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Phenergan
promethazine
Black Box Warnings .
Respiratory Depression
contraindicated in patients <2 yo due to cases of resp. depression, some fatal, at wide-range of wt-based doses; in patients 2 yo and older, use with caution at lowest effective dose, avoid combo with other resp. depressant drugs
Severe Tissue Injury, Gangrene
severe chemical irritation and tissue damage, including gangrene, tissue necrosis, and thrombophlebitis have occurred regardless of parenteral administration route; some cases require surgical intervention, including fasciotomy, skin graft, and/or amputation; IV injection at concentration >1 mg per mL, intra-arterial injection, and SC injection contraindicated; IM route preferred; if must use IV, dilute through IV catheter inserted in large vein, preferably central venous catheter; immediately D/C if pain occurs, evaluate for possible arterial injection or perivascular extravasation, and initiate appropriate medical management
Adult Dosing .
Dosage forms: INJ: 25 mg per mL, 50 mg per mL
Dosage Form Details
- [TAB, SOL forms discontinued in US for this brand; see generic]
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]
- Max: 50 mg/dose PO/IM; 25 mg/dose IV; 100 mg/day; Alt: 12.5-25 mg IM/IV q4-6h; 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: 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
refractory nausea/vomiting, chemo-related (off-label)
- [12.5-25 mg PO q4-6h]
- Info: search 'CINV' for epocrates Chemo-Induced Nausea & Vomiting in Adults decision tool
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: INJ: 25 mg per mL, 50 mg per mL
Dosage Form Details
- [TAB, SOL forms discontinued in US for this brand; see generic]
allergic conditions
- [2 yo and older]
- Dose: 0.1 mg/kg/dose PO q6h prn; Max: 12.5 mg/dose during the 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 prior to travel; Max: 25 mg/dose; 100 mg/day; 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 the 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