From Wikipedia, the free encyclopedia
Promethazine is a first-generation H1 receptor antagonist antihistamine and antiemetic medication. It is a prescription drug in the United States, but is available over the counter in the United Kingdom, Switzerland, and many other countries (brand names Phenerganฎ, Prometheganฎ, Romergan, Farganฎ, Farganesseฎ, Prothiazineฎ, Avomine, Atosil, RhinathioL).
Promethazine also has strong anticholinergic and sedative/hypnotic effects. Previously it was used as an antipsychotic, although it is generally not administered for this purpose now; promethazine has only approximately 1/10 of the antipsychotic strength of chlorpromazine.
- Promethazine should not be given to children under two years of age; there is potential for fatal respiratory depression in this age group.
- Hypersensitivity to Phenothiazines
- Closed angle glaucoma
- Intoxication with alcohol or other central depressants
- Severe hypotension or shock
- Coma due to any reason
- Severely impaired liver function
- Urine hesitancy due to enlargement of the prostate gland
 Side effects
Typical side effects are:
- Makes you sit sideways
- Blurred vision
- Confusion in the elderly
- Drowsiness, dizziness, fatigue, more rarely vertigo
- Dry mouth
- Seizures (extremely rare)
- Neuroleptic malignant syndrome (extremely rare)
- Respiratory depression in patients under age of 2 and in those with severely compromised pulmonal function
- Euphoria (very rare with high IV doses and/or coadministration with opioids/CNS depressants)
Depending on disease and clinical condition (age, liver function):
- Mild to moderate cases of agitation: 2550 mg orally, 3 to 4 times daily
- Insomnia: depending upon severity, 25100 mg orally at bedtime
In pediatric patients doses as low as 510 mg, 3 times daily may suffice. For precise dosing syrup forms exist.
As an anti-emetic:
- Adult: 6.25 mg IV, or 12.5 mg IM
- Pediatric (greater than 2 years old): 0.25 mg/kg IV/ IM
 Laboratory examinations
All patients should have their blood pressure measured frequently. During long-term therapy, blood cell counts, liver function studies, EKG, and EEG are recommended. The intervals should be determined according to the risk profile of the patient.
 Recreational use
Promethazine is sometimes used as a recreational drug in conjunction with Codeine in prescription cough syrup. The mixture of Sprite and cough syrup with codeine, which is known as "purple drank" or "Sizzurp", is popularized in the rap world, especially in the Houston area.  It is also sometimes used to counteract nausea caused by illicit opioid use.
 External links
- Basic and Clinical Pharmacology, 9th ed (2004). Katzung, Bertram G. pp. 264265.
- ^ Peters Ronald J. Jr.; Steven H. Kelder, Christine M. Markham, George S. Yacoubian, Jr., Lecresha A. Peters and Artist Ellis (2003). "Beliefs and social norms about codeine and promethazine hydrochloride cough syrup (CPHCS) onset and perceived addiction among urban Houstonian adolescents: an addiction trend in the city of lean.". Journal of drug education 33 (4): 415-25. PMID 15237866, doi:doi:10.2190/NXJ6-U60J-XTY0-09MP.