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Author: Admin | 2025-04-28
Drug class: First Generation Antihistamines IntroductionUsesDosageWarningsInteractionsStabilityFAQ IntroductionPromethazine is a phenothiazine derivative with potent first generation antihistaminic properties.Uses for Promethazine (Antihistamine)Promethazine shares the uses of the antihistaminic drugs. Promethazine’s pronounced sedative effect limits the usefulness of the drug as an antihistamine in many ambulatory patients. In contrast to most other phenothiazines, promethazine is effective in the management of motion sickness. (See Uses in the Antihistamines General Statement 4:00.)For the use of promethazine as a sedative and antiemetic, see Promethazine Hydrochloride 28:24.92 and also see the Phenothiazines General Statement 28:16.08.24.Promethazine (Antihistamine) Dosage and AdministrationAdministrationPromethazine hydrochloride may be administered orally, rectally, or by deep IM injection. Promethazine hydrochloride also is administered by IV injection. However, because IV administration of the drug has been associated with severe tissue injury, including gangrene requiring amputation, the US Food and Drug Administration (FDA) states that deep IM injection is the preferred method for administration of promethazine hydrochloride injections. (See Cautions: Precautions and Contraindications.) If IV administration of promethazine hydrochloride is required, FDA states that the drug should be administered through the tubing of an IV infusion set that is known to be correctly functioning; FDA also states that the maximum rate of IV administration is 25 mg/minute, and the maximum concentration of the injection is 25 mg/mL. If the patient complains of pain at the injection site during presumed IV injection of the drug, the injection should immediately be stopped, and the possibility of intra-arterial placement of the needle or perivascular extravasation should be evaluated. Promethazine hydrochloride injection is commercially available in 2 strengths: 25 mg/mL and 50 mg/mL. FDA states that the preparation containing 50 mg/mL is for IM injection only; the preparation containing 25 mg/mL may be administered by IM or IV injection.Because of the risk of severe tissue injury and amputations if promethazine hydrochloride is inadvertently administered intra-arterially or if extravasation were to occur, some medication safety experts (e.g., the Institute for Safe Medication Practices [ISMP]) recommend that parenteral administration of the drug be avoided and replaced by safer alternative therapies.Subcutaneous or intra-arterial injection of promethazine hydrochloride is contraindicated. Promethazine hydrochloride injection should be
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