Promethazine and phenylephrine
Looking up MedlinePlus…
From MedlinePlus, U.S. National Library of Medicine
Dosing in kidney impairment
This label has no separate kidney-impairment dosing section. Check warnings and clinical pharmacology in the full label.
Preparation and administration
DOSAGE AND ADMINISTRATION It is important that promethazine hydrochloride and phenylephrine hydrochloride oral solution, USP is measured with an accurate measuring device (see Precautions-Information for Patients ). A household teaspoon is not an accurate measuring device and could lead to overdosage, especially when half a teaspoon is to be measured.
It is strongly recommended that an accurate measuring device be used. A pharmacist can provide instructions for measuring the correct dose. Promethazine hydrochloride and phenylephrine hydrochloride oral solution, USP is contraindicated for children under 2 years of age (see WARNINGS –Black Box Warning and Use in Pediatric Patients ).
Drug interactions
Check promethazine and phenylephrine against a medication listLabel text (5 paragraphs)
Drug Interactions: Promethazine CNS Depressants - Promethazine may increase, prolong, or intensify the sedative action of other central-nervous system depressants, such as alcohol, sedatives/hypnotics (including barbiturates), narcotics, narcotic analgesics, general anesthetics, tricylic antidepressants, and tranquilizers; therefore, such agents should be avoided or administered in reduced dosage to patients receiving promethazine HCl. When given concomitantly with promethazine, the dose of barbiturates should be reduced by at least one-half, and the dose of narcotics should be reduced by one-quarter to one-half. Dosage must be individualized.
Excessive amounts of promethazine HCl relative to a narcotic may lead to restlessness and motor hyperactivity in the patient with pain; these symptoms usually disappear with adequate control of the pain. Epinephrine - Because of the potential for promethazine to reverse epinephrine's vasopressor effect, epinephrine should NOT be used to treat hypotension associated with promethazine overdose. Anticholinergics - Concomitant use of other agents with anticholinergic properties should be undertaken with caution.
Monoamine oxidase inhibitors (MAOI) - Drug interactions, including an increased incidence of extrapyramidal effects, have been reported when some MAOI and phenothiazines are used concomitantly. Phenylephrine Drug Phenylephrine with prior administration of monoamine oxidase inhibitors (MAOI). Effect Cardiac pressor response potentiated. May cause acute hypertensive crisis. Drug Phenylephrine with tricyclic antidepressants. Effect Pressor response increased. Drug Phenylephrine with ergot alkaloids. Effect Excessive rise in blood pressure. Drug Phenylephrine with bronchodilator sympathomimetic agents and with epinephrine or other sympathomimetics.
Effect Tachycardia or other arrhythmias may occur. Drug Phenylephrine with atropine sulfate Effect Reflex bradycardia blocked; pressor response enhanced. Drug Phenylephrine with prior administration of propranolol or other β -adrenergic blockers. Effect Cardiostimulating effects blocked. Drug Phenylephrine with prior administration of phentolamine or other α-adrenergic blockers. Effect Pressor response decreased. Drug Phenylephrine with diet preparations, such as amphetamines or phenylpropanolamine. Effect Synergistic adrenergic response. Drug/Laboratory Test Interactions: The following laboratory tests may be affected in patients who are receiving therapy with promethazine hydrochloride.
Pregnancy Tests: Diagnostic pregnancy tests based on immunological reactions between HCG and anti-HCG may result in false-negative or false-positive interpretations. Glucose Tolerance Test: An increase in blood glucose has been reported in patients receiving promethazine.
Contraindications
Promethazine is contraindicated in comatose states, and in individuals known to be hypersensitive or to have had an idiosyncratic reaction to promethazine or to other phenothiazines. Antihistamines are contraindicated for use in the treatment of lower respiratory tract symptoms, including asthma. Phenylephrine is contraindicated in patients with hypertension or with peripheral vascular insufficiency (ischemia may result with risk of gangrene or thrombosis of compromised vascular beds). Phenylephrine should not be used in patients known to be hypersensitive to the drug or in those receiving a monoamine oxidase inhibitor (MAOI).
Safety data
Reported adverse events (FAERS)
Liver injury (LiverTox)
LiverTox has no chapter for promethazine and phenylephrine. Check the label's hepatic warnings.
Pregnancy and lactation
Pregnancy
Pregnancy Tests: Diagnostic pregnancy tests based on immunological reactions between HCG and anti-HCG may result in false-negative or false-positive interpretations. Glucose Tolerance Test: An increase in blood glucose has been reported in patients receiving promethazine.
Lactation
Nursing Mothers: It is not known whether promethazine or phenylephrine are excreted in human milk. Caution should be exercised when promethazine and phenylephrine is administered to a nursing woman.
For breastfeeding, also see LactMed (National Library of Medicine), which summarizes milk levels and infant effects.
Supply and cost
Drug shortage status
Recalls (last 24 months)
Therapeutic equivalence (Orange Book)
Price ladder
Not the price at the counterThese are not what a patient pays at the pharmacy counter. They are what pharmacies, health plans, and government buyers pay, before manufacturer rebates. A patient's cost depends on their insurance (copay, coinsurance, or deductible) or the pharmacy's cash price.