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 (IV dosing used but not FDA labeled)

  1. Adults: 12.5 to 25 mg PO/IM/PR q4-6 hours
  2. 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 Phenergan in ER patients
    1. Ernst (2000) Ann Emerg Med 36(2): 89-94 [PubMed] (or open in [QxMD Read])
  2. Sedation may delay Emergency Room 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 2/10/2012 at Target.com)
PROMETHAZINE 6.25 MG/5 ML* Syrup #30 for $4.00 ($0.13/unit)
PROMETHAZINE 25 MG* Tablet #30 for $4.00 ($0.13/unit)
PROMETHAZINE DM (on 2/10/2012 at Target.com)
PROMETHAZINE DM Syrup #30 for $4.00 ($0.13/unit)
Promethazine-DM (on 2/9/2012 at DrugStore.com)
Promethazine-DM 6.25-15mg/5ml Syrup #118 for $20.99 ($0.18/unit)
Promethazine-Codeine (on 2/9/2012 at DrugStore.com)
Promethazine-Codeine 6.25-10mg/5ml Syrup #90 for $13.99 ($0.16/unit)
Promethazine VC Plain (on 2/9/2012 at DrugStore.com)
Promethazine VC Plain 6.25-5mg/5ml Syrup #473 for $39.99 ($0.08/unit)
Promethazine HCl (on 2/9/2012 at DrugStore.com)
Promethazine HCl 50mg/ml Solution 1ml Vial #25 for $59.99 ($2.40/unit)
Promethazine HCl 12.5mg Suppository #12 for $49.99 ($4.17/unit)
Promethazine HCl 6.25mg/5ml Syrup #118 for $12.99 ($0.11/unit)
Promethazine HCl 12.5mg Tablets #30 for $15.99 ($0.53/unit)
Promethazine HCl 25mg Tablets #30 for $21.99 ($0.73/unit)
Promethazine HCl 50mg Tablets #30 for $21.99 ($0.73/unit)

Ontology: Promethazine (C0033405)

Definition (CHV) a drug used to treat allergy symptoms
Definition (CHV) a drug used to treat allergy symptoms
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.
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.
Concepts Organic Chemical (T109) , Pharmacologic Substance(T121)
MSH D011398
SnomedCT 322154000, 256051006, 372871004, 8372007
English Promethazine, promethazine, 10H-Phenothiazine-10-ethanamine, N,N,alpha-trimethyl-, Promethazine [nausea], Promethazine [nausea] [see c8i..], Promethazine [nausea] [see c8i..] (product), Proazamine, Prometazin, Promethazine [Chemical/Ingredient], prometazin, Diprazinum, Promethazine product, Promethazine (product), Promethazine (substance), Promethazine [dup] (substance), Promethazine [nausea] [see c8i..] (substance), PROMETHAZINE
Swedish Prometazin
Czech promethazin
Spanish Promethazine [dup] (substance), Promethazine, prometazina [náuseas] [ver c8i..], prometazina [náuseas] [ver c8i..] (producto), prometazina (sustancia), prometacina (sustancia), prometacina, prometazina (producto), prometazina, Fenergan, Proazamina, Prometazina
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
Polish Prometazyna, Difergan, Fenergan
French Prométhazine
German Proazamin, Promethazin
Italian Prometazina
Portuguese Fenergan, Proazamina, Prometazina

Ontology: Phenergan (C0591971)

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