PromethazinePromethazine Hydrochloride

About Promethazine

Promethazine blocks histamine, easing allergy symptoms, and also calms nausea and causes drowsiness. It is labeled for allergic rhinitis and hives, as an add-on after epinephrine in anaphylaxis, for motion sickness, nausea and vomiting around surgery, sedation, and pain after operations alongside other medicine. Drowsiness is the main effect, so wait to drive until you know how it affects you.

The boxed warning bars it in children under 2, because it has caused fatal breathing suppression, and asks for the lowest effective dose in older children; MedlinePlus says older adults usually should not take it. The injection, used in hospitals and clinics, has a second boxed warning for severe tissue injury, including gangrene, by any route: deep muscle injection is preferred, injection under the skin or into an artery is contraindicated, and the FDA now asks that intravenous doses be diluted and given through a catheter in a large vein, not the hand or wrist.

It is not used in coma, after a reaction to any phenothiazine, or for lower respiratory symptoms such as asthma, and needs caution with sleep apnea or lung disease, seizures, narrow-angle glaucoma, an enlarged prostate, heart disease or liver problems. Rarely it causes neuroleptic malignant syndrome or a drop in white blood cells. Cough syrups pairing it with dextromethorphan, or with codeine (Schedule V, adults 18 and over only), are separate products.

Taking Promethazine

How to take it

For allergies usually one to four times a day, before meals or at bedtime; for nausea every 4 to 6 hours as needed; for motion sickness 30 to 60 minutes before travel, then 8 to 12 hours later if needed. Measure liquid with the device provided, not a kitchen spoon. Suppositories go in the rectum only: unwrap, dip the tip in water and insert while lying on your left side.

If you miss a dose

Take it as soon as you remember, unless the next dose is nearly due; then skip the missed one. Do not take a double dose.

Storage

Tablets and liquid at room temperature, away from heat, moisture and light; suppositories in the refrigerator. Keep out of reach of children.

Interactions to know about

Alcohol, opioids, sleeping pills, barbiturates, anxiety medicines, tricyclic antidepressants and other sedatives add to drowsiness and slowed breathing; the label advises lower opioid and barbiturate doses when combined. MAO inhibitors and anticholinergic medicines need caution. It makes skin sensitive to sunlight, so use sunscreen and avoid unnecessary sun. Get urgent care for slowed breathing, fever with stiff muscles, seizures or uncontrollable movements.

This summarizes the official prescribing information. Your prescriber’s and pharmacist’s instructions, and the leaflet that comes with your medicine, take priority.

Why the cash price for Promethazine differs from pharmacy to pharmacy

Promethazine tablets have many makers, so a fill is priced mostly on the dispensing fee and the pharmacy’s pricing method; a per-tablet price adds up for doses taken several times a day.

The oral solution and suppositories come from fewer makers, and suppositories need refrigeration, so not every pharmacy stocks every strength and quotes vary more.

Ways to pay less for Promethazine without insurance

• Ask whether promethazine tablets are on the pharmacy’s flat-price generic list.
• If the oral solution was chosen only for convenience, ask whether tablets would suit you.
• For suppositories, check that the pharmacy has your strength in stock first.
• For motion sickness on a trip, ask for enough tablets for the whole trip in one fill.
• Upload the prescription to Script Unlock so licensed pharmacies can quote their cash price. You pay the pharmacy directly.

Questions to ask your pharmacist about Promethazine

1. 1.Is it safe for my child, and at what dose?
2. 2.Can I drive or drink alcohol while taking it?
3. 3.Does it interact with my pain, sleep, anxiety or depression medicines?
4. 4.How should I store and use the suppositories?
5. 5.Which side effects mean I should stop and get help?

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