I. Indications

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

II. Mechanism

  1. Phenothiazine Antiemetic

III. Contraindications

  1. Do not use under age 2 years

IV. Adverse Effects

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

V. Precautions

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

VI. 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

VII. Efficacy

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

VIII. References

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

Images: Related links to external sites (from Google)

Cost: Medications

PROMETHAZINE (on 2/19/2015 at Target.com)
PROMETHAZINE 25 MG* Tablet #90 for $10.00 $0.11 each
PROMETHAZINE 6.25 MG/5 ML* Syrup #90 for $10.00 $0.11 each
PROMETHAZINE DM (on 2/19/2015 at Target.com)
PROMETHAZINE DM Syrup #90 for $10.00 $0.11 each
promethazine (on 1/21/2015 at Medicaid.Gov Survey of pharmacy drug pricing)
PROMETHAZINE 12.5 MG SUPPOS Generic $8.71 each
PROMETHAZINE 12.5 MG TABLET Generic $0.10 each
PROMETHAZINE 25 MG SUPPOSITORY Generic $8.55 each
PROMETHAZINE 25 MG TABLET Generic $0.08 each
PROMETHAZINE 25 MG/ML AMPUL Generic $1.43 per ml
PROMETHAZINE 25 MG/ML VIAL Generic $0.88 per ml
PROMETHAZINE 50 MG SUPPOSITORY Generic $25.75 each
PROMETHAZINE 50 MG TABLET Generic $0.15 each
PROMETHAZINE 50 MG/ML AMPUL Generic $1.80 per ml
PROMETHAZINE 6.25 MG/5 ML SYRP Generic $0.02 per ml
PROMETHAZINE VC SYRUP Generic $0.22 per ml
PROMETHAZINE VC-CODEINE SYRUP Generic $0.38 per ml
PROMETHAZINE-CODEINE SYRUP Generic $0.03 per ml
PROMETHAZINE-DM SYRUP Generic $0.02 per ml

Ontology: Promethazine (C0033405)

Definition (CHV) a drug used to treat allergy symptoms
Definition (CHV) a drug used to treat allergy symptoms
Definition (NCI) A phenothiazine derivative with antiemetic and antihistaminic properties. Promethazine antagonizes the central and peripheral effects of histamine mediated by histamine H1 receptors. The effects include bronchoconstriction, vasodilation and spasmodic contractions of gastrointestinal smooth muscle. In addition, this agent binds to muscarinic receptors, resulting in anticholinergic and antiemetic activities.
Definition (MSH) A phenothiazine derivative with histamine H1-blocking, antimuscarinic, and sedative properties. It is used as an antiallergic, in pruritus, for motion sickness and sedation, and also in animals.
Concepts Pharmacologic Substance (T121) , Organic Chemical (T109)
MSH D011398
SnomedCT 256051006, 322154000, 372871004, 8372007
LNC LP15006-7, MTHU001492
English Promethazine, 10H-Phenothiazine-10-ethanamine, N,N,alpha-trimethyl-, Promethazine [nausea], Promethazine [nausea] [see c8i..], Proazamine, Prometazin, Promethazine [Chemical/Ingredient], prometazin, Promethazine [nausea] [see c8i..] (product), promethazine, PROMETHAZINE, Diprazinum, Promethazine product, Promethazine (product), Promethazine (substance), Promethazine [dup] (substance), Promethazine [nausea] [see c8i..] (substance)
Swedish Prometazin
Czech promethazin
Finnish Prometatsiini
Russian PROZAMIN, PROMETAZIN, TIAZINAMII, METILPROMETAZIN, МЕТИЛПРОМЕТАЗИН, ПРОЗАМИН, ПРОМЕТАЗИН, ТИАЗИНАМИЙ
Japanese ヒベルナ, メチレンジサルチル酸プロメタジン, プロザミン, プロメタジン塩酸塩, ピレチア, フェネルガン, 塩酸プロメタジン, イソプロメタジン, プロメタジン
Spanish prometazina (sustancia), prometazina [náuseas] [ver c8i..] (producto), prometazina [náuseas] [ver c8i..], Fenergan, prometacina (sustancia), prometacina, prometazina (producto), prometazina, Proazamina, Prometazina
Polish Prometazyna, Difergan, Fenergan
Portuguese Fenergan, Proazamina, Prometazina
French Prométhazine
German Proazamin, Promethazin
Italian Prometazina

Ontology: Phenergan (C0591971)

Definition (CHV) brand name of an allergy medicine
Definition (CHV) brand name of an allergy medicine
Concepts Pharmacologic Substance (T121) , Organic Chemical (T109)
MSH D011398
English Phenargan, phenergan, phenergan [brand name], Phenergan