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promethazine (injection)

Pronunciation

Generic Name: promethazine (injection) (pro METH a zeen)
Brand Name: Phenergan

What is promethazine injection?

Promethazine is in a group of drugs called phenothiazines (FEEN-oh-THYE-a-zeens). It works by changing the actions of chemicals in your brain.

Promethazine is used to treat or prevent nausea and vomiting caused by anesthesia or surgery, certain types of allergic reactions, pain caused by surgery or childbirth, and to sedate patients before surgery or medical procedures.

Promethazine injection is usually given when a person cannot take the medication orally (by mouth).

Promethazine injection may also be used for purposes not listed in this medication guide.

What is the most important information I should know about promethazine injection?

Promethazine should not be given to a child younger than 2 years old. Promethazine can cause severe breathing problems or death in very young children.

Tell your caregivers if you feel any burning, pain, or swelling around the IV needle when promethazine is injected.

Call your doctor at once if you later develop symptoms throughout your body, such as: severe pain, burning, swelling, numbness, cold feeling, severe irritation, skin changes, or discoloration in your fingers or toes.

What should I discuss with my health care provider before I receive promethazine injection?

You should not receive this medicine if you are allergic to promethazine or to similar medicines such as chlorpromazine, fluphenazine, mesoridazine, perphenazine, prochlorperazine, thioridazine, or trifluperazine.

Promethazine should not be given to a child younger than 2 years old. Promethazine can cause severe breathing problems or death in very young children.

To make sure promethazine is safe for you, tell your doctor if you have:

  • asthma, chronic obstructive pulmonary disease (COPD), sleep apnea, or other breathing disorder;

  • a sulfite allergy;

  • a history of seizures;

  • a weak immune system (bone marrow depression);

  • glaucoma;

  • enlarged prostate or problems with urination;

  • stomach ulcer or obstruction;

  • heart disease or high blood pressure;

  • liver disease;

  • adrenal gland tumor (pheochromocytoma);

  • low levels of calcium in your blood (hypocalcemia); or

  • if you have ever had a serious side effect while using promethazine or any other phenothiazine.

FDA pregnancy category C. It is not known whether promethazine will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant while using this medicine.

It is not known whether promethazine passes into breast milk or if it could harm a nursing baby. You should not breast-feed while using this medicine.

How is promethazine injection given?

Promethazine is injected deep into a muscle. A healthcare provider will give you this injection.

Promethazine injection is usually given every 2 to 4 hours depending on the condition it is used for.

Tell your caregivers if you feel any burning, pain, or swelling around the IV needle when promethazine is injected.

Promethazine injection is usually given for only a short time until no longer needed or until you can take promethazine by mouth.

This medicine can cause unusual results with certain medical tests. Tell any doctor who treats you that you have recently received promethazine injection.

What happens if I miss a dose?

Since promethazine injection is given by a healthcare professional, you are not likely to miss a dose.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

Overdose symptoms may include overactive reflexes, loss of coordination, severe drowsiness or weakness, fainting, dilated pupils, weak or shallow breathing, or seizure (convulsions).

What should I avoid while receiving promethazine injection?

This medicine may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be alert. Avoid getting up too fast from a sitting or lying position, or you may feel dizzy. Get up slowly and steady yourself to prevent a fall.

Avoid exposure to sunlight or tanning beds. Promethazine can make you sunburn more easily. Wear protective clothing and use sunscreen (SPF 30 or higher) when you are outdoors.

Promethazine injection side effects

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

Tell your caregivers at once if you have:

  • pain, burning, irritation, or skin changes where the injection was given;

  • severe pain, swelling, numbness, cold feeling, or discoloration in your fingers or toes;

  • weak or shallow breathing;

  • hallucinations;

  • uncontrolled muscle movements in your face (chewing, lip smacking, frowning, tongue movement, blinking or eye movement);

  • jaundice (yellowing of the skin or eyes);

  • easy bruising or bleeding (nosebleeds, bleeding gums);

  • sudden weakness or ill feeling, fever, chills, sore throat, mouth sores, red or swollen gums, trouble swallowing; or

  • severe nervous system reaction--very stiff (rigid) muscles, high fever, sweating, confusion, fast or uneven heartbeats, tremors, feeling like you might pass out.

Common side effects may include:

  • drowsiness, dizziness;

  • ringing in your ears;

  • double vision;

  • feeling nervous;

  • dry mouth; or

  • tired feeling, sleep problems (insomnia).

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

See also: Side effects (in more detail)

Promethazine dosing information

Usual Adult Dose for Allergic Reaction:

Oral or Rectal: 6.25 to 12.5 mg orally or rectally before meals and at bedtime, if necessary, OR 25 mg orally or rectally once a day at bedtime

Parenteral: 25 mg IM or IV once, and may be repeated within 2 hours if necessary

Comments:
-Once treatment begins, the dose should be reduced to the smallest effective amount needed to control symptoms.
-Minor transfusion and/or amelioration of allergic reactions may be controlled with 25 mg doses.

Uses:
-Allergic conjunctivitis due to inhalant allergens and foods
-Amelioration of allergic reactions to blood or plasma
-Dermographism
-In anaphylaxis as an adjunct to epinephrine and other standard measures after the acute symptoms have been controlled
-Mild, uncomplicated allergic skin manifestations of urticaria and angioedema
-Other uncomplicated allergic condition of the immediate type when oral therapy is impossible or contraindicated
-Perennial and seasonal allergic rhinitis
-Vasomotor rhinitis

Usual Adult Dose for Allergic Rhinitis:

Oral or Rectal: 6.25 to 12.5 mg orally or rectally before meals and at bedtime, if necessary, OR 25 mg orally or rectally once a day at bedtime

Parenteral: 25 mg IM or IV once, and may be repeated within 2 hours if necessary

Comments:
-Once treatment begins, the dose should be reduced to the smallest effective amount needed to control symptoms.
-Minor transfusion and/or amelioration of allergic reactions may be controlled with 25 mg doses.

Uses:
-Allergic conjunctivitis due to inhalant allergens and foods
-Amelioration of allergic reactions to blood or plasma
-Dermographism
-In anaphylaxis as an adjunct to epinephrine and other standard measures after the acute symptoms have been controlled
-Mild, uncomplicated allergic skin manifestations of urticaria and angioedema
-Other uncomplicated allergic condition of the immediate type when oral therapy is impossible or contraindicated
-Perennial and seasonal allergic rhinitis
-Vasomotor rhinitis

Usual Adult Dose for Anaphylaxis:

Oral or Rectal: 6.25 to 12.5 mg orally or rectally before meals and at bedtime, if necessary, OR 25 mg orally or rectally once a day at bedtime

Parenteral: 25 mg IM or IV once, and may be repeated within 2 hours if necessary

Comments:
-Once treatment begins, the dose should be reduced to the smallest effective amount needed to control symptoms.
-Minor transfusion and/or amelioration of allergic reactions may be controlled with 25 mg doses.

Uses:
-Allergic conjunctivitis due to inhalant allergens and foods
-Amelioration of allergic reactions to blood or plasma
-Dermographism
-In anaphylaxis as an adjunct to epinephrine and other standard measures after the acute symptoms have been controlled
-Mild, uncomplicated allergic skin manifestations of urticaria and angioedema
-Other uncomplicated allergic condition of the immediate type when oral therapy is impossible or contraindicated
-Perennial and seasonal allergic rhinitis
-Vasomotor rhinitis

Usual Adult Dose for Urticaria:

Oral or Rectal: 6.25 to 12.5 mg orally or rectally before meals and at bedtime, if necessary, OR 25 mg orally or rectally once a day at bedtime

Parenteral: 25 mg IM or IV once, and may be repeated within 2 hours if necessary

Comments:
-Once treatment begins, the dose should be reduced to the smallest effective amount needed to control symptoms.
-Minor transfusion and/or amelioration of allergic reactions may be controlled with 25 mg doses.

Uses:
-Allergic conjunctivitis due to inhalant allergens and foods
-Amelioration of allergic reactions to blood or plasma
-Dermographism
-In anaphylaxis as an adjunct to epinephrine and other standard measures after the acute symptoms have been controlled
-Mild, uncomplicated allergic skin manifestations of urticaria and angioedema
-Other uncomplicated allergic condition of the immediate type when oral therapy is impossible or contraindicated
-Perennial and seasonal allergic rhinitis
-Vasomotor rhinitis

Usual Adult Dose for Light Sedation:

Oral or Rectal: 25 to 50 mg orally or rectally once

Parenteral:
-Early stages of labor: 50 mg IM or IV once
-Nighttime sedation: 25 to 50 mg IM or IV once

Comments:
-Oral and rectal formulations may be used for nighttime, presurgical, or obstetrical sedation.
-Sedative doses may be given the night before surgery.
-Preoperative doses should be given with appropriate doses of an analgesic/hypnotic and an atropine-like agent.

Uses:
-For sedation and relief of apprehension and to produce light sleep from which the patient can be easily aroused
-Preoperative, postoperative, and obstetric (during labor) sedation

Usual Adult Dose for Sedation:

Oral or Rectal: 25 to 50 mg orally or rectally once

Parenteral:
-Early stages of labor: 50 mg IM or IV once
-Nighttime sedation: 25 to 50 mg IM or IV once

Comments:
-Oral and rectal formulations may be used for nighttime, presurgical, or obstetrical sedation.
-Sedative doses may be given the night before surgery.
-Preoperative doses should be given with appropriate doses of an analgesic/hypnotic and an atropine-like agent.

Uses:
-For sedation and relief of apprehension and to produce light sleep from which the patient can be easily aroused
-Preoperative, postoperative, and obstetric (during labor) sedation

Usual Adult Dose for Motion Sickness:

Treatment:
-Oral and Rectal: 25 mg orally, or rectally once, then 12.5 to 25 mg every 4 to 6 hours as needed
-Parenteral: 12.5 to 25 mg IM or IV every 4 hours as needed

Prophylaxis:
-Initial day: 25 mg orally or rectally 30 to 60 minutes before traveling, then 8 to 12 hours as needed
-Succeeding days of travel: 25 mg orally or rectally upon rising, with the dose repeated before the evening meal

Comment:
-Oral formulations are preferred; however, rectal or parenteral formulations may be given if oral formulations are not tolerated.

Use:
-Active and prophylactic treatment of motion sickness

Usual Adult Dose for Nausea/Vomiting:

Treatment: 12.5 to 25 mg IM, IV, orally, or rectally every 4 hours as needed

Prophylaxis:
-Oral and Rectal: 25 mg orally every 4 to 6 hours as needed

Comments:
-Parenteral or rectal formulations may be used when patients cannot tolerate oral formulations.
-Prophylactic doses may be used to prevent nausea and vomiting during surgery and the postoperative period.

Uses:
-Prevention and control of nausea and vomiting associated with certain types of anesthesia and surgery
-Antiemetic therapy in postoperative patients

Usual Adult Dose for Opiate Adjunct:

Parenteral:
Pre- or postoperative use: 25 to 50 mg IM or IV once
Established labor: 25 to 75 mg IM or IV, repeated up to 2 times in 4-hour intervals
-Maximum dose: 100 mg every 24 hours

Comments:
-The average parenteral dose given during established labor is 50 mg.
-Preoperative doses should be given with appropriate doses of an analgesic/hypnotic and an atropine-like agent.

Uses:
-Administered IV as an adjunct to anesthesia or analgesia with reduced amounts of meperidine of other narcotic analgesics in special surgical situations (e.g., repeated bronchoscopy, ophthalmic surgery, poor-risk patients)
-Therapy adjunctive to meperidine or other analgesics for control of postoperative pain

Usual Pediatric Dose for Allergic Reaction:

2 years and older:
Oral or Rectal: 6.25 to 12.5 mg orally or rectally before meals and at bedtime, as necessary OR 25 mg orally or rectally once a day at bedtime

Parenteral: 12.5 mg IM or IV once, and may be repeated within 2 hours if necessary

Comments:
-Once treatment begins, the dose should be reduced to the smallest effective amount needed to control symptoms.
-Minor transfusion and/or amelioration of allergic reactions may be controlled with 12.5 mg doses.

Uses:
-Perennial and seasonal allergic rhinitis
-Vasomotor rhinitis
-Allergic conjunctivitis due to inhalant allergens and foods
-Mild, uncomplicated allergic skin manifestations of urticaria and angioedema
-Amelioration of allergic reactions to blood or plasma
-Dermographism
-Adjunctive therapy to epinephrine and other standard measures for anaphylactic reactions, after acute manifestations have been controlled

Usual Pediatric Dose for Motion Sickness:

2 years and older:
Treatment:
-Parenteral: 6.25 to 12.5 mg IM or IV every 4 hours a day

Treatment and prevention:
-Oral and Rectal: 12.5 to 25 mg orally or rectally 2 times a day

Comments:
-The initial dose should be given 30 to 60 minutes before anticipated travel, and may be repeated in 8 to 12 hours as needed.
-Subsequent doses on succeeding days of travel should be given on rising and again before the evening meal.

Use:
-Active and prophylactic treatment of motion sickness

Usual Pediatric Dose for Nausea/Vomiting:

2 years and older:
Treatment:
Oral or Rectal: 1.1 mg/kg orally or rectally every 4 to 6 hours as needed
-Maximum dose: 25 mg

Parenteral: 6.25 to 12.5 mg IM or IV every 4 hours as needed

Prophylaxis: Up to 25 mg orally or rectally every 4 to 6 hours as needed

Comments:
-This drug should not be used to treat nausea and vomiting of unknown etiology.
-Doses should be adjusted to the age and severity of the patient.

Uses:
-Prevention and control of nausea and vomiting associated with certain types of anesthesia and surgery
-Antiemetic therapy in postoperative patients

Usual Pediatric Dose for Light Sedation:

2 years and older:
Preoperative medication: 1.1 mg/kg IM, IV, orally, or rectally once
-Maximum dose: Up 25 mg

Sedation and/or adjunctive use with analgesics: 12.5 to 25 mg IM, IV, orally, or rectally once

Comments:
-Sedative doses may be given the night before surgery.
-Preoperative doses should be given with appropriate doses of an analgesic/hypnotic and an atropine-like agent.

Uses:
-Preoperative, postoperative, or obstetric sedation
-Relief of apprehension and production of light sleep from which the patient can be easily aroused

Usual Pediatric Dose for Sedation:

2 years and older:
Preoperative medication: 1.1 mg/kg IM, IV, orally, or rectally once
-Maximum dose: Up 25 mg

Sedation and/or adjunctive use with analgesics: 12.5 to 25 mg IM, IV, orally, or rectally once

Comments:
-Sedative doses may be given the night before surgery.
-Preoperative doses should be given with appropriate doses of an analgesic/hypnotic and an atropine-like agent.

Uses:
-Preoperative, postoperative, or obstetric sedation
-Relief of apprehension and production of light sleep from which the patient can be easily aroused

What other drugs will affect promethazine injection?

Using this medicine with other drugs that make you sleepy or slow your breathing can cause dangerous or life-threatening side effects. Ask your doctor before taking a sleeping pill, narcotic pain medicine, muscle relaxer, or medicine for anxiety, depression, or seizures.

Other drugs may interact with promethazine, including prescription and over-the-counter medicines, vitamins, and herbal products. Tell each of your health care providers about all medicines you use now and any medicine you start or stop using.

Where can I get more information?

  • Your doctor or pharmacist can provide more information about promethazine injection.
  • Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
  • Disclaimer: Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

Copyright 1996-2012 Cerner Multum, Inc. Version: 4.01.

Date modified: June 01, 2017
Last reviewed: June 09, 2014

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