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PROMETHAZINE Lactation?(Not Recommended) Trade Name: Phenergan
Class / Mechanism of Action
Phenothiazine derivative Antiemetic, Histamine H1 Antagonist, Sedative
Blocks postsynaptic dopaminergic receptors in the brain; strong alpha adrenergic blocking effect and
depresses release of hypothalamic and hypophyseal hormones; reduces stimuli to the reticular system
Onset of action IV: 5 minutes, Duration 4-6 hours
Indications
Labeled Indications: Symptomatic treatment for allergic conditions; antiemetic; motion sickness;
sedative; adjunct to postoperative analgesia and anesthesia
Unlabeled: Treatment of nausea and vomiting of pregnancy
Contraindications
• Hypersensitivity to promethazine, phenothiazine allergy, or any component of the formulation
• Coma
• Children <2 years old
• Intra-arterial and SubQ administration
Adverse Reactions / Precautions
• May cause Bradycardia, hyper-/hypotension, nonspecific QT changes, orthostatic hypotension,
tachycardia: Life threatening arrhythmias have occurred with normal dosage
• May cause extrapyramidal symptoms (pseudoparkinsonism, acute dystonic reactions, akathisia, etc.)
• Avoid use in severe respiratory disease (asthma, COPD), and in patients using other sedatives or
depressants: may lead to respiratory depression
• Vesicant: can cause severe tissue injury regardless of route of delivery
o Deep IM injection; or IV in line. Slow IVP over 1 minute
o For IV, ensure proper needle/catheter venous placement; avoid extravasation
Dose and Administration: ADULT PEDIATRIC Always Reference BROSELOW Tape
Antiemetic: Antiemetic:
IV push over >1 minute IM, IV:
• 12.5mg, not to exceed 25mg • Children ≥2 years: 0.25mg/kg 4-6 times/day
o May repeat 12.5mg once after 10min if prn (max: 12.5mg/dose)
first dose ineffective
o Subsequent dose of 25mg may be Preoperative analgesia/hypnotic adjunct:
IM, IV:
given q4hr
o Can dilute with 10-20mL of NS • Children ≥2 years: 1.1mg/kg in combination
with an analgesic or hypnotic (at reduced
dosage) and with an atropine like agent (at
Sedation, analgesia/hypnotic adjunct: appropriate dosage).
IM, IV:
• 25-50mg in combination with analgesic or Note: Promethazine dosage should not exceed
hypnotic (at reduced dosage) half of suggested adult dosage.
Allergic conditions (including allergic reactions to
blood or plasma):
IM, IV:
• 25mg, may repeat q2hr prn

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