Promethazine: functions, dosage, side effects, how to use

What drug Promethazine?

What is Promethazine for?

Promethazine is a drug with a function to treat nausea and vomiting associated with certain conditions (for example, after surgery). This medication is also used to treat symptoms of fatal allergies (anaphylaxis) and reactions to blood products. The injectable form can be used to treat mild allergic reactions when you are unable to take the medicine. It can also be used before / after surgery, other procedures or delivery to calm you down, prevent nausea / vomiting, and to help certain narcotic pain relievers (for example, meperidene) work better.

Promethazine is an antihistamine (phenothiazine type). Works by blocking certain natural substances (histamine) that your body excretes during an allergic reaction. Other effects (eg anti-nausea, sedative, pain reliever) can work by affecting other natural substances (eg acetylcholine) and acting directly on certain parts of the brain.

This medicine should not be used in children younger than 2 years of age.

The promethazine dosage and the side effects of promethazine are described further below.

How to use Promethazine?

Follow the rules given by your doctor or pharmacist before starting treatment. If you have any questions, consult your doctor or pharmacist.

The best way to use this medication is by injecting it deep into the muscle. It can also be injected slowly into a large vein (not in the hand or wrist) by a medical professional. Do not inject this medication under the skin or into an artery. If you have questions, ask your doctor or pharmacist.

The dose and frequency of drug administration will be determined based on body weight, age, condition, and response to treatment. The injections can be repeated as needed, usually every 4 hours.

If you are self-medicating at home, learn all the preparations and instructions for use from a healthcare professional. Before use, check the product for particles or discoloration. If either of the two things happens, do not use the liquid. Learn how to store and dispose of medical equipment safely.

Tell your doctor if your condition does not improve or gets worse.

How is Promethazine stored?

This medication is best stored at room temperature, away from direct light and damp places. Don't keep it in the bathroom. Don't freeze it. Other brands of this drug may have different storage rules. Observe the storage instructions on the product package or ask your pharmacist. Keep all medicines away from children and pets.

Do not flush medicines down the toilet or down the drain unless instructed to do so. Discard this product when it has expired or when it is no longer needed. Consult your pharmacist or local waste disposal company about how to safely dispose of your product.

Promethazine dosage

The information provided is not a substitute for medical advice. ALWAYS consult your doctor or pharmacist before starting treatment.

What is the dosage of Promethazine for adults?

Standard adult dosage for Anaphylaxis

Parenteral: 25 mg IV or IM once, followed by close monitoring for response. This dose can be repeated within 2 hours if needed. Oral medication is given as soon as possible if treatment is needed

Oral: 25 mg taken by mouth once. This dose can be repeated every 4 hours as needed.

Rectal: 25 mg given once. This dose can be repeated every 4 hours as needed.

Standard adult dosage for allergic reactions

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

IM or IV: 25 mg, can be repeated within 2 hours if needed.

Standard adult dosage for allergic rhinitis

Parenteral: 25 mg IV or IM once, followed by close monitoring for response. This dose can be repeated within 2 hours if needed. Oral medication is given as soon as possible if treatment is needed

Oral: 25 mg at bedtime. Alternatively, 12.5 mg can be given before dinner and given again at bedtime for the antihistamine effect.

Rectal: 25 mg at bedtime. Alternatively, 12.5 mg can be given before dinner and given again at bedtime for the antihistamine effect.

The safety of using promethazine for a long time to treat allergic rhinitis has not been determined.

Standard adult dosage for mild sedation

Parenteral: 25 mg IV or IM once, followed by close monitoring for response. Additional doses, up to 50 mg, may be given to obtain the desired clinical effect.

Oral: 25 mg once. Additional doses, up to 50 mg, may be given to obtain the desired clinical effect.

Rectal: 25 mg once. Additional doses, up to 50 mg, may be given to obtain the desired clinical effect.

Standard adult dosage for hangovers

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

Standard adult dosage for nausea / vomiting

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

Standard adult dosage for Opiate Adjunct

Oral, rectal, IM or IV: 25 to 50 mg every 4 hours as needed to increase the effect of co-administered opioids.

Standard adult dosage for Urticaria

Parenteral: 25 mg IV or IM, followed by close monitoring for response. Can be given again within 2 hours if needed. Oral medication is given as soon as possible if further treatment is needed.

Oral: 25 mg at bedtime. Alternatively, 12.5 mg can be given before dinner and repeated at bedtime for antihistamine effects

Rectal: 25 mg at bedtime. Alternatively, 12.5 mg can be given before dinner and repeated at bedtime for antihistamine effects

Standard adult dosage for Sedation

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

Standard adult dosage for vertigo

Acute Vertigo:

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

Maintenance:

12.5 to 50 mg every 4 to 8 hours

The maximum dose does not exceed 75 mg.

What is the dosage of Promethazine for children?

Standardized pediatric dosage for allergic reactions

More than or the equivalent of 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

Standard pediatric dosage for motion sickness

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

Standard pediatric dosage for Nausea / Vomiting

More than or the equivalent of 2 years: oral or rectal, IM or IV: 0.25 to 1 mg / kg / dose (not more than 25 mg) 4 to 6 times daily as needed

Standard pediatric dosage for Sedation

More than or the equivalent of 2 years:

Sedation: oral, IM, IV, or rectal: 0.5 to 1 mg / kg / dose (no more than 25 mg) every 6 hours as needed.

More than or the equivalent of 2 years: preoperative analgesia / hypnotic adjunct: IM, IV: 1.1 mg / kg once combined with an analgesic or hypnotic (reduced dose) and with an atropine-like agent (at the appropriate dose). Note: the dose of promethazine should not exceed half the recommended dose for adults.

In what dosage is Promethazine available?

Promethazine is available in the following dosages.

Tablets: 12.5 mg; 25 mg; 50 mg

Promethazine side effects

What side effects can be experienced due to Promethazine?

Seek medical help immediately if you experience an allergic reaction: hives; difficulty breathing; swelling of the face, lips, tongue, or throat.

Stop using promethazine and contact your doctor if you experience the following serious side effects:

• Twitching or involuntary movements of your eyes, lips, tongue, face, arms, or legs
• Uncontrolled shaking, drooling, difficulty swallowing, problems with balance or walking
• Feeling restless, restless
• High fever, stiff muscles, sweating, fast or irregular heartbeat, fast breathing
• Feeling about to pass out
• Convulsions
• Pale skin, easy sores or bleeding, sore throat, flu symptoms
• Decreased vision at night, watery eyes, increased sensitivity to light
• Hallucinations
• Nausea and stomach pain, skin rash, and jaundice (yellowing of the skin or eyes);
• Urinating less frequently
• Joint pain or swelling accompanied by fever, swollen glands, muscle aches, behavior or thoughts that are different from usual, uneven skin color; or
• Slow heart rate, weak pulse, fainting, slow breathing (even breathing may stop).

Less serious side effects include:

• Dizziness, drowsiness, anxiety
• Blurred vision, dry mouth, blocked nose
• Ringing in the ears
• Weight gain, swelling of the hands or feet
• Impotence, difficulty orgasm; or
• Constipation.

Not everyone experiences the following side effects. There may be some side effects not listed above. If you have concerns about certain side effects, consult your doctor or pharmacist.

Promethazine Drug Warnings and Cautions

What should be known before using Promethazine?

In deciding to use this drug, the risks of using the drug must be carefully considered with the benefits that will be obtained later. This is a decision you and your doctor will make. For this remedy, here's what you need to consider:

Allergy

Tell your doctor if you have had any different reactions or are allergic to this or any other medicine. And tell your doctor if you have certain allergies, such as to food, dyes, preservatives, or animals. For over-the-counter products, read the labels or ingredients on the packaging carefully.

Children

Further studies have not been conducted regarding the relationship between age and the effect of promethazine injection in the pediatric population. The use of promethazine injections is not recommended in children under 2 years of age because it increases the risk of respiratory depression. Be careful when giving drugs to children 2 years of age and older.

Elderly

Research conducted to date has not demonstrated specific problems in geriatrics regarding the limited usefulness of promethazine injection in the elderly. However, elderly patients are more sensitive to the side effects of this drug than young adults, and tend to be more susceptible to heart or blood vessel disease or prostate problems, requiring an adjustment in the dose for elderly patients receiving promethazine injection.

Is Promethazine safe for pregnant and lactating women?

There is no adequate research on the risks of using this drug in pregnant or breastfeeding women. Always consult your doctor to weigh the potential benefits and risks before using this medication. This drug is included in the risk of pregnancy category C according to the US Food and Drug Administration (FDA). The following references the pregnancy risk categories according to the FDA:

A = No risk, B = not at risk in several studies, C = May be risky, D = There is positive evidence of risk, X = Contraindicated, N = Unknown

Promethazine Drug Interactions

What medicines may interact with Promethazine?

Drug interactions can change the performance of your medications or increase the risk of serious side effects. Not all possible drug interactions are listed in this document. Keep a list of all the products you use (including prescription / non-prescription drugs and herbal products) and consult your doctor or pharmacist. Do not start, stop, or change the dose of any medication without your doctor's approval.

Using this medication with any of the following drugs is not recommended. Your doctor may decide not to treat you with this drug or change some of the medicines you have used.

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

Using this medication with any of the following drugs is usually not recommended, but may be needed in some cases. If both drugs are prescribed together, your doctor may change the dose or the frequency with which you use one or both drugs.

• 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 medication with one of the following drugs will increase your risk of certain side effects, but taking the two drugs together may be the best treatment for you. If both drugs are prescribed together, your doctor may change the dose or how often you use one or both drugs.

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

Can food or alcohol interact with Promethazine?

Certain drugs should not be used with meals or when eating certain foods because drug interactions can occur. Consuming alcohol or tobacco with certain drugs can also cause interactions to occur. Discuss your use of drugs with food, alcohol, or tobacco with your health care provider.

What health conditions may interact with Promethazine?

The presence of other health problems in your body may affect the use of this medicine. Tell your doctor if you have other health problems, especially:

• Brain disease or injury
• Breathing or lung problems (eg, asthma, COPD)
• Coma condition
• Reye's Syndrome
• Apnea — Should not be used in patients with this condition
• Bladder blockage
• Bone marrow disease (eg, agranulocytosis, leukopenia)
• Enlarged prostate
• Glaucoma
• Heart or blood vessel disease
• Indigestion
• Liver disease (including jaundice)
• Neuroleptic malignant syndrome
• Respiratory depression
• Gastric ulcer
• Difficulty urinating — Use with caution. Can make conditions worse
• Seizures — This drug can increase the risk of seizures, especially in patients who are also taking narcotic drugs or anesthetics.

Promethazine overdose

What should I do in an emergency or overdose?

In case of an emergency or overdose, contact the local emergency services provider (112) or immediately to the nearest hospital emergency department.

Symptoms of an overdose include:

• Difficulty breathing
• Slow or stopped breathing
• Dizzy
• Dizziness
• Fainting
• Loss of consciousness
• Fast heart rate
• Stiff muscles make it difficult to move
• Hands and feet can't stop moving
• Dry mouth
• Enlarged eyeballs (black circle in the middle of the eye)
• Flushing
• Nausea
• Constipation
• Feeling excited or restless
• Nightmare

What should I do if I miss a dose?

If you forget a dose of this medicine, take it as soon as possible. However, when it is nearing the time of the next dose, skip the missed dose and return to the usual dosing schedule. Don't double the dose.