View source for Promethazine

==Administration==
*Type: Antiemetic; [[Phenothiazine]] Derivative; Sedative<ref>Braude D, Crandall C. Ondansetron versus promethazine to treat acute undifferentiated nausea in the ED. Acad Emerg Med. 2008;15(3):209-215. PMID 18304050</ref>
*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==
*[[Allergic conditions]]: 6.25-12.5mg PO tid
**May give additional dose of 12.5-25mg PO qhs

*[[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==
*[[Drug Ratings in Pregnancy|Pregnancy Rating]]: C

===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

==Indications by Condition==
''The following table is automatically generated from disease/condition pages across WikEM.''

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 |?Has Indication=Indication
 |?Has Dose=Dose
 |?Has Context=Context
 |?Has Route=Route
 |?Has Population=Population
 |format=table
 |headers=plain
 |mainlabel=-
 |sort=Has Indication
 |limit=50
}}


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