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promethazine
generic
Black Box Warnings .
Respiratory Depression
contraindicated in pts <2 yo due to cases of resp. depression, some fatal, at wide-range of wt-based doses; in pts 2 yo and older, use w/ caution at lowest effective dose, avoid combo w/ other resp. depressant drugs
Severe Tissue Injury, Gangrene
promethazine injection can cause severe chemical irritation and tissue damage including burning, pain, thrombophlebitis, tissue necrosis and gangrene regardless of administration route; may result from perivascular extravasations, unintentional intra-arterial injection, and intraneuronal or perineuronal inflitration; some cases require surgical intervention
Adult Dosing .
Dosage forms: TAB: 12.5 mg, 25 mg, 50 mg; SOL: 6.25 mg per 5 mL; INJ: 25 mg per mL, 50 mg per mL
allergic conditions
- [6.25-25 mg PO tid-qid prn]
- Max: 100 mg/day; Alt: 6.25-25 mg IM/IV tid-qid prn; Info: give before meals and bedtime; if must give injectable, IM preferred over IV; may give second IM/IV dose 2h after first dose
motion sickness
- [25 mg PO bid]
- Start: 0.5-1h prior to travel; Alt: 25 mg IM bid
nausea/vomiting
- [12.5-25 mg PO q4-6h prn]
- Max: 50 mg/dose PO/IM; 25 mg/dose IV; 100 mg/day; Alt: 12.5-25 mg IM/IV q4-6h prn; Info: if must give injectable, IM preferred over IV
sedation
- [25-50 mg PO x1]
- Max: 50 mg/dose PO/IM; 25 mg/dose IV; Alt: 25-50 mg IM x1; 25 mg IV x1; Info: if must give injectable, IM preferred over IV
urticaria
- [6.25-25 mg PO tid-qid prn]
- Max: 50 mg/dose PO/IM; 25 mg/dose IV; 100 mg/day; Alt: 6.25-25 mg IM/IV tid-qid prn; Info: give before meals and bedtime; if must give injectable, IM preferred over IV; may give second IM/IV dose 2h after first dose
renal dosing
- [no adjustment]
- renal impairment: no adjustment
- HD/PD: no adjustment; no supplement
hepatic dosing
- [see below]
- hepatic impairment: not defined, caution advised
Peds Dosing .
- Dosage forms: TAB: 12.5 mg, 25 mg, 50 mg; SOL: 6.25 mg per 5 mL; INJ: 25 mg per mL, 50 mg per mL
allergic conditions
- [2 yo and older]
- Dose: 0.1 mg/kg/dose PO q6h prn; Max: 12.5 mg/dose during day, 25 mg/dose qhs; 100 mg/day; Info: may give additional dose of up to 0.5 mg/kg/dose PO qhs; use lowest effective dose; avoid other resp. depressants
motion sickness
- [2 yo and older]
- Dose: 0.5 mg/kg/dose PO q12h; Start: 0.5-1h before travel; Max: 25 mg/dose; Alt: 0.5 mg/kg/dose IM q12h; Info: use lowest effective dose; avoid other resp. depressants
nausea/vomiting
- [2 yo and older]
- Dose: 0.25-1 mg/kg/dose PO q4-6h prn; Max: 25 mg/dose; 100 mg/day; Alt: 0.25-1 mg/kg/dose IM/IV q4-6h prn; Info: if must give injectable, IM preferred over IV; use lowest effective dose; avoid other resp. depressants
sedation
- [2 yo and older]
- Dose: 12.5-25 mg PO x1; Max: 25 mg/dose; Alt: 12.5-25 mg IM/IV x1; Info: if must give injectable, IM preferred over IV; use lowest effective dose; avoid other resp. depressants
urticaria
- [2 yo and older]
- Dose: 0.1 mg/kg/dose PO q6h prn; Max: 12.5 mg/dose during day, 25 mg/dose qhs; 100 mg/day; Info: may give additional dose of up to 0.5 mg/kg/dose PO qhs; use lowest effective dose; avoid other resp. depressants
renal dosing
- [not defined]
- renal impairment: consider adult renal dosing for guidance
- HD/PD: consider adult renal dosing for guidance
hepatic dosing
- [see below]
- hepatic impairment: not defined, caution advised