II. Indications

  1. Nausea or Vomiting
  2. Motion Sickness or Vertigo
    1. Other agents are preferred (e.g. Dimenhydrinate)

III. Mechanism

IV. Contraindications

  1. Do not use under age 2 years

V. Adverse Effects

  1. Excessive sedation
  2. Respiratory Depression
    1. Apnea and death have occurred in children

VI. Precautions

  1. Long plasma Half-Life (observe prior to discharge)
  2. Lowers Seizure threshold
  3. Avoid use in children (absolutely contraindicated <2yo)

VII. Dosing

  1. Precautions: IV dosing used but not FDA labeled
  2. Adults: 12.5 to 25 mg PO/IM/PR q4-6 hours
  3. Children: 0.25 to 0.5 mg/kg PO/IM/PR q4-6 hours
    1. Maximum: 25 mg per dose

VIII. Efficacy

  1. Less effective Antiemetic than Prochlorperazine (Compazine) in ER patients
    1. Ernst (2000) Ann Emerg Med 36(2): 89-94 [PubMed]
  2. Sedation may delay Emergency Department discharge

IX. References

  1. Johnson (1993) Harriet Lane, Mosby, p. 521
  2. (2002) Tarascon Pocket Pharmacopoeia, p. 67

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Cost: Medications

promethazine (on 12/21/2022 at Medicaid.Gov Survey of pharmacy drug pricing)
PROMETHAZINE 12.5 MG SUPPOS Generic $3.51 each
PROMETHAZINE 12.5 MG TABLET Generic $0.05 each
PROMETHAZINE 25 MG SUPPOSITORY Generic $3.47 each
PROMETHAZINE 25 MG TABLET Generic $0.05 each
PROMETHAZINE 50 MG TABLET Generic $0.08 each
PROMETHAZINE 6.25 MG/5 ML SOLN Generic $0.03 per ml
PROMETHAZINE 6.25 MG/5 ML SYRP Generic $0.03 per ml
PROMETHAZINE-CODEINE SOLUTION Generic $0.03 per ml
PROMETHAZINE-CODEINE SYRUP Generic $0.03 per ml
PROMETHAZINE-DM 6.25-15 MG/5 ML Generic $0.05 per ml