Promethazine: Difference between revisions

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==Administration==
==Administration==
*Type: Antiemetic; Phenothiazine Derivative; Sedative
*Type: Antiemetic; [[Phenothiazine]] Derivative; Sedative
*Dosage Forms: 12.5,25,50; 6.25/5 mL sol; IM; IV
*Dosage Forms: 12.5mg, 25mg, 50mg; 6.25mg/5 mL sol; IM; IV
*Routes of Administration: Oral
*Routes of Administration: Oral
*Common Trade Names: Phenadoz; Phenergan; Promethegan
*Common Trade Names: Phenadoz; Phenergan; Promethegan


==Adult Dosing==
==Adult Dosing==
*Allergic conditions: 6.25-12.5 mg PO tid
*[[Allergic conditions]]: 6.25-12.5mg PO tid
**May give additional dose of 12.5-25 mg PO qhs
**May give additional dose of 12.5-25mg PO qhs


*Nausea/vomiting: 12.5-25 mg PO/IM/IV q4-6h
*[[Nausea/vomiting]]: 12.5-25mg PO/IM/IV q4-6h
**Max: 50 mg/dose PO/IM; 25 mg/dose IV  
**Max: 50mg/dose PO/IM; 25mg/dose IV  
**IM preferred over IV
**IM preferred over IV


*Motion sickness: 25 mg PO bid
*Motion sickness: 25mg PO bid
**Start: 0.5-1h prior to travel
**Start: 0.5-1h prior to travel


*Sedation: 25-50 mg PO/IM/IV x1
*Sedation: 25-50mg PO/IM/IV x1
**Max: 50 mg/dose PO/IM; 25 mg/dose IV
**Max: 50mg/dose PO/IM; 25mg/dose IV
**IM preferred over IV
**IM preferred over IV


==Pediatric Dosing==
==Pediatric Dosing==
===Only Approved for >2 years===
===Only Approved for >2 years===
*Allergic conditions: 0.1 mg/kg PO q6h
*Allergic conditions: 0.1mg/kg PO q6h
**Max: 12.5 mg/dose during day, 25 mg/dose qhs
**Max: 12.5mg/dose during day, 25mg/dose qhs
**May give additional dose of up to 0.5 mg/kg PO qhs
**May give additional dose of up to 0.5mg/kg PO qhs
**Use lowest effective dose
**Use lowest effective dose
**Avoid other resp. depressants
**Avoid other resp. depressants


*Nausea/vomiting: 0.25-1 mg/kg PO/IM/IV q4-6h prn;  
*Nausea/vomiting: 0.25-1mg/kg PO/IM/IV q4-6h PRN;  
**Max: 25 mg/dose
**Max: 25mg/dose


*Motion sickness: 0.5 mg/kg PO q12h prn; Start: 0.5-1h before travel
*Motion sickness: 0.5mg/kg PO q12h PRN; Start: 0.5-1h before travel
**Max: 25 mg/dose; Info: use lowest effective dose
**Max: 25mg/dose; Info: use lowest effective dose
**Avoid other resp. depressants
**Avoid other resp. depressants


*Sedation: 12.5-25 mg PO/IM/IV x1
*Sedation: 12.5-25mg PO/IM/IV x1
**Max: 25 mg/dose
**Max: 25mg/dose
**IM preferred over IV
**IM preferred over IV
**Use lowest effective dose
**Use lowest effective dose
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==Special Populations==
==Special Populations==
*Pregnancy Risk Factor: C
*[[Drug Ratings in Pregnancy|Pregnancy Rating]]: C


===Renal Dosing===
===Renal Dosing===
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*nonselective antagonist of central and peripheral H1 receptors; anticholinergic
*nonselective antagonist of central and peripheral H1 receptors; anticholinergic


==See Also==
*[[Antiemetics]]
==References==
==References==
<UpToDate, Micromedex>
<UpToDate, Micromedex>
[[Category:Pharmacology]]
[[Category:Pharmacology]]
[[Category:GI]]

Latest revision as of 12:55, 6 March 2021

Administration

  • Type: Antiemetic; Phenothiazine Derivative; Sedative
  • Dosage Forms: 12.5mg, 25mg, 50mg; 6.25mg/5 mL sol; IM; IV
  • Routes of Administration: Oral
  • Common Trade Names: Phenadoz; Phenergan; Promethegan

Adult Dosing

  • Nausea/vomiting: 12.5-25mg PO/IM/IV q4-6h
    • Max: 50mg/dose PO/IM; 25mg/dose IV
    • IM preferred over IV
  • Motion sickness: 25mg PO bid
    • Start: 0.5-1h prior to travel
  • Sedation: 25-50mg PO/IM/IV x1
    • Max: 50mg/dose PO/IM; 25mg/dose IV
    • IM preferred over IV

Pediatric Dosing

Only Approved for >2 years

  • Allergic conditions: 0.1mg/kg PO q6h
    • Max: 12.5mg/dose during day, 25mg/dose qhs
    • May give additional dose of up to 0.5mg/kg PO qhs
    • Use lowest effective dose
    • Avoid other resp. depressants
  • Nausea/vomiting: 0.25-1mg/kg PO/IM/IV q4-6h PRN;
    • Max: 25mg/dose
  • Motion sickness: 0.5mg/kg PO q12h PRN; Start: 0.5-1h before travel
    • Max: 25mg/dose; Info: use lowest effective dose
    • Avoid other resp. depressants
  • Sedation: 12.5-25mg PO/IM/IV x1
    • Max: 25mg/dose
    • IM preferred over IV
    • Use lowest effective dose
    • Avoid other resp. depressants

Special Populations

Renal Dosing

  • No adjustment

Hepatic Dosing

  • Caution advised with hepatic impairment

Contraindications

  • Hypersensitivity to drug/component
  • Patients <2 yo
  • Comatose patients
  • Respiratory depression
  • SC injection
  • intra- or periarterial administration

Adverse Reactions

Serious

  • extravasation/tissue damage (IV use > IM use)
  • apnea
  • respiratory depression
  • respiratory depression, fatal (infants)
  • seizures
  • leukopenia
  • thrombocytopenia
  • agranulocytosis

Common

  • drowsiness
  • sedation
  • blurred vision
  • dizziness
  • confusion
  • disorientation

Pharmacology

  • Half-life: 7-14 hrs
  • Metabolism: urine, feces
  • Excretion: CYP450

Mechanism of Action

  • nonselective antagonist of central and peripheral H1 receptors; anticholinergic

See Also

References

<UpToDate, Micromedex>

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