Promethazine (Phenergan, Anergan)

Category:

• Nervous System

Description:

• Antihistamine, antiemetic, sedative, antitussive, antivertigo agent

Indications:

• Symptomatic relief of various allergies, active and prophylactic treatment of motion sickness

• Preoperative, postoperative, or obstetric sedation

• Nausea/vomiting associated with anesthesia and surgery

• Adjunct to analgesic for control of postoperative pain

Contraindications:

• Narrow-angle glaucoma

Precautions:

• Pregnancy category C

• Acute asthma, bladder neck obstruction, prostatic hypertrophy

• Predisposition to urinary retention, cardiovascular disease, glaucoma

• Hepatic function impairment, hypertension, history of peptic ulcer

• Seizure disorder, intestinal obstruction

Adverse Reactions (Side Effects):

• CNS: anxiety, confusion, dizziness, drowsiness, EPS reactions, paradoxical hyperexcitability, euphoria, fatigue, poor coordination

• CV: hypotension, palpitations, tachycardia

• EENT: Blurred vision, dilated pupils, dry nose, nasal stuffiness, tinnitus

• GI: anorexia, cholestatic jaundice, constipation, diarrhea, dry mouth nausea, vomiting

• GU: amenorrhea, dysuria, galactorrhea, gynecomastia, impotence, urinary retention

• HEME: agranulocytosis, hemolytic anemia, thrombocytopenia

• METAB: hyperprolactinemia

• RESP: chest tightness, increased thick secretions, wheezing

• SKIN: photosensitivity, rash, urticaria  

Dosage:

Administered orally, rectally, intramuscularly, intravenously

• Adult:             

  • Antihistimine: 

    • PO/PR 12.5mg 3 times daily and 25mg at bedtime

    • IM/IV 25mg, repeated in 2 hours if necessary, convert to PO as soon as possible

  • Antiemetic: 

    • PO/IM/IV/PR 12.5-25mg every 4 hours as needed

  • Motion sickness: 

    • PO/PR 25mg 30-60mg prior to departure, then every 12 hours as needed

  • Sedation: 

    • PO/IM/IV/PR 25-50mg daily

• Child:            

  • Antihistamine: 

    • PO/PR 0.1 mg/kg/dose every 6 hours during the day and 0.5 mg/kg at bedtime as needed

  • Antiemetic: 

    • PO/IM/IV/PR 0.25-1 mg/kg every 4-6 hours as needed

  • Motion sickness: 

    • PO/PR 0.5 mg/kg/dose 30-60 minutes prior to departure, then every 12 hours as needed

  • Sedation: 

    • PO/IM/IV/PR 0.5-1 mg/kg/dose every 6 hours as needed