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

Back to Medical Corps Pharmacy Page