Promethazine injection is used to treat nausea and vomiting related to certain conditions (e.g., after surgery, motion sickness). It is also used with other medication to treat life-threatening allergic symptoms (anaphylaxis) and reactions to blood products. The injectable form may be used to treat milder allergic reactions when you cannot take another medication by mouth. It may also be used before/after surgery, other procedures, or labor and delivery to help you feel calmer, to prevent nausea/vomiting, and to help certain narcotic pain relievers (e.g., meperidine) work better. Promethazine is an antihistamine (phenothiazine type). It works by blocking a certain natural substance (histamine) that your body makes during an allergic reaction. Its other effects (e.g., anti-nausea, calming, pain relief) may work by affecting other natural substances (e.g., acetylcholine) and by acting directly on certain parts of the brain. This medication should not be used in children younger than 2 years.
How To Use
It is best to inject this medication deep into a muscle. It may also be injected into a large vein (not in the hand or wrist) by a health care professional. Do not inject this medication under the skin or into an artery. If you have any questions about the proper use of this medication, ask your doctor or pharmacist. Before using, check this product visually for particles or discoloration. If either is present, do not use the liquid. Clean the injection site well before injecting the medication. If giving this medication into a vein, inject into a running IV line (a line with IV fluid flowing in it). Make sure the IV is working well before injecting. Inject the medication into an injection port on the tubing as far from the vein as possible. Diluting the medication may decrease risk of tissue injury. Give slowly (no faster than 25 milligrams per minute). This medication can cause serious tissue damage. Tell your doctor or nurse immediately if you experience pain, burning, or redness at the injection site. If this occurs, the injection should be stopped and the injection site checked. Your dosage and how often you receive the medication will be determined by your weight, age, condition, and response to therapy. Injections may be repeated if needed, usually every 4 hours. Inform your doctor if your condition does not improve or if it worsens. Learn how to store and discard needles and medical supplies safely. Consult your pharmacist.
Your doctor or pharmacist may already be aware of any possible drug interactions and may be monitoring you for them. Do not start, stop, or change the dosage of any medicine before checking with your doctor or pharmacist first. Before using this medication, tell your doctor or pharmacist of all prescription and nonprescription/herbal products you may use, especially of: anticholinergics (e.g., benztropine, belladonna alkaloids), cancer chemotherapy (e.g., methotrexate), guanethidine, guanadrel, sibutramine, MAO inhibitors (e.g., furazolidone, isocarboxazid, linezolid, moclobemide, phenelzine, procarbazine, rasagiline, selegiline, tranylcypromine). Tell your doctor or pharmacist if you have taken MAO inhibitors (e.g., furazolidone, isocarboxazid, linezolid, moclobemide, phenelzine, procarbazine, rasagiline, selegiline, tranylcypromine) within 2 weeks before, during, or after using promethazine. Also report the use of drugs which might increase seizure risk when combined with promethazine such as bupropion, isoniazid (INH), metrizamide, phenothiazines (e.g., thioridazine), theophylline, tramadol, or tricyclic antidepressants (e.g., amitriptyline), among others. Consult your doctor or pharmacist for details. Tell your doctor or pharmacist if you also take drugs that cause drowsiness such as: certain antihistamines (e.g., diphenhydramine), anti-seizure drugs (e.g., carbamazepine), medicine for sleep or anxiety (e.g., alprazolam, diazepam, zolpidem), muscle relaxants, narcotic pain relievers (e.g., codeine), psychiatric medicines (e.g., chlorpromazine, risperidone, trazodone). Check the labels on all your medicines (e.g., cough-and-cold products) because they may contain ingredients that cause drowsiness. Ask your pharmacist about using those products safely. This medication may interfere with certain laboratory tests (including some pregnancy tests, blood sugar tests), possibly causing false test results. Make sure laboratory personnel and all your doctors know you use this drug. This document does not contain all possible interactions. Therefore, before using this product, tell your doctor or pharmacist of all the products you use. Keep a list of all your medications with you, and share the list with your doctor and pharmacist.
Do not share this medication with others.
If overdose is suspected, contact your local poison control center or emergency room immediately. US residents can call the US National Poison Hotline at 1-800-222-1222. Canada residents can call a provincial poison control center. Symptoms of overdose may include: slow/shallow breathing, deep sleep, seizures, muscle spasms, flushing, widened pupils.
See also Warning section. Before using promethazine, tell your doctor or pharmacist if you are allergic to it; or to any other phenothiazines (e.g., prochlorperazine); or if you have any other allergies. This product may contain inactive ingredients (such as sulfites including metabisulfite), which can cause allergic reactions or other problems. Talk to your pharmacist for more details. This medication should not be given to a patient who is in a coma. This medication should not be used if you have certain medical conditions. Before using this medicine, consult your doctor or pharmacist if you have: certain lung/breathing problems (e.g., asthma, chronic obstructive pulmonary disease-COPD, sleep apnea). Before using this medication, tell your doctor or pharmacist your medical history, especially of: blood/immune system problems (e.g., bone marrow depression), a certain eye problem (narrow-angle glaucoma), heart disease (e.g., angina, irregular heartbeat), high or low blood pressure, liver disease, certain nervous system problem (neuroleptic malignant syndrome), Reye's syndrome, seizure, stomach/bowel problems (e.g., blockage, ulcer disease), sun sensitivity when using other medications, urination problems (e.g., due to enlarged prostate, blockage). This drug may make you dizzy or drowsy or cause blurred vision. Do not drive, use machinery, or do any activity that requires alertness or clear vision until you are sure you can perform such activities safely. Children should be supervised during bicycle riding and other possibly hazardous activities to avoid injury. Avoid alcoholic beverages. Promethazine may make you more sensitive to the sun. Avoid prolonged sun exposure, tanning booths, and sunlamps. Use a sunscreen and wear protective clothing when outdoors. This medication can reduce sweating, making you more likely to get heat stroke. Avoid strenuous work/exercise, drink plenty of fluids, and dress lightly while in hot weather. Caution is advised when using this drug in the elderly because they may be more sensitive to its effects, especially confusion and drowsiness. Caution is advised when using this drug in children because they may be more sensitive to its effects, especially slowed breathing (see Warning section). Special caution should be taken in children who a severe loss of body water (dehydration), those who have a family history of sudden infant death syndrome (SIDS), and those who are hard to wake up from sleep. During pregnancy, this medication should be used only when clearly needed. Discuss the risks and benefits with your doctor. It is unknown whether promethazine passes into breast milk. It may have undesirable effects on a nursing infant. Therefore, breast-feeding while using this medication is not recommended. Consult your doctor before breast-feeding.
Store at room temperature between 68-77 degrees F (20-25 degrees C) away from light and moisture. Keep covered in carton until ready to use. Do not store in the bathroom. Keep all medicines away from children and pets. Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company for more details about how to safely discard your product.
Drowsiness, dizziness, constipation, blurred vision, or dry mouth may occur. If any of these effects persist or worsen, notify your doctor. Some people, especially children, may experience excitability rather than drowsiness. Remember that your doctor has prescribed this medication because he or she has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects. This medication can cause severe tissue damage, possibly requiring surgery. Tell your doctor/nurse immediately if you experience burning, pain, redness, swelling, or numbness at or near the injection site. Tell your doctor immediately if any of these unlikely but serious side effects occur: lack of coordination, severe dizziness, fainting, slow/fast heartbeat, muscle stiffness, involuntary muscle movements, muscle spasms (e.g., rolling eyes, twisting neck/back), restlessness, decreased/painful urination. Seek immediate medical attention if any of these unlikely but very serious side effects occur: slow/shallow breathing, difficulty waking up, hot/dry skin. Tell your doctor immediately if any of these rare but very serious side effects occur: signs of serious infection (e.g., persistent sore throat, fever), unusual bleeding/ bruising, severe stomach/abdominal pain, yellowing of eyes/skin, dark urine. This drug may infrequently cause a very serious (rarely fatal) nervous system disorder (neuroleptic malignant syndrome). If you notice any of the following unlikely but very serious side effects, seek immediate medical attention: severe muscle stiffness, mental/mood changes (e.g., confusion, extreme drowsiness), high fever, seizures, irregular/fast heartbeat, increased sweating. A very serious allergic reaction to this drug is rare. However, seek immediate medical attention if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing. This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist. In the US - Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088. In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.
Promethazine should not be used in children younger than 2 years since it might cause slow/shallow breathing (respiratory depression), which in some cases could be fatal. This problem has occurred even with normal doses in this age group. Use this drug with caution in children older than 2 years. The lowest effective dosage should be used, and other drugs that affect breathing should be avoided. Seek immediate medical attention in the unlikely event that slow/shallow breathing occurs. In children, use drugs for nausea only in cases of prolonged vomiting with a known cause. Avoid use of promethazine in children with liver disease (including possible Reye's syndrome).
This is a summary and does NOT have all possible information about this product. This information does not assure that this product is safe, effective, or appropriate for you. This information is not individual medical advice and does not substitute for the advice of your health care professional. Always ask your health care professional for complete information about this product and your specific health needs.
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