Pharm

Promethazine

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Promethazine, Phenergan

  • Indications
  1. Nausea or Vomiting
  2. Motion Sickness or Vertigo
    1. Other agents are preferred (e.g. Dimenhydrinate)
  • Contraindications
  1. Do not use under age 2 years
  • Adverse Effects
  1. Excessive sedation
  2. Respiratory Depression
    1. Apnea and death have occurred in children
  • Precautions
  1. Long plasma half-life (observe prior to discharge)
  2. Lowers Seizure threshold
  3. Avoid use in children (absolutely contraindicated <2yo)
  • 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
  • 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
  • References
  1. Johnson (1993) Harriet Lane, Mosby, p. 521
  2. (2002) Tarascon Pocket Pharmacopoeia, p. 67