What is promethazine?

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Generic Name: Promethazine Brand Name(s): Generics only. No brands available.

Know the basics

What is promethazine used for?

Promethazine injection is used to treat nausea and vomiting related to certain conditions (e.g., after surgery, motion sickness). It is also used with other medication to treat life-threatening allergic symptoms (anaphylaxis) and reactions to blood products. The injectable form may be used to treat milder allergic reactions when you cannot take another medication by mouth. It may also be used before/after surgery, other procedures, or labor and delivery to help you feel calmer, to prevent nausea/vomiting, and to help certain narcotic pain relievers (e.g., meperidine) work better.

Promethazine is an antihistamine (phenothiazine type). It works by blocking a certain natural substance (histamine) that your body makes during an allergic reaction. Its other effects (e.g., anti-nausea, calming, pain relief) may work by affecting other natural substances (e.g., acetylcholine) and by acting directly on certain parts of the brain.

This medication should not be used in children younger than 2 years.

How should I take promethazine?

It is best to inject this medication deep into a muscle. It may also be injected slowly into a large vein (not in the hand or wrist) by a health care professional. Do not inject this medication under the skin or into an artery. If you have any questions about the proper use of this medication, ask your doctor or pharmacist.

Your dosage and how often you receive the medication will be determined by your weight, age, condition, and response to therapy. Injections may be repeated if needed, usually every 4 hours.

If you are giving this medication to yourself at home, learn all preparation and usage instructions from your health care professional. Before using, check this product visually for particles or discoloration. If either is present, do not use the liquid. Learn how to store and discard medical supplies safely.

Inform your doctor if your condition does not improve or if it worsens.

How do I store promethazine?

Store at room temperature away from light and moisture. Do not store in the bathroom. Do not freeze. Different brands of this medication may have different storage needs. Check the product package for instructions on how to store your brand, or ask your pharmacist. Keep all medicines away from children and pets.

Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company for more details about how to safely discard your product.

Know the precautions & warnings

What should I know before using promethazine?

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For this medicine, the following should be considered:

Allergies

Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Pediatric

Appropriate studies have not been performed on the relationship of age to the effects of promethazine injection in the pediatric population. Use of promethazine injection is not recommended in children younger than 2 years of age because of the increased risk of respiratory depression. Caution should be used when this medicine is given to children 2 years of age and older.

Geriatric

Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of promethazine injection in the elderly. However, elderly patients may be more sensitive to the side effects of this medicine than in younger adults, and are more likely to have age-related heart or blood vessel disease or prostate problems, which may require an adjustment in the dose for patients receiving promethazine injection.

Is it safe to take promethazine during pregnancy or breast-feeding?

There are no adequate studies in women for determining risk when using this medication during pregnancy or while breastfeeding. Please always consult with your doctor to weigh the potential benefits and risks before taking this medication. This medication is pregnancy risk category C (A=No risk, B=No risk in some studies, C=There may be some risk, D=Positive evidence of risk, X=Contraindicated, N=Unknown).

Know the side effects

What are the side effects of promethazine?

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Stop using promethazine and call your doctor at once if you have any of these serious side effects:

  • twitching, or uncontrollable movements of your eyes, lips, tongue, face, arms, or legs;
  • tremor (uncontrolled shaking), drooling, trouble swallowing, problems with balance or walking;
  • feeling restless, jittery, or agitated;
  • high fever, stiff muscles, confusion, sweating, fast or uneven heartbeats, rapid breathing;
  • feeling like you might pass out;
  • seizure (convulsions);
  • pale skin, easy bruising or bleeding, fever, sore throat, flu symptoms;
  • decreased night vision, tunnel vision, watery eyes, increased sensitivity to light;
  • hallucinations, agitation;
  • nausea and stomach pain, skin rash, and jaundice (yellowing of the skin or eyes);
  • urinating less than usual or not at all;
  • joint pain or swelling with fever, swollen glands, muscle aches, chest pain, vomiting, unusual thoughts or behavior, and patchy skin color; or
  • slow heart rate, weak pulse, fainting, slow breathing (breathing may stop).

Less serious side effects may include:

  • dizziness, drowsiness, anxiety;
  • blurred vision, dry mouth, stuffy nose;
  • ringing in your ears;
  • weight gain, swelling in your hands or feet;
  • impotence, trouble having an orgasm; or
  • constipation.

Not everyone experiences these side effects. There may be some side effects not listed above. If you have any concerns about a side-effect, please consult your doctor or pharmacist.

Know the interactions

What drugs may interact with promethazine?

Promethazine may interact with other drugs that you are currently taking, which can change how your drug works or increase your risk for serious side effects. To avoid any potential drug interactions, you should keep a list of all the drugs you are using (including prescription drugs, nonprescription drugs and herbal products) and share it with your doctor and pharmacist. For your safety, do not start, stop, or change the dosage of any drugs without your doctor’s approval.

Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.

  • Cisapride
  • Dronedarone
  • Grepafloxacin
  • Mesoridazine
  • Metoclopramide
  • Pimozide
  • Piperaquine
  • Sodium Oxybate
  • Sparfloxacin
  • Thioridazine

Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

  • Acrivastine
  • Alfuzosin
  • Amiodarone
  • Amitriptyline
  • Amoxapine
  • Anagrelide
  • Apomorphine
  • Aripiprazole
  • Arsenic Trioxide
  • Asenapine
  • Astemizole
  • Azithromycin
  • Buprenorphine
  • Bupropion
  • Buserelin
  • Carbinoxamine
  • Chloroquine
  • Chlorpromazine
  • Ciprofloxacin
  • Citalopram
  • Clarithromycin
  • Clomipramine
  • Clozapine
  • Crizotinib
  • Dabrafenib
  • Dasatinib
  • Delamanid
  • Desipramine
  • Deslorelin
  • Disopyramide
  • Dofetilide
  • Dolasetron
  • Domperidone
  • Droperidol
  • Erythromycin
  • Escitalopram
  • Fentanyl
  • Fingolimod
  • Flecainide
  • Fluconazole
  • Fluoxetine
  • Gatifloxacin
  • Gemifloxacin
  • Gonadorelin
  • Goserelin
  • Granisetron
  • Halofantrine
  • Haloperidol
  • Histrelin
  • Hydrocodone
  • Hydromorphone
  • Ibutilide
  • Iloperidone
  • Imipramine
  • Isradipine
  • Ivabradine
  • Ketoconazole
  • Lapatinib
  • Leuprolide
  • Levofloxacin
  • Levorphanol
  • Lithium
  • Lopinavir
  • Lumefantrine
  • Meclizine
  • Mefloquine
  • Methadone
  • Metrizamide
  • Metronidazole
  • Mifepristone
  • Morphine
  • Morphine Sulfate Liposome
  • Moxifloxacin
  • Nafarelin
  • Nilotinib
  • Norfloxacin
  • Nortriptyline
  • Octreotide
  • Ofloxacin
  • Ondansetron
  • Oxycodone
  • Oxymorphone
  • Paliperidone
  • Pazopanib
  • Pentamidine
  • Perflutren Lipid Microsphere
  • Posaconazole
  • Procainamide
  • Procarbazine
  • Prochlorperazine
  • Propafenone
  • Protriptyline
  • Quetiapine
  • Quinine
  • Ranolazine
  • Salmeterol
  • Saquinavir
  • Sevoflurane
  • Sodium Phosphate
  • Sodium Phosphate, Dibasic
  • Sodium Phosphate, Monobasic
  • Solifenacin
  • Sorafenib
  • Sotalol
  • Sunitinib
  • Suvorexant
  • Tapentadol
  • Telavancin
  • Telithromycin
  • Terfenadine
  • Tetrabenazine
  • Toremifene
  • Tramadol
  • Trifluoperazine
  • Trimipramine
  • Triptorelin
  • Umeclidinium
  • Vandetanib
  • Vardenafil
  • Vemurafenib
  • Voriconazole
  • Ziprasidone
  • Zolpidem

Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

  • Belladonna
  • Belladonna Alkaloids
  • Betel Nut
  • Evening Primrose
  • Meperidine
  • Midodrine
  • Perampanel
  • Phenylalanine

Does food or alcohol interact with promethazine?

Promethazine may interact with food or alcohol by altering the way the drug works or increase the risk for serious side effects. Please discuss with your doctor or pharmacist any potential food or alcohol interactions before using this drug.

Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.

  • Cisapride
  • Dronedarone
  • Grepafloxacin
  • Mesoridazine
  • Metoclopramide
  • Pimozide
  • Piperaquine
  • Sodium Oxybate
  • Sparfloxacin
  • Thioridazine

Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

  • Acrivastine
  • Alfuzosin
  • Amiodarone
  • Amitriptyline
  • Amoxapine
  • Anagrelide
  • Apomorphine
  • Aripiprazole
  • Arsenic Trioxide
  • Asenapine
  • Astemizole
  • Azithromycin
  • Buprenorphine
  • Bupropion
  • Buserelin
  • Carbinoxamine
  • Chloroquine
  • Chlorpromazine
  • Ciprofloxacin
  • Citalopram
  • Clarithromycin
  • Clomipramine
  • Clozapine
  • Crizotinib
  • Dabrafenib
  • Dasatinib
  • Delamanid
  • Desipramine
  • Deslorelin
  • Disopyramide
  • Dofetilide
  • Dolasetron
  • Domperidone
  • Droperidol
  • Erythromycin
  • Escitalopram
  • Fentanyl
  • Fingolimod
  • Flecainide
  • Fluconazole
  • Fluoxetine
  • Gatifloxacin
  • Gemifloxacin
  • Gonadorelin
  • Goserelin
  • Granisetron
  • Halofantrine
  • Haloperidol
  • Histrelin
  • Hydrocodone
  • Hydromorphone
  • Ibutilide
  • Iloperidone
  • Imipramine
  • Isradipine
  • Ivabradine
  • Ketoconazole
  • Lapatinib
  • Leuprolide
  • Levofloxacin
  • Levorphanol
  • Lithium
  • Lopinavir
  • Lumefantrine
  • Meclizine
  • Mefloquine
  • Methadone
  • Metrizamide
  • Metronidazole
  • Mifepristone
  • Morphine
  • Morphine Sulfate Liposome
  • Moxifloxacin
  • Nafarelin
  • Nilotinib
  • Norfloxacin
  • Nortriptyline
  • Octreotide
  • Ofloxacin
  • Ondansetron
  • Oxycodone
  • Oxymorphone
  • Paliperidone
  • Pazopanib
  • Pentamidine
  • Perflutren Lipid Microsphere
  • Posaconazole
  • Procainamide
  • Procarbazine
  • Prochlorperazine
  • Propafenone
  • Protriptyline
  • Quetiapine
  • Quinine
  • Ranolazine
  • Salmeterol
  • Saquinavir
  • Sevoflurane
  • Sodium Phosphate
  • Sodium Phosphate, Dibasic
  • Sodium Phosphate, Monobasic
  • Solifenacin
  • Sorafenib
  • Sotalol
  • Sunitinib
  • Suvorexant
  • Tapentadol
  • Telavancin
  • Telithromycin
  • Terfenadine
  • Tetrabenazine
  • Toremifene
  • Tramadol
  • Trifluoperazine
  • Trimipramine
  • Triptorelin
  • Umeclidinium
  • Vandetanib
  • Vardenafil
  • Vemurafenib
  • Voriconazole
  • Ziprasidone
  • Zolpidem

Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

  • Belladonna
  • Belladonna Alkaloids
  • Betel Nut
  • Evening Primrose
  • Meperidine
  • Midodrine
  • Perampanel
  • Phenylalanine

What health conditions may interact with promethazine?

Promethazine may interact with your health condition. This interaction may worsen your health condition or alter the way the drug works. It is important to always let your doctor and pharmacist know all the health conditions you currently have.

The presence of other medical problems may affect the use of this medicine. Make sure you tell your doctor if you have any other medical problems, especially:

  • Brain disease or injury or
  • Breathing or lung problems (e.g., asthma, COPD) or
  • Comatose state (unconscious) or
  • Reye’s syndrome or
  • Sleep apnea, history of—Should not be used in patients with these conditions.
  • Bladder-neck blockage or
  • Bone marrow disease (e.g., agranulocytosis, leukopenia) or
  • Enlarged prostate or
  • Glaucoma, narrow-angle or
  • Heart or blood vessel disease or
  • Intestinal blockage or
  • Liver disease (including jaundice) or
  • Neuroleptic malignant syndrome, history of or
  • Respiratory depression (very slow breathing) or
  • Stomach ulcer or
  • Urinary tract blockage or difficult urination—Use with caution. May make these conditions worse.
  • Seizure disorders—This medicine may increase the chance of seizures especially in patients who are also using narcotic or anesthetic medicines.

Understand the dosage

The information provided is not a substitute for any medical advice. You should ALWAYS consult with your doctor or pharmacist before using this Promethazine.

What is the dose of Promethazine for an adult?

Usual Adult Dose for Anaphylaxis

Parenteral: 25 mg IV or IM once, followed by close observation for response. This dose may be repeated within 2 hours if needed. Oral therapy should be started as soon as feasible if continued medication is required.

Oral: 25 mg orally once. This dose may be repeated every 4 hours as needed.

Rectal: 25 mg administered rectally once. This dose may be repeated every 4 hours as needed.

Usual Adult Dose for Allergic Reaction

Oral or rectal: 12.5 mg before meals and 25 mg at bedtime, if necessary. Alternatively, a single 25 mg dose given at bedtime or 6.25 mg to 12.5 mg three times daily.

IM or IV: 25 mg, may repeat in 2 hours if necessary.

Usual Adult Dose for Allergic Rhinitis

Parenteral: 25 mg IV or IM, followed by close observation for response. This dose may be repeated within 2 hours if needed. Oral therapy should be started as soon as feasible if continued medication is required.

Oral: 25 mg at bedtime. Alternatively, 12.5 mg may be administered before the evening meal and again at bedtime for antihistamine effects.

Rectal: 25 mg at bedtime. Alternatively, 12.5 mg may be administered before the evening meal and again at bedtime for antihistamine effects.

The safety of promethazine for long-term treatment of allergic rhinitis has not been established.

Usual Adult Dose for Light Sedation

Parenteral: 25 mg IV or IM once, followed by close observation for response. An additional dose, up to 50 mg, may be administered to achieve the desired clinical effect.

Oral: 25 mg once. An additional dose, up to 50 mg, may be administered to achieve the desired clinical effect.

Rectal: 25 mg once. An additional dose, up to 50 mg, may be administered to achieve the desired clinical effect.

Usual Adult Dose for Motion Sickness

Oral or rectal: 25 mg 30 to 60 minutes before departure, then every 12 hours as needed.

Usual Adult Dose for Nausea/Vomiting

Oral, rectal, IM or IV: 12.5 to 25 mg every 4 to 6 hours as needed.

Usual Adult Dose for Opiate Adjunct

Oral, rectal, IM or IV: 25 to 50 mg every 4 hours as needed to augment the effects of concomitantly administered opioids.

Usual Adult Dose for Urticaria

Parenteral: 25 mg IV or IM, followed by close observation for response. This dose may be repeated within 2 hours if needed. Oral therapy should be started as soon as feasible if continued medication is required.

Oral: 25 mg at bedtime. Alternatively, 12.5 mg may be administered before the evening meal and again at bedtime for antihistamine effects.

Rectal: 25 mg at bedtime. Alternatively, 12.5 mg may be administered before the evening meal and again at bedtime for antihistamine effects.

Usual Adult Dose for Sedation

Oral, rectal, IM or IV: 25 to 50 mg/dose.

Usual Adult Dose for Vertigo

Acute Vertigo:

Initial: 25 mg IM, IV, orally, or by suppository.

Maintenance: 12.5 to 50 mg every 4 to 8 hours.

Maximum daily dose should not exceed 75 mg.

What is the dose of Promethazine for a child?

Usual Pediatric Dose for Allergic Reaction

Greater than or equal to 2 years: oral or rectal: 0.1 mg/kg/dose every 6 hours during the day and 0.5 mg/kg/dose at bedtime as needed.

Usual Pediatric Dose for Motion Sickness

Greater than or equal to 2 years: Oral or rectal: 0.5 mg/kg (not to exceed 25 mg) 30 minutes to 1 hour before departure, then every 12 hours as needed.

Usual Pediatric Dose for Nausea/Vomiting

Greater than or equal to 2 years: oral, rectal, IM or IV: 0.25 to 1 mg/kg/dose (not to exceed 25 mg) 4 to 6 times a day as needed.

Usual Pediatric Dose for Sedation

Greater than or equal to 2 years: Sedation: oral, IM, IV, or rectal: 0.5 to 1 mg/kg/dose (not to exceed 25 mg) every 6 hours as needed.

Greater than or equal to 2 years: Preoperative analgesia/hypnotic adjunct: IM, IV: 1.1 mg/kg once in combination with an analgesic or hypnotic (at reduced dosage) and with an atropine-like agent (at appropriate dosage). Note: Promethazine dosage should not exceed half of suggested adult dosage.

How is Promethazine available?

Promethazine is available in the following dosage forms and strengths:

Tablets: 12.5 mg; 25 mg; 50 mg

What should I do in case of an emergency or overdose?

In case of an emergency or an overdose, call your local emergency services or go to your nearest emergency room.

Symptoms of overdose may include:

  • difficulty breathing
  • slowed or stopped breathing
  • dizziness
  • lightheadedness
  • fainting
  • loss of consciousness
  • fast heartbeat
  • tight muscles that are difficult to move
  • loss of coordination
  • continuous twisting movements of the hands and feet
  • dry mouth
  • wide pupils (black circles in the middle of the eyes)
  • flushing
  • nausea
  • constipation
  • abnormal excitement or agitation
  • nightmares

What should I do if I miss a dose?

If you miss a dose of Promethazine, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and take your regular dose as scheduled. Do not take a double dose.

Hello Health Group does not provide medical advice, diagnosis or treatment.

msBahasa Malaysia

Review Date: May 30, 2016 | Last Modified: January 4, 2017

Sources