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Phenergan
promethazine
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
severe chemical irritation and tissue damage, incl. gangrene, tissue necrosis, and thrombophlebitis have occurred regardless of parenteral admin. route; some cases require surgical intervention, incl. fasciotomy, skin graft, and/or amputation; IV injection at conc. >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; immed. 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 Forms Discontinued in US
- [tab, solution not avail. as 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
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 Forms Discontinued in US
- [tab, solution not avail. as 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