Promethazine, Oral/Rectal/Injection

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KEY POINTS

• This medicine is used for many reasons, such as to help you relax, prevent motion sickness, or relieve allergy symptoms. Take it exactly as directed. Never give this medicine to a child without your healthcare provider's approval. It should never be given to children under 2 years of age.
• This medicine may cause unwanted side effects. Tell your healthcare provider if you have any side effects that are serious, continue, or get worse.
• Tell all healthcare providers who treat you about all the prescription medicines, nonprescription medicines, supplements, natural remedies, and vitamins that you take.

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What are other names for this medicine?

Type of medicine: antihistamine; antinausea; antiemetic; phenothiazine

Generic and brand names: promethazine, injection; promethazine, oral; promethazine, rectal; Phenadoz; Phenergan; Promethegan

What is this medicine used for?

This medicine is used to:

• Relieve the symptoms of hay fever or other allergic reactions
• Relieve nausea and vomiting
• Prevent motion sickness
• Help you sleep
• Help you relax (as a sedative)
• Increase the actions of pain medicines after surgery

This medicine may be used to treat other conditions as determined by your healthcare provider.

What should my healthcare provider know before I take this medicine?

Before taking this medicine, tell your healthcare provider if you have ever had:

• A family history of sudden infant death syndrome (SIDS)
• An allergic reaction to any medicine
• A stroke or transient ischemic attack (TIA), brain tumor, or head injury
• Bone marrow problems
• Bladder or prostate problems or trouble urinating
• Glaucoma (elevated pressure in the eyes)
• Heart disease
• High blood pressure
• Liver disease
• Lung or breathing problems such as asthma, COPD, or sleep apnea
• Myasthenia gravis
• Parkinson’s disease
• Reye's Syndrome
• Seizures
• Ulcers

Do not take this medicine if you have a history of sleep apnea (when you stop breathing while sleeping and wake up gasping for air). Talk with your healthcare provider about this.

Females of childbearing age: Talk with your healthcare provider if you are pregnant or plan to become pregnant. It is not known whether this medicine will harm an unborn baby. Do not breast-fee while taking this medicine without your healthcare provider's approval.

How do I use it?

Check the label on the medicine for directions about your specific dose. Take this medicine exactly as your healthcare provider prescribes. Do not take more of it or take it longer than prescribed.

Do not use this medicine in children under age 2.

This medicine comes in the form of tablets and liquid for oral use, as suppositories for rectal use, and as injections (shots).

Oral forms of this medicine work best when taken with food or a full glass of milk (8 ounces). If you have the liquid form of this medicine, use the measuring spoon, cup, dropper, or oral syringe that comes with the medicine, or ask your pharmacist for one. Do not use a kitchen spoon because the dose may not be correct.

To use a suppository, remove the foil wrapper and moisten the suppository with water. If the suppository is too soft to insert easily, run cold water over it or put it in ice water until it is firm. If it is too dry or hard, moisten it with warm water. Lie on your left side and bend your right knee up toward your chest. Gently push the suppository into your rectum (pointed end first) deep enough so that it will not come out. Keep lying down for about 5 minutes. This lets the medicine dissolve and keeps the suppository from coming out.

This medicine may be given by injection (shots) by your healthcare provider. The injections may cause severe tissue damage. Tell your healthcare provider if you have any redness, burning, pain, or swelling where the medicine is going into your body.

What if I miss a dose?

If you miss a dose, take it as soon as you remember unless it is almost time for the next scheduled dose. In that case, skip the missed dose and take the next one as directed. Do not take double doses. If you are not sure of what to do if you miss a dose, or if you miss more than one dose, contact your healthcare provider.

What if I overdose?

If you or anyone else has intentionally taken too much of this medicine, call 911 or go to the emergency room right away. If you pass out, have seizures, weakness or confusion, or have trouble breathing, call 911. If you think that you or anyone else may have taken too much of this medicine, call the poison control center. Do this even if there are no signs of discomfort or poisoning. The poison control center number is 800-222-1222.

Symptoms of an acute overdose may include: severe drowsiness, dizziness, dry mouth, large pupils, flushing, nausea, vomiting, shallow breathing, fainting, muscle twitches, loss of balance, seizures.

What should I watch out for?

Never give this medicine to a child without your healthcare provider's approval. It should never be given to children under 2 years of age.

Do not take any prescription or nonprescription antihistamines, sedatives, narcotic pain medicines, sleeping pills, or antidepressants without your healthcare provider's approval.

While taking this medicine, be careful when you exercise, especially when it is hot. This medicine affects your body's ability to cool down, and you may get too hot. If you get too hot, you might vomit, feel dizzy, have a fast heartbeat, get very stiff muscles, or confused. Contact your provider immediately if you have these symptoms.

Adults over the age of 65 may be at greater risk for side effects. Talk with your provider about this.

This medicine increases the effects of alcohol and other drugs that slow down the nervous system. Do not drink alcohol or take other medicines unless your healthcare provider approves.

This medicine may cause a false reading of some pregnancy tests. Talk with your healthcare provider about this.

This medicine may make you very drowsy. Do not drive or operate machinery unless you are fully alert.

This medicine may make your skin more sensitive to the sun and may cause you to sunburn more easily. While you are taking this medicine, avoid long exposure to the sun. While you are in the sun, wear protective clothing and sunscreen lotion until you know how you will react to the sun. Do not use a sunlamp. If you get a severe sunburn, contact your healthcare provider right away.

Dry mouth is a common side effect of this medicine. Tell your healthcare provider if it becomes bothersome.

If you need emergency care, surgery, allergy skin tests, lab tests, or dental work, tell the healthcare provider or dentist you are taking this medicine.

What are the possible side effects?

Along with its needed effects, your medicine may cause some unwanted side effects. Some side effects may be very serious. Some side effects may go away as your body adjusts to the medicine. Tell your healthcare provider if you have any side effects that continue or get worse.

Life-threatening (Report these to your healthcare provider right away. If you cannot reach your healthcare provider right away, get emergency medical care or call 911 for help.): Allergic reaction (hives; itching; rash; trouble breathing; tightness in your chest; swelling of your lips, tongue, and throat).

Serious (Report these to your healthcare provider right away.): Rash, sore throat, high fever, stiff muscles, excitability, severe drowsiness or dizziness, fainting, flushing, heavy sweating, trouble breathing, muscle spasms, twitching in the face and body, confusion, trouble walking or talking, uncontrolled tongue or jaw movement, vision changes, ringing in the ears, trouble urinating, fast or irregular heartbeat, seizures, hallucinations, yellowing of skin or eyes, dark urine, light-colored bowel movements, severe nausea or vomiting; pain, burning, redness, or swelling at the injection site.

Other: Sensitivity to the sun, dry mouth, drowsiness, dizziness, nausea, constipation, trouble sleeping, nightmares, stuffy nose.

What products might interact with this medicine?

When you take this medicine with other medicines, it can change the way this or any of the other medicines work. Nonprescription medicines, vitamins, natural remedies, and certain foods may also interact. Using these products together might cause harmful side effects. Talk to your healthcare provider if you are taking:

• Alcohol
• Alfuzosin (Uroxatral)
• Antianxiety medicines such as alprazolam (Xanax), butabarbital (Butisol), chlordiazepoxide, clorazepate (Gen-Xene, Tranxene), diazepam (Valium), lorazepam (Ativan), meprobamate (Equanil), and oxazepam
• Antiarrhythmic medicines (to treat irregular heartbeat) such as amiodarone (Cordarone, Pacerone), disopyramide (Norpace), dofetilide (Tikosyn), dronedarone (Multaq), flecainide, procainamide, propafenone (Rythmol), quinidine, and sotalol (Betapace, Sorine)
• Antibiotics such as azithromycin (Zithromax, Zmax), ciprofloxacin (Cipro), clarithromycin (Biaxin), erythromycin (E.E.S., Ery-Tab, Erythrocin), levofloxacin (Levaquin), metronidazole, moxifloxacin (Avelox), pentamidine (NebuPent, Pentam), rifampin (Rifadin), telavancin (Vibativ), and telithromycin (Ketek)
• Antidepressants such as amitriptyline, citalopram (Celexa), duloxetine (Cymbalta), escitalopram (Lexapro), fluoxetine (Prozac), fluvoxamine (Luvox), imipramine (Tofranil), nortriptyline (Pamelor), sertraline (Zoloft), and venlafaxine (Effexor)
• Antifungal medicines such as clotrimazole, fluconazole (Diflucan), itraconazole (Sporanox), ketoconazole (Nizoral), posaconazole (Noxafil), terbinafine (Lamisil), and voriconazole (Vfend)
• Antihistamines such as chlorpheniramine (Chlor-Trimeton), diphenhydramine (Benadryl), and hydroxyzine (Vistaril)
• Antipsychotic medicines such as aripiprazole (Abilify), asenapine (Saphris), chlorpromazine, clozapine (Clozaril, FazaClo), fluphenazine, haloperidol (Haldol), iloperidone (Fanapt), olanzapine (Zyprexa), paliperidone (Invega), perphenazine, pimozide (Orap), prochlorperazine (Compro), quetiapine (Seroquel), risperidone (Risperdal), thioridazine, trifluoperazine, and ziprasidone (Geodon)
• Antiseizure medicines such as carbamazepine (Carbatrol, Epitol, Equetro, Tegretol), fosphenytoin (Cerebyx), phenobarbital, and phenytoin (Dilantin, Phenytek)
• Apomorphine (Apokyn)
• Atropine/diphenoxylate (Lomotil)
• Belladonna
• Bupropion (Aplenzin, Forfivo, Wellbutrin, Buproban, Zyban)
• Cabergoline
• Cancer medicines such as abiraterone (Zytiga), arsenic trioxide (Trisenox), crizotinib (Xalkori), dabrafenib (Tafinlar), dasatinib (Sprycel), lapatinib (Tykerb), nilotinib (Tasigna), pazopanib (Votrient), procarbazine (Matulane), sorafenib (Nexavar), sunitinib (Sutent), toremifene (Fareston), vandetanib (Caprelsa), and vemurafenib (Zelboraf)
• Cinacalcet (Sensipar)
• Doxepin (Silenor)
• Erectile dysfunction medicines such as avanafil (Stendra), sildenafil (Viagra), tadalafil (Cialis), and vardenafil (Levitra, Staxyn)
• Fingolimod (Gilenya)
• HIV medicines such as atazanavir (Reyataz), darunavir (Prezista), delavirdine (Rescriptor), lopinavir/ritonavir (Kaletra), nevirapine (Viramune), ritonavir (Norvir), saquinavir (Invirase), and tipranavir (Aptivus)
• Lithium (Lithobid)
• Malaria medicines such as artemether/lumefantrine (Coartem), chloroquine, mefloquine, primaquine, and quinine
• MAO inhibitors such as isocarboxazid (Marplan), phenelzine (Nardil), selegiline (Eldepryl, Emsam, Zelapar), and tranylcypromine (Parnate) (Do not take this medicine and an MAO inhibitor within 14 days of each other.)
• Meclizine (Dramamine)
• Methscopolamine (Pamine)
• Metoclopramide (Metozolv, Reglan)
• Mifepristone (Korlym, Mifeprex)
• Muscle relaxants such as baclofen (Gablofen, Lioresal), carisoprodol (Soma), cyclobenzaprine (Amrix), methocarbamol (Robaxin), and tizanidine (Zanaflex)
• Natural remedies such as evening primrose, gotu kola, kava, St. John's wort, and valerian
• Octreotide (Sandostatin)
• Pain medicines such as codeine, fentanyl (Abstral, Actiq, Duragesic, Fentora, Sublimaze), hydrocodone (Hysingla, Zohydro), hydromorphone (Dilaudid, Exalgo), meperidine (Demerol), methadone (Dolophine, Methadose), morphine (Kadian, MS Contin), oxycodone (OxyContin, Roxicodone), oxymorphone (Opana), tapentadol (Nucynta), and tramadol (ConZip, Ultram)
• Paroxetine (Brisdelle, Paxil, Pexeva)
• Peginterferon alfa-2b (Sylatron)
• Pramlintide (Symlin)
• Ranolazine (Ranexa)
• Scopolamine (Transderm Scop)
• Sleeping pills such as flurazepam, pentobarbital (Nembutal), suvorexant (Belsomra), temazepam (Restoril), triazolam (Halcion), zaleplon (Sonata), and zolpidem (Ambien, Edluar, Intermezzo)
• Solifenacin (VESIcare)

If you are not sure if your medicines might interact, ask your pharmacist or healthcare provider. Keep a list of all your medicines with you. List all the prescription medicines, nonprescription medicines, supplements, natural remedies, and vitamins that you take. Be sure that you tell all healthcare providers who treat you about all the products you are taking.

How should I store this medicine?

Store the tablet and liquid forms of this medicine at room temperature. Keep the container tightly closed. Protect it from heat, high humidity, and bright light. If you have the suppositories, store them in the refrigerator.

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This advisory includes selected information only and may not include all side effects of this medicine or interactions with other medicines. Ask your healthcare provider or pharmacist for more information or if you have any questions.

Ask your pharmacist for the best way to dispose of outdated medicine or medicine you have not used. Do not throw medicines in the trash.

Keep all medicines out of the reach of children.

Do not share medicines with other people.