Promethazine syrup IP Phenergan is a medication that has several uses. It is primarily used as an antihistamine, sedative, and antiemetic (anti-nausea/vomiting) drug. Some of the main uses of promethazine syrup IP Phenergan include:
Treating Allergies
Promethazine is a first-generation antihistamine. It blocks the effects of histamine, a chemical released by the body during an allergic reaction. By preventing histamine from attaching to receptors, promethazine prevents allergy symptoms like sneezing, runny nose, watery eyes, and itching from occurring. It can provide relief from allergy symptoms caused by hay fever, pet dander, dust mites, and other environmental triggers.
Treating Motion Sickness
Promethazine is effective at preventing nausea and vomiting due to motion sickness. It can be used to treat and prevent motion sickness associated with travel by car, boat, plane, or amusement park rides. By blocking histamine receptors, it reduces dizziness and nausea that can occur due to motion.
Treating Morning Sickness in Pregnancy
Promethazine is sometimes prescribed in low doses to treat nausea and vomiting in early pregnancy. It is considered safe for use in pregnancy and is one of the preferred anti-nausea medications prescribed during the first trimester. It can provide relief from morning sickness symptoms like nausea and vomiting that commonly affect pregnant women.
Preventing and Treating Nausea and Vomiting after Surgery
Promethazine is given before and after surgery to prevent post-operative nausea and vomiting (PONV). Nausea and vomiting are common side effects after general anesthesia due to the medication effects on the vestibular system of the inner ear and the gag reflex. Promethazine can help relax the gastrointestinal tract and suppress the urge to vomit after surgery.
Relieving Nausea and Vomiting from Other Conditions
In addition to motion sickness and PONV, promethazine can also reduce nausea and vomiting caused by:
- Gastroenteritis (stomach flu)
- Gastroparesis
- Food poisoning
- Migraines
- Chemotherapy
- Pregnancy
Its anti-nausea effects can provide relief from vomiting, retching, and upset stomach caused by various medical conditions.
Treating Vertigo
Promethazine can sometimes be prescribed for symptoms of vertigo including dizziness, lightheadedness, imbalance, and nausea. It is thought to work by reducing neurotransmission in the inner ear and blocking histamine receptors that influence dizziness and motion sickness.
Sedative Effects
In addition to its antihistamine effects, promethazine is also a central nervous system depressant. It has sedative and anti-anxiety properties due to its effects on certain receptors in the brain. Lower doses can help relieve symptoms of anxiety or trouble sleeping. Higher doses are used as a sedative medicine before and after surgery and other medical procedures.
Increasing Pain Medication Effectiveness
Promethazine may be combined with opioid pain medications like codeine. When added to prescribed narcotic pain relievers, promethazine can amplify the pain-reducing effects. It also helps prevent nausea that may occur as a side effect of the narcotic medications.
Available Forms
Promethazine syrup IP Phenergan can be found in:
- Oral solution/syrup – 6.25mg promethazine HCl per 5mL
- Tablets – 12.5mg, 25mg, 50mg promethazine HCl
- Rectal suppositories – 12.5mg, 25mg, 50mg promethazine HCl
- Injections – 25mg/mL promethazine HCl in 1mL ampules
The oral syrup and rectal suppositories are commonly prescribed for nausea and vomiting. Tablets are used mainly for allergies and sedation. Injections are given when rapid control of severe nausea and vomiting is needed.
Proper Dosage
Promethazine syrup IP Phenergan dosage depends on the patient and condition being treated. Typical dosing guidelines are:
- Allergies in adults: 25mg by mouth every 4-6 hours as needed
- Nausea/vomiting in adults: 12.5-25mg by mouth every 4-6 hours as needed
- Children ages 2+: 0.5mg per pound of body weight by mouth every 4-6 hours as needed, up to 25mg per dose
- Motion sickness prevention in adults: 25-50mg by mouth 30-60 minutes before travel
- Surgery sedation in adults: 25-50mg the night before surgery; 25mg by mouth or injection on day of surgery
Promethazine should be taken as directed by a healthcare provider. Extended-release tablets and oral syrup/solution are sometimes preferred for ongoing treatment to allow for more consistent dosing.
How Long Does it Take to Work?
Promethazine starts working within 30-60 minutes after oral dosing. Effects peak within 2-3 hours and can last up to 12 hours. It may work more rapidly when given by rectal suppository or injection.
When treating motion sickness, it is best to take promethazine 30-60 minutes before travel for maximum preventative effects. For other uses, it can be taken on an as-needed basis for symptomatic relief of nausea or allergy symptoms.
Drug Interactions
Promethazine can interact with several prescription and over-the-counter medicines including:
| Type of Drug | Interaction Effects |
|---|---|
| Sedatives like benzodiazepines or sleep medications | May cause excessive sedation or respiratory depression |
| Antidepressants (SSRIs, MAOIs) | May cause increased heart rate, blood pressure changes, tremors |
| Narcotic pain relievers | May amplify CNS depression; increased risk of overdose |
| Alcohol | Increased drowsiness, impaired concentration |
| Antihypertensives | May inhibit blood pressure lowering effects |
| Atropine | Reduces absorption of promethazine |
Promethazine has a high risk of drug interactions. Patients should tell their doctor about all current medications before starting treatment with promethazine.
Side Effects
Promethazine is generally well-tolerated when used at prescribed doses. Potential side effects include:
- Drowsiness
- Dizziness
- Blurred vision
- Dry mouth
- Constipation
- Difficulty urinating
- Nervousness
- Restlessness
- Skin rash or itching
- Shaking
- Nightmares
- Weakness
- Confusion
- Seizures (rare)
Promethazine is more likely to cause side effects in children and older adults. Sedation and impaired motor coordination are most common. Paradoxical excitation may also occur, especially in those with dementia or brain damage.
Warnings and Precautions
Promethazine oral syrup and tablets come with several safety warnings including:
- May cause drowsiness – use caution when driving or operating machinery
- Avoid drinking alcohol while taking promethazine
- Use with caution in patients with asthma, COPD, sleep apnea, or respiratory impairment
- Contains sulfites – may cause allergic reaction in susceptible individuals
- Use lower doses in elderly patients due to increased sedation risk
- Not approved for use in pediatric patients less than 2 years old
- Potentially fatal respiratory depression may occur with excessive doses
Promethazine has an FDA black box warning for potentially fatal respiratory depression. Excess doses, especially when combined with other CNS depressants like opioids or alcohol, may dangerously slow or stop breathing.
Contraindications
Promethazine is contraindicated in patients:
- With known hypersensitivity to promethazine or other phenothiazines
- Taking MAO inhibitors – can cause dangerous drug interactions
- With risk factors for respiratory depression unless monitored in a health care facility
- Under 2 years of age due to airway risks
- With narrow-angle glaucoma
- With stenosing peptic ulcer or pyloroduodenal obstruction
Abuse Potential
Promethazine has a potential for abuse, especially with prolonged use of high doses. It may produce a euphoric high, feelings of relaxation, and perceptual distortions. Injecting promethazine tablets can also lead to infections, blocked blood vessels, or gangrene.
Co-abuse with opioids and sedatives heightens the risks. Combining promethazine with alcohol or other drugs synergistically increases central nervous system depression. This can slow heart rate and breathing to dangerous levels leading to overdose and death.
Overdose Symptoms
An overdose of promethazine can be fatal. Acute overdose symptoms may include:
- Severe drowsiness
- Weakness
- Confusion
- Hallucinations
- Fainting
- Seizures
- Coma
- Breathing difficulties
- Bluish discoloration of the skin
- Narrowing of the pupil
- Rapid heart rate
- Low blood pressure
- Death
A promethazine overdose is a medical emergency. Immediate medical care is vital to prevent respiratory arrest and circulatory collapse.
Warnings Signs of Addiction
Signs that a person may be abusing or addicted to promethazine include:
- Taking more than the recommended dose
- Taking promethazine more often or for longer than intended
- Going through the prescription faster than expected
- Wanting to continue using promethazine despite side effects
- Taking promethazine for reasons other than originally prescribed
- Obtaining promethazine illegally without a prescription
- Combining promethazine with alcohol or illicit drugs
- Experiencing cravings for promethazine when not taking it
- Need to increase dosage to get the same effects
- Feeling unable to function normally without promethazine
- Spending excessive time trying to obtain more promethazine
- Using promethazine despite negative impacts on life and health
Those struggling with promethazine addiction should seek professional treatment. Withdrawal under medical supervision can improve the chances of getting sober safely.
Promethazine Withdrawal Symptoms
Stopping promethazine suddenly after regular use can cause withdrawal symptoms including:
- Insomnia
- Nightmares
- Anxiety
- Depression
- Restlessness
- Irritability
- Body aches
- Chills
- Sweating
- Nausea and vomiting
- Tremors
- Fatigue
- Weakness
- Headaches
Symptoms are usually worst in the first 1-3 days after stopping. Medical detox can help ease cravings and minimize withdrawal reaction severity and duration.
Finding Treatment for Addiction
Treatment programs for promethazine addiction may involve:
- Medical detox – Tapering off promethazine use under medical supervision. May utilize other medications to ease withdrawal.
- Behavioral counseling – Individual and group therapy focused on relapse prevention.
- 12-step programs – Community support groups like Narcotics Anonymous.
- Aftercare planning – Developing ongoing recovery plans and access to support systems.
- Dual diagnosis treatment – Programs that address co-occurring mental health disorders.
A combination of detox, counseling, support groups, and relapse prevention helps treat promethazine addiction for the long term. Inpatient or outpatient programs lasting 30-90 days or longer provide comprehensive treatment.
Tips for Family Members
For family members of someone addicted to promethazine, tips include:
- Educate yourself about promethazine abuse
- Approach your loved one with kindness and concern
- Avoid enabling behaviors like giving them money
- Encourage and support them in seeking treatment
- Communicate boundaries and cut off supply routes
- Remove promethazine from your home if possible
- Don’t ignore or try to cover up addiction behaviors
- Participate in family counseling and support groups
- Set a good example with your own health behaviors
- Take care of your own physical and mental health
Getting a loved one treatment improves the chances of recovery. But ultimately, they need to make the decision to get sober themselves. Protect your own well-being throughout the process.
Conclusion
Promethazine syrup IP Phenergan is a prescription antihistamine and antiemetic drug. It has several medical uses including treating allergies, nausea, vomiting, dizziness, anxiety, and trouble sleeping. The oral solution is commonly used to prevent motion sickness and control postoperative nausea. However, promethazine also has the potential for abuse and addiction. Warning signs of addiction include taking it in ways other than prescribed, combining with other substances, and being unable to control use despite negative consequences. Treatment involves detox, behavioral therapies, and support systems. Families should approach addicted loved ones with compassion while also setting boundaries.
