mg/day. Dosage should not exceed maximum recommendations per indication.
1.1 mg/kg/dose PO/PR/IM/IV (Max: 25 mg/dose). Dosage should not exceed maximum recommendations per indication.
>= 2 years: 1.1 mg/kg/dose PO/PR/IM/IV (Max: 25 mg/dose). Dosage should not exceed maximum recommendations per indication.
< 2 years: Use is contraindicated due to the risk for fatal respiratory depression.
Use is contraindicated due to the risk for fatal respiratory depression.
Use is contraindicated due to the risk for fatal respiratory depression.
How supplied
Promethazine hydrochloride
tablet
- 12.5mg
- 25mg
- 50mg
suppository
- 12.5mg
- 25mg
- 50mg
injectable solution
- 25mg/mL
- 50 mg/mL
syrup
- 6.25mg/5mL
