Promethazine is an antihistamine that relieves allergy symptoms. It is not a cough medication. However, it may help with allergy-related dry cough and other symptoms, such as insomnia, nausea and vomiting, and motion sickness.
Medically reviewed by Alisha D. Sellers, BS Pharmacy, PharmD
Promethazine belongs to the drug class known as phenothiazines and is commonly marketed under the brand Phenergan.
Promethazine is available by prescription only and classified as a controlled substance due to its potential for misuse and dependence. You should use it under the supervision and prescription of a healthcare professional.
Promethazine comes in various forms, including:
tablets
liquids
injectables
suppositories
Your healthcare professional may prescribe promethazine as a liquid or tablet for cough relief. These are easy to take and offer effective relief.
By blocking histamine — a chemical involved in allergic reactions — promethazine may help reduce the body’s allergic response, which sometimes includes coughing.
Promethazine also reduces the action of dopamine in the brain, further contributing to its cough-suppressing effects. Dopamine is a neurotransmitter and hormone involved in different body functions.
Is promethazine effective for cough?
Promethazine may relieve cough symptoms caused by allergies. It provides short-term symptom management but doesn’t resolve the underlying cause of your cough.
Promethazine is most effective in managing dry cough symptoms. It does not have the same efficacy for wet, productive coughs where your body attempts to expel excess mucus or phlegm.
In addition to cough relief, promethazine may also help alleviate other cold symptoms, such as:
stuffy nose
runny nose
sneezing caused by colds or allergies
rhinitis (irritation of membranes inside your nose)
Before surgery: Promethazine is commonly used before surgery as a preoperative medication. It helps reduce anxiety and may provide sedative effects for a person undergoing surgical procedures.
Sedation: Promethazine’s sedative properties help promote relaxation and sleepiness in certain situations. You can use it for short-term sedation during medical procedures or to help with sleep difficulties.
Nausea and vomiting: Promethazine effectively alleviates nausea and vomiting symptoms, which can help people who experience these symptoms due to various causes such as motion sickness, chemotherapy, or gastrointestinal disorders.
Allergies: Blocking the action of histamine helps relieve symptoms like sneezing, itching, and a runny nose commonly associated with allergies.
While promethazine can be beneficial for these uses, using it under the supervision and prescription of a healthcare professional is essential.
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Promethazine with codeine is a combination medication that contains two active ingredients: promethazine and codeine. It is commonly used for cough relief, particularly in cases where the cough is severe or unresponsive to other treatments.
Codeine is an opioid medication that affects the brain’s cough reflex and reduces the urge to cough. It is considered a controlled substance because it has the potential for misuse and addiction. It is classified as a narcotic due to its pain-relieving and sedative properties.
Promethazine codeine formulations, such as Phenergan with Codeine and Pentazine with Codeine, were previously available in syrup form only. These brand names have now been discontinued, and currently, only generic versions of promethazine codeine are available due to concerns about misuse and addiction related to codeine-containing medications.
Safety
Mixing promethazine with other cold or cough medications without consulting a healthcare professional may increase the chance of serious health problems, such as respiratory depression (severe difficulty breathing).
Promethazine codeine formulations are commonly associated with a risk of misuse, potentially resulting in addiction, overdose, and other serious health consequences.
It is essential to use promethazine codeine formulations only as a healthcare professional prescribes.
Taking promethazine with codeine for longer than recommended may lead to dependence, tolerance (where it no longer has the same effect with a given dose), and potential adverse effects.
Promethazine is contraindicated for people with a history of hypersensitivity to promethazine or phenothiazines and children ages 2 years or younger due to the potential for respiratory depression.
Additionally, the use of promethazine with codeine should be avoided in:
children under 12 years old due to the potential for fatal respiratory depression
people with compromised respiratory function, such as those with sleep apnea
people with a history of hypersensitivity to promethazine or codeine
Black box warnings for promethazine with codeine include the potential chance of:
Black box warnings are issued by the Food and Drug Administration (FDA), and the goal is to warn that it is necessary to use these medications cautiously and as prescribed under the guidance of a healthcare professional.
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Promethazine may be an effective option for managing cough symptoms, particularly in allergic and non-productive coughs. However, it is crucial to use this medication cautiously and under the guidance of a healthcare professional.
Promethazine may cause sedation and other side effects, and you should not mix it with other common cold or cough medications without proper medical advice.
Consider consulting a healthcare professional for guidance if you have concerns about promethazine or dry cough symptoms.