Promethazine

Pronunciation: proe-METH-a-zeen
Generic Name: Promethazine
Brand Name: Phenergan

Promethazine should not be used in children younger than 2 years old. Potentially fatal side effects (eg, difficult or slowed breathing, drowsiness leading to coma) may occur in this age group when taking Promethazine.

Caution should be used when using Promethazine in children 2 years old and older. The lowest possible dose should be used in this age group, and it should not be used with other medicines that cause slowed breathing.

Promethazine is usually given as an injection into a muscle (IM) or a vein (IV). It should not be injected into an artery or under the skin. Serious tissue damage, including gangrene, may occur if it is injected into these areas. Tissue damage may also occur in some cases following injection into a vein. This may occur right away or up to several hours or days after you receive a dose. Contact your doctor immediately if you notice burning, pain, swelling, or blistering around the injection site.

Promethazine is used for:

Relieving allergy symptoms (eg, itching, hives). It is used to prevent and control nausea and vomiting during and after surgery. It is also used to help produce light sleep; treat motion sickness; or treat pain after surgery, in combination with other medicines. It may also be used for other conditions as determined by your doctor.

Promethazine is a phenothiazine antihistamine. It works by blocking histamine, which decreases the symptoms of allergies and helps decrease nausea and vomiting.

Do NOT use Promethazine if:

• you are allergic to any ingredient in Promethazine


• you have severe central nervous system depression or are in a coma


• you have severe lung or breathing problems (eg, chronic obstructive pulmonary disease [COPD], sleep apnea)


• you are also taking astemizole, cisapride, terfenadine, or tramadol

Contact your doctor or health care provider right away if any of these apply to you.

Before using Promethazine:

Some medical conditions may interact with Promethazine. Tell your doctor or pharmacist if you have any medical conditions, especially if any of the following apply to you:

• if you are pregnant, planning to become pregnant, or are breast-feeding


• if you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement


• if you have allergies to medicines, foods, or other substances


• if you have a history of nervous system problems, bone marrow depression, heart problems, a blood disease, glaucoma, increased eye pressure, low blood pressure, liver problems, stomach problems (eg, ulcers), a blockage of your bladder or bowel, an enlarged prostate, Parkinson disease, seizures, or Reye syndrome


• if you are dehydrated, regularly consume large amounts of alcohol, or you will be exposed to very high temperatures

Some MEDICINES MAY INTERACT with Promethazine. Tell your health care provider if you are taking any other medicines, especially any of the following:

• Angiotensin-converting enzyme (ACE) inhibitors (eg, enalapril), astemizole, cisapride, general anesthetics (eg, thiopental), methyldopa, terfenadine, or tramadol because side effects, such as low blood pressure and seizures, may occur


• ACE inhibitors (eg, enalapril), haloperidol, lithium, meperidine, metrizamide, monoamine oxidase inhibitors (MAOIs) (eg, phenelzine), naltrexone, polypeptide antibiotics (eg, actinomycin), trazodone, or tretinoin because the risk of their side effects may be increased by Promethazine


• Bromocriptine, epinephrine, levodopa, or pergolide because their effectiveness may be decreased by Promethazine

This may not be a complete list of all interactions that may occur. Ask your health care provider if Promethazine may interact with other medicines that you take. Check with your health care provider before you start, stop, or change the dose of any medicine.

How to use Promethazine:

Use Promethazine as directed by your doctor. Check the label on the medicine for exact dosing instructions.

• Promethazine is usually given as an injection at your doctor's office, hospital, or clinic. If you will be using Promethazine at home, a health care provider will teach you how to use it. Be sure you understand how to use Promethazine. Follow the procedures you are taught when you use a dose. Contact your health care provider if you have any questions.


• Promethazine should be given as an injection into a muscle or a vein. Do not inject Promethazine into an artery or under the skin.


• Do not use Promethazine if it contains particles, is cloudy or discolored, or if the vial is cracked or damaged.


• Keep this product, as well as syringes and needles, out of the reach of children and pets. Do not reuse needles, syringes, or other materials. Ask your health care provider how to dispose of these materials after use. Follow all local rules for disposal.


• If you are using Promethazine for motion sickness, take a dose at least 30 to 60 minutes before you begin traveling.


• If you miss a dose of Promethazine and you are using it regularly, use it as soon as possible. If several hours have passed or if it is nearing time for the next dose, do not double the dose to catch up, unless advised by your health care provider. Do not use 2 doses at once.

Ask your health care provider any questions you may have about how to use Promethazine.

Important safety information:

• Promethazine may cause drowsiness, dizziness, or blurred vision. These effects may be worse if you use it with alcohol or certain medicines. Use Promethazine with caution. Do not drive or perform other possibly unsafe tasks until you know how you react to it.


• Do not drink alcohol or use medicines that may cause drowsiness (eg, sleep aids, muscle relaxers) while you are using Promethazine; it may add to their effects. Ask your pharmacist if you have questions about which medicines may cause drowsiness.


• Some of these products contain sulfites. Sulfites may cause an allergic reaction in some patients (eg, asthma patients). If you have ever had an allergic reaction to sulfites, ask your pharmacist if your product has sulfites in it.


• Promethazine may increase your risk of seizures. Your risk may be greater if you also have certain medical conditions, use certain medicines, or if you use a lot of alcohol. Talk to your doctor to see if you may have a greater risk of seizures while taking Promethazine.


• Neuroleptic malignant syndrome (NMS) is a possibly fatal syndrome that can be caused by Promethazine. Symptoms may include fever; stiff muscles; confusion; abnormal thinking; fast or irregular heartbeat; and sweating. Contact your doctor at once if you have any of these symptoms.


• Promethazine may cause you to become sunburned more easily. Avoid the sun, sunlamps, or tanning booths until you know how you react to Promethazine. Use a sunscreen or wear protective clothing if you must be outside for more than a short time.


• Promethazine may cause the results of some pregnancy tests to be wrong. Check with your doctor if you have questions or concerns about your pregnancy test results.


• Diabetes patients - Promethazine may affect your blood sugar. Check blood sugar levels closely. Ask your doctor before you change the dose of your diabetes medicine.


• Use Promethazine with extreme caution in the ELDERLY; they may be more sensitive to its effects, especially drowsiness.


• Promethazine should not be used in CHILDREN younger than 2 years old. Serious, and sometimes fatal, side effects (difficult or slowed breathing, drowsiness leading to coma) have occurred when Promethazine has been used in children in this age group.


• Promethazine should be used with extreme caution in CHILDREN 2 years old or older. The lowest effective dose should be used in children 2 years old and older.


• PREGNANCY and BREAST-FEEDING: If you become pregnant, contact your doctor. You will need to discuss the benefits and risks of using Promethazine while you are pregnant. It is not known if Promethazine is found in breast milk. Do not breast-feed while using Promethazine.

Possible side effects of Promethazine:

All medicines may cause side effects, but many people have no, or minor, side effects. Check with your doctor if any of these most COMMON side effects persist or become bothersome:

Dizziness; drowsiness; dry mouth; nausea; vomiting; weakness.

Seek medical attention right away if any of these SEVERE side effects occur:

Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); blurred vision; burning, pain, swelling, or blistering around the injection site; confusion; excessive sweating; fainting; fever, chills, or persistent sore throat; hallucinations; loss of coordination; mental or mood changes (eg, agitation, delirium, exaggerated sense of well-being, excitability, hysteria, nervousness); ringing in the ears; seizures; severe of persistent dizziness; shortness of breath or trouble breathing; slow or fast heartbeat; tremor; trouble sleeping; uncontrolled muscle movements (eg, arm or leg movements, twitching of the face or tongue, jerking or twisting); unusual bruising or bleeding; yellowing of the skin or eyes.

This is not a complete list of all side effects that may occur. If you have questions about side effects, contact your health care provider. Call your doctor for medical advice about side effects. To report side effects to the appropriate agency, please read the Guide to Reporting Problems to FDA.

See also: Promethazine side effects (in more detail)

If OVERDOSE is suspected:

Contact 1-800-222-1222 (the American Association of Poison Control Centers), your local poison control center, or emergency room immediately. Symptoms may include convulsions; dry mouth; flushing; hallucinations; loss of consciousness; nightmares; seizures; shortness of breath; trouble breathing; unusual drowsiness or restlessness.

Proper storage of Promethazine:

Promethazine is usually handled and stored by a health care provider. If you are using Promethazine at home, store Promethazine as directed by your pharmacist or health care provider. Keep Promethazine out of the reach of children and away from pets.

General information:

• If you have any questions about Promethazine, please talk with your doctor, pharmacist, or other health care provider.


• Promethazine is to be used only by the patient for whom it is prescribed. Do not share it with other people.


• If your symptoms do not improve or if they become worse, check with your doctor.


• Check with your pharmacist about how to dispose of unused medicine.

This information is a summary only. It does not contain all information about Promethazine. If you have questions about the medicine you are taking or would like more information, check with your doctor, pharmacist, or other health care provider.

Issue Date: February 1, 2012

Database Edition 12.1.1.002

Copyright © 2012 Wolters Kluwer Health, Inc.

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Compare Promethazine with other medications

• Allergic Reactions
• Anaphylaxis
• Hay Fever
• Light Sedation
• Motion Sickness
• Nausea/Vomiting
• Opiate Adjunct
• Sedation
• Urticaria
• Vertigo