Promethegan, Promethazine
Generic Phenergan
Promethazine (proe METH a zeen) is a generic medication prescribed for allergies, nausea and vomiting, and several other conditions. Promethazine belongs to a group of drugs called antihistamines.
Promethazine (proe METH a zeen) is a generic medication prescribed for allergies, nausea and vomiting, and several other conditions. Promethazine belongs to a group of drugs called antihistamines.
- Generic
- • Suppository
- • 12 of 25mg
- • 1 Box
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Intro
Introduction
Written by Sarah Lewis, PharmD
Medically reviewed by Melissa Badowski, PharmD, MPH, FCCP
Updated on September 15, 2023
Promethazine (proe METH a zeen) is a generic medication prescribed for allergies, nausea and vomiting, and several other conditions. Promethazine belongs to a group of drugs called antihistamines.
The Food and Drug Administration (FDA) has approved promethazine for:
- allergy symptoms
- sleep and relief of anxiety before or after surgery, during labor and delivery, and at other times
- pain relief after surgery
- motion sickness
- nausea and vomiting
Boxed warnings
Promethazine has boxed warnings, which are the most serious warnings from the FDA. These include:
- risk of fatal respiratory depression in children, with all forms of promethazine
- risk of serious tissue injury, with promethazine injection
For details, see the “Interactions and warnings for promethazine” section.
FAQ
Common questions about promethazine
Below you’ll find answers to a few commonly asked questions about promethazine.
Is it safe to take promethazine with codeine?
Possibly. Doctors sometimes prescribe promethazine with codeine to treat a severe cough. There is a liquid product that combines these two drugs for this purpose.
But both promethazine and codeine are central nervous system (CNS) depressants. This means they both slow brain activity and can cause slowed or stopped breathing. Taking them together can increase these effects. So you should only take this combination under a doctor’s supervision.
You can find out more about taking these two drugs together by talking with your doctor.
What brand names are available for promethazine?
There aren’t any brand-name drugs available for promethazine. Promethazine is a generic version of the brand-name drug Phenergan. But this drug is no longer on the market.
A generic medication is an identical copy of the active drug in a brand-name medication. (An active drug is the ingredient that makes a medication work.) Generic drugs are believed to be as effective and safe as brand-name drugs. And generic drugs typically cost less compared to brand-name drugs.
Talk with your doctor or pharmacist to learn more about this.
Is promethazine a narcotic?
No, promethazine isn’t a narcotic. It belongs to a group of drugs called antihistamines. It works in a different way than a narcotic. But promethazine has some effects that are like narcotics. For example, it can slow brain activity and cause slow breathing and severe drowsiness.
You can learn more about this by talking with your doctor or pharmacist.
How does promethazine work? And how long does it take to start working?
Promethazine works by blocking a natural substance called histamine. Blocking histamine has several effects on the body, including relieving allergy symptoms and making you feel sleepy. It also reduces activity in the brain that causes nausea and vomiting.
Promethazine should start to work within about 20 minutes of taking it by mouth. For an injection into a vein, it’ll start working within 5 minutes. For an injection into a muscle, it’ll take about 20 minutes to start working.
If you’d like to know more about this, talk with your doctor or pharmacist.
Side effects
Side effects of promethazine
Promethazine may cause mild or serious side effects. More common mild side effects of promethazine and its serious side effects are listed below. This article doesn’t include all possible side effects of the drug. Side effects can vary based on your age, overall health, and any other medications you take.
To learn more about promethazine’s side effects, see this article or ask your doctor or pharmacist. You can also refer to the prescribing information for promethazine listed in the “Resources” section.
Mild side effects
More common mild side effects reported with some forms of promethazine are listed below.
This article doesn’t include all possible mild side effects of the drug. To learn more about promethazine’s side effects, refer to the prescribing information for promethazine listed in the “Resources” section.
With many drugs, mild side effects may go away within a few days or a couple of weeks. If the side effects are bothersome, tell your doctor or pharmacist. They may be able to suggest ways to manage them.
Promethazine oral tablets and oral syrup’s mild side effects include:
- blurred vision
- dizziness
- drowsiness
- dry mouth
- mild allergic reaction*
* For details about this side effect, see the “Interactions and warnings for promethazine” section.
Serious side effects
Serious side effects of promethazine are listed below.
This article doesn’t include all possible serious side effects of the drug. To learn more about promethazine’s side effects based on the form, refer to the prescribing information for promethazine listed in the “Resources” section.
With many drugs, serious side effects are possible but not common. If you have serious side effects from this drug, call your doctor right away. If you’re having severe symptoms or a medical emergency, call 911 or a local emergency number.
In general, promethazine’s serious side effects include:
- blood pressure or heart rate changes
- extrapyramidal symptoms (involuntary movements that you can’t control)
- hallucinations (seeing or hearing things that aren’t there)
- impaired mental or physical abilities, which can affect your ability to drive a car or operate machinery
- seizures
- liver problems
- low blood cell counts, including white blood cells and platelets
- neuroleptic malignant syndrome (a rare reaction that can be life threatening)
- respiratory depression (slowed or stopped breathing)
- severe drowsiness or disorientation
- swelling of the skin and its deep layers due to fluid buildup
- boxed warnings:
- risk of fatal respiratory depression in children, for all forms*
- risk of serious tissue injury, with promethazine injection*
- severe allergic reaction†
* For details about this side effect, see the “Interactions and warnings for promethazine” section.
Uses
Uses of promethazine
The Food and Drug Administration (FDA) approves prescription drugs such as promethazine for certain conditions. Approved uses for promethazine are described below.
Use for allergy symptoms
Doctors may prescribe all forms of promethazine for treating allergy symptoms. It’s used for this purpose in adults and with caution in children ages 2 years and older. It’s usually prescribed as a short-term treatment.
Allergy symptoms can range from mild to severe. They can include runny nose, itchy eyes, or a skin rash. Severe symptoms can be life threatening and include breathing problems and throat swelling. They can happen with hay fever, foods, insect stings, or other allergens. Promethazine can help relieve these symptoms.
Promethazine is prescribed together with epinephrine for severe allergic reactions.
Use for sedation for surgery
Doctors may prescribe all forms of promethazine to make you feel sleepy and relaxed for surgery, labor and delivery, and at other times. It’s used for this purpose in adults and with caution in children ages 2 years and older. It’s usually prescribed as a short-term treatment.
It can help relieve anxiety about a surgery or procedure. Promethazine is one medication doctors can use for this purpose.
Use for nausea and vomiting
Doctors may prescribe all forms of promethazine for treating or helping prevent nausea and vomiting with anesthesia and surgery. It’s used for this purpose in adults and with caution in children ages 2 years and older. It’s usually prescribed as a short-term treatment.
Nausea and vomiting are possible when you have anesthesia and surgery. These symptoms can also occur after surgery when you are recovering from anesthesia. Vomiting during these times can lead to serious problems. Promethazine can help prevent or manage nausea and vomiting during these times.
Use for motion sickness
Doctors may prescribe all forms of promethazine for treating or helping prevent motion sickness. It’s used for this purpose in adults and with caution in children ages 2 years and older. It’s usually prescribed as a short-term treatment.
With motion sickness, you feel ill due to real or perceived movement. Symptoms can include nausea, dizziness, and sweating. You feel this way because your brain is getting confusing signals from your eyes and inner ears. Your inner ears help with your sense of balance. Promethazine can help reduce these confusing signals.
Use for pain after surgery
Doctors may prescribe all forms of promethazine, along with other pain relievers, for treating pain after surgery. It’s used for this purpose in adults and with caution in children ages 2 years and older. It’s usually prescribed as a short-term treatment.
Doctors usually prescribe strong pain relievers after surgery. Using promethazine with these pain relievers can help reduce the amount of pain reliever you need. This may shorten your stay in the postoperative unit. It may also help reduce side effects and other problems with the pain relievers.
Interactions and warnings
Interactions and warnings for promethazine
Below you’ll find information about promethazine’s possible interactions and warnings.
Interactions of promethazine
Certain things may affect how a drug works. These include getting vaccines, consuming alcohol or certain foods, or taking the drug with other medications. This effect is called a drug interaction.
Before you take promethazine, ask your doctor to check for possible interactions. Be sure to tell them about any of the following you take or use:
- prescription or over-the-counter drugs
- vitamins, herbs, or supplements
To learn about drug-condition interactions, see the “Warnings for promethazine” section below.
Warnings for promethazine
Some people should not take promethazine, and others should take it cautiously.
Boxed warnings
Promethazine has boxed warnings about the following risks. Boxed warnings are the most serious warnings from the Food and Drug Administration (FDA).
To learn more about these warnings, read below. You can also talk with your doctor or pharmacist.
Risk of fatal respiratory depression in children. With respiratory depression, you have slow or shallow breathing, pauses in breathing, or breathing that stops. This side effect, which sometimes leads to death, has been reported with all forms of promethazine use in children.
Due to this risk, promethazine should not be used in children younger than 2 years of age. It should be used with caution in children ages 2 years and older.
If you have concerns about respiratory depression in children, tell your doctor. They may recommend a different treatment.
Risk of serious tissue injury. With serious tissue injury, you have severe damage to body tissues. In some cases, the damage can lead to tissue death and the need for amputation. This side effect has been reported with promethazine injection.
Due to this risk, promethazine injection shouldn’t be given as an injection under the skin. The preferred way to give it is as a deep injection into muscle. In some cases, promethazine may be given as an injection into a vein. If your doctor recommends this option, they’ll make sure it’s safely administered.
Symptoms can include:
- burning
- numbness
- open sores
- pain
- redness or discoloration
- swollen or inflamed veins
If you experience any of these symptoms, seek immediate medical care.
Other warnings
Promethazine could cause harm to people with certain health conditions. This effect is called a drug-condition interaction. Other factors can also affect whether promethazine is a safe option for you.
Ask your doctor about specific warnings for promethazine, and be sure to tell your doctor about your:
- current health, including any allergies to medications
- past health conditions or surgeries
Allergic reaction
Promethazine can cause an allergic reaction in some people. Severe allergic reactions are rare but possible.
If you’ve had an allergic reaction to promethazine or any of its ingredients, your doctor will likely not prescribe promethazine. They can tell you about medications that are safer options for you.
A mild allergic reaction may cause the following symptoms:
A severe allergic reaction may cause the following symptoms:
- swelling under your skin, usually in your hands, feet, eyelids, or lips
- swelling of your mouth, throat, or tongue, which can cause breathing problems
If you have an allergic reaction to promethazine, call your doctor right away. If you have severe symptoms, call 911 or a local emergency number.
Overdose of promethazine
If you take promethazine by mouth, you should not take more promethazine than your doctor prescribes. For some drugs, doing so may lead to harmful effects or overdose.
If you think you’ve taken too much promethazine, call your doctor or pharmacist right away. Or you could call 800-222-1222 to speak with someone at America’s Poison Centers. You can also use its online resource. If you have concerning symptoms, call 911 or a local emergency number immediately. You can also go to the closest emergency room.
Pregnancy or breastfeeding and promethazine
Information about promethazine and pregnancy and breastfeeding is described below.
Promethazine and pregnancy
It’s not known whether promethazine should be taken during pregnancy. If you’re planning a pregnancy or can become pregnant, talk with your doctor before taking this medication.
Promethazine and breastfeeding
Promethazine should not be taken while breastfeeding. If you’re currently breastfeeding or planning to do so, talk with your doctor before taking this medication. Your doctor may recommend other ways to feed your child during treatment with promethazine.
Ask your doctor
What to ask your doctor
Let your doctor know if you have questions about promethazine or would like more details about it.
Here’s a list of some possible questions you may want to ask your doctor:
- How should I take promethazine?
- Does promethazine interact with any of my other medications?
- Am I at higher risk of side effects for any reason?
- What is the most important information I should know about promethazine?
Resources
Resources
- Food and Drug Administration. (2023). Orange Book: Approved drug products with therapeutic equivalence evaluations. https://www.accessdata.fda.gov/scripts/cder/ob/index.cfm
- Promethazine hydrochloride injection. (2023). https://nctr-crs.fda.gov/fdalabel/services/spl/set-ids/c930985b-bba3-4f3a-a1ae-1d808670efde/spl-doc#LINK_675c09ee-4cfd-4f07-a5a8-5a1c7ed0c68a
- Promethazine hydrochloride solution. (2022). https://nctr-crs.fda.gov/fdalabel/services/spl/set-ids/bd8d1f9a-242c-440b-a5eb-a50f64a1c1d9/spl-doc
- Promethazine hydrochloride suppository. (2023). https://nctr-crs.fda.gov/fdalabel/services/spl/set-ids/047b9a7c-586b-4635-a63e-2c7ce9ec34e7/spl-doc
- Promethazine hydrochloride syrup. (2023). https://nctr-crs.fda.gov/fdalabel/services/spl/set-ids/73c76b87-8d98-4d78-ab00-549f3bc3c324/spl-doc
- Promethazine hydrochloride tablet. (2023). https://nctr-crs.fda.gov/fdalabel/services/spl/set-ids/44cd6d46-fbb9-4836-9426-d8ce2cb6d66d/spl-doc
Disclaimer: Optum Perks has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.
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