What is promethazine syrup plain 6.25 mg 5ml?

Quick Answer

Promethazine syrup plain 6.25 mg 5ml is a prescription cough medicine containing the active ingredient promethazine hydrochloride. Promethazine belongs to a class of medications called phenothiazines. It works by blocking the effects of histamine in the body and has antihistamine, antiemetic, sedative, and anticholinergic properties. The plain promethazine syrup does not contain any additional active ingredients like codeine or guaifenesin that are found in other cough syrup preparations. It is used to treat allergic symptoms, motion sickness, nausea, vomiting, and cough. The standard adult dosage is 5-10 ml (12.5-25 mg promethazine) every 4-6 hours as needed. The syrup comes in concentrations of 6.25 mg/5ml which equates to 1.25 mg of promethazine per 1 ml.

What is promethazine?

Promethazine is a first-generation antihistamine medication that is used to treat allergies, motion sickness, nausea, vomiting, sedation, and cough. It was originally developed in the 1940s and was approved by the FDA in 1951 under the brand name Phenergan.

Here are some key facts about promethazine:

– It is a central nervous system depressant that has sedative, hypnotic, antiemetic, anticholinergic, and local anesthetic effects.

– It blocks the effects of histamine in the body by binding to H1 receptor sites and preventing histamine from binding. This provides relief from allergic symptoms.

– It helps prevent motion sickness by reducing stimulation of the inner ear.

– It provides relief from nausea and vomiting by blocking serotonin and dopamine receptors in the brain’s vomiting center.

– It suppresses cough by acting on the cough center in the medulla in the brain.

– Some common brand name formulations containing promethazine include Phenergan, Phenadoz, Promethegan, and Promacot.

– It’s available as oral tablets, rectal suppositories, injectable solution, oral syrup, and topical gel.

– Promethazine is classified as a phenothiazine, which is a class of antipsychotic medications. However, it is used in clinical practice mainly for its antihistamine effects.

So in summary, promethazine is a versatile medication with antihistamine, antiemetic, sedative, and anticholinergic properties that make it useful for treating a variety of symptoms and conditions. The cough syrup preparations are used to help relieve cough symptoms.

What are the uses of promethazine cough syrup?

Promethazine plain syrup is used to treat a variety of respiratory symptoms associated with allergies, the common cold, or flu. Here are some of the main uses and indications for promethazine cough syrup:

– **Cough suppression:** Promethazine suppresses the cough reflex by acting on the cough center in the medulla of the brain. The antihistamine effects may also help reduce cough caused by postnasal drip.

– **Sore throat pain relief:** The local anesthetic properties of promethazine can help numb pain from sore throats. The sedative effects also promote rest.

– **Cold and allergy symptoms:** Promethazine provides relief from symptoms like sneezing, watery eyes, runny nose, and itching which are common with colds and seasonal allergies.

– **Nasal congestion:** By drying up excess respiratory secretions, promethazine helps clear nasal passageways and sinus congestion.

– **Sleep promotion:** The sedating effects of promethazine encourage sleep and rest, which can help recovery from respiratory illnesses.

– **Nausea and vomiting:** Promethazine is antiemetic and can curb nausea and vomiting sometimes associated with coughs and colds.

So in summary, promethazine cough syrup is most commonly used for its cough-suppressing action, but also provides relief from other cold and flu symptoms like sore throat, congestion, allergies, and even nausea. The drowsiness often caused by promethazine can aid rest.

What are the side effects of promethazine syrup?

While promethazine syrup can provide relief from respiratory symptoms, it also carries a risk of side effects, especially when taken in higher doses. Some potential side effects to be aware of include:

– **Drowsiness:** Drowsiness and sedation are common side effects due to the medication’s depressant effects on the central nervous system. This can impair physical and mental abilities.

– **Impaired coordination and balance:** Promethazine may cause reduced motor control, balance and coordination. Move slowly and exercise caution to avoid falls.

– **Vision problems:** Blurred vision, difficulty focusing and dilated pupils can occur. This hampers the ability to operate vehicles or machinery.

– **Confusion and delirium:** Promethazine may cause a reversible state of delirium, disorientation or confusion, especially in the elderly.

– **Nausea and vomiting:** While usually taken to prevent nausea, promethazine can sometimes have the paradoxical effect of worsening nausea and vomiting.

– **Constipation:** Slowed gastrointestinal motility leading to constipation is a potential anticholinergic side effect.

– **Dry mouth and nose:** Decreased salivation and respiratory tract secretions can occur due to anticholinergic effects.

– **Urinary retention:** Difficulty fully emptying the bladder may happen in some people due to smooth muscle relaxation.

If any severe or concerning reactions occur, seek prompt medical attention. Those with certain medical conditions may be advised to avoid promethazine.

What is the dosage for promethazine cough syrup?

Promethazine syrup is available in concentrations of 6.25mg/5mL. The standard promethazine dosage for cough in adults and children over 12 years is:

– **Adults:** 5-10mL (one to two teaspoonfuls) every 4 to 6 hours as needed. The maximum daily dose is 40mL.

– **Children 12 years and over:** 5-10mL every 4 to 6 hours as needed, up to a max of 20mL per day.

– **Children under 12:** Not recommended without express medical direction.

– **Children under 2:** Contraindicated due to risks of severe breathing problems.

Here are some dosage considerations:

– Follow the doctor’s exact prescribed dose. Never exceed recommended amounts.

– Only use the dosing device (cup or oral syringe) provided with the medication. Do not use household spoons.

– Measure each dose carefully and shake the bottle before pouring each dose.

– If sedation is excessive, reduce the dose frequency. One dose at bedtime may be adequate.

– Due to variability between products, follow directions accompanying the specific syrup brand and formulation being taken.

– Discard any unused portion after initial opening. Check expiration dates and never use expired syrups.

Consult a doctor regarding any questions or concerns about proper dosing. Promethazine dosage adjustment may be needed for elderly patients or those with medical conditions like kidney or liver impairment.

How does promethazine work to relieve cough?

Promethazine relieves cough through a combination of mechanisms targeting both the cough reflex and the underlying inflammation that triggers coughing:

– **Suppression of the cough reflex** – Promethazine directly suppresses the cough reflex by acting on the cough center in the medulla region of the brain. This reduces sensitivity and blocks signals for cough initiation.

– **Antihistamine effects** – Promethazine blocks histamine receptors and has anti-allergic properties. This helps dry up post-nasal drip and thin respiratory secretions that can trigger coughs.

– **Anticholinergic effects** – It inhibits acetylcholine, leading to reduced secretions in the airways and drying of the mucosa. This reduces cough-provoking trickle and alleviates sore throat pain.

– **Sedation** – The calming and sleep-promoting effects of promethazine allow the body to rest and help suppress the urge to cough.

– **Local anesthetic effects** – Promethazine has numbing effects on nerve endings in the throat and respiratory tract, further muting cough reflexes.

– **Anti-inflammatory effects** – There may be some direct anti-inflammatory effects in the airways, reducing swelling and irritation.

So in summary, promethazine leverages its diverse pharmacological effects to impact coughing via the central nervous system, respiratory tract, and inflammation pathways. This comprehensive mechanism provides broad relief from irritating and uncomfortable cough symptoms.

Is promethazine cough syrup safe for regular long-term use?

Promethazine cough syrup is generally intended for short-term relief of cough and should not be used regularly for extended periods without medical direction. Here are some concerns with long-term use:

– **Dependence and addiction** – Promethazine has the potential for misuse and dependence with regular use due to its sedative properties. Psychological and physical dependence can develop.

– **Tolerance** – The effects may decrease over time with regular dosing, requiring higher doses to get the same effect. This increases the risks of side effects.

– **Respiratory depression** – Excessive doses of promethazine may dangerously slow breathing rates. This risk increases with long-term exposure.

– **Impaired cognition and coordination** – The sedation and anticholinergic effects may become more prominent with sustained use, hampering concentration, memory and physical abilities.

– **Masking underlying conditions** – Chronic coughs can be a symptom of serious health problems like COPD or infections. Relying on medication may prevent proper diagnosis.

– **Rebound symptoms** – Stopping promethazine after regular use can lead to worsened cough and insomnia until the body readjusts.

For these reasons, promethazine syrup should be carefully used at the lowest effective dose for short periods under medical supervision. Persistent coughs lasting more than 1-2 weeks may warrant further investigation. Safer long-term options for chronic cough management may include prescription expectorants or use of cough suppressants only at night.

Is promethazine cough syrup safe during pregnancy and breastfeeding?

Promethazine cough syrup is not considered completely safe for use during pregnancy or breastfeeding and should only be used cautiously under medical direction. Here is an overview of the risks:

– **Pregnancy** – Promethazine is classified as a Category C drug, indicating risk cannot be ruled out. It can cross the placenta and may cause mild respiratory depression or neurological disturbances in the fetus. It should be avoided in late pregnancy due to anti-cholinergic risks during delivery.

– **Breastfeeding** – Small amounts of promethazine enter breastmilk and can result in drowsiness, irritability, and inadequate weight gain in the infant. It is not recommended while nursing, especially in mothers of newborns or preterm infants.

– **Age and weight** – Promethazine has more risks in low birth weight or premature babies due to immature drug metabolism. Use is contraindicated in neonates.

If promethazine cough syrup is needed, the lowest effective dose should be used for the shortest possible duration. The risks and benefits must be very closely evaluated by the obstetrician or pediatrician for each individual circumstance. Non-drug measures to manage cough symptoms may be tried first during pregnancy and breastfeeding if feasible.

What precautions should be taken when giving promethazine syrup to children?

Promethazine syrup should be administered to children only with extreme care due to increased risks of side effects. Here are some precautions to take:

– Do not administer to children under 2 years old due to risks of fatal respiratory depression.

– Use caution in children 2 to 6 years old. Only use if clearly needed and monitor very closely.

– Measure doses very carefully using an appropriate medication syringe or cup. Never estimate or use household spoons.

– Closely adhere to age-appropriate dosing recommendations provided by the pediatrician. Do not exceed prescribed dose or frequency.

– Avoid use in dehydrated or debilitated children who are at greater risk of complications.

– Co-administer with food to minimize stomach upset.

– Recognize signs of overdose like excessive sleepiness, agitation, confusion, vision changes, respiratory depression.

– Keep out of reach and monitor use to prevent accidental ingestion. Promethazine has led to deaths in children from inappropriate self-administration.

– Be alert to paradoxical reactions like hyperactivity which may require medical evaluation.

Promethazine syrup has an unfavorable risk profile in children due to their variable metabolism. It should not be used casually or as a first line treatment. Consider safer alternatives first and reserve promethazine as a last resort with strict pediatric guidance.

What are some alternatives to promethazine for cough?

Some over-the-counter alternatives to promethazine syrup for relieving cough include:

– **Guaifenesin** – An expectorant that helps thin mucus secretions and promotes productive coughs to clear airways. Available in various brand name and generic products.

– **Dextromethorphan** – A non-opioid cough suppressant that inhibits the cough reflex. Found in many OTC cough syrups. Should not be used in young children.

– **Cough drops or lozenges** – Provide on-the-spot relief and coat irritated throat tissue. Look for soothing ingredients like honey, menthol, eucalyptus. Avoid giving hard candies to young children.

– **Saline nasal spray** – Saltwater nasal sprays moisturize dry nasal passages and rinse out excess mucus to relieve post-nasal drip. Can be used several times a day as needed.

– **Humidifier** – Loosens and thins mucus, reducing congestion and cough triggers. Clean humidifiers regularly to prevent mold growth.

– **Honey** – Has cough-calming properties and coats the throat. Should never be given to infants due to botulism risk.

– **Warm fluids** – Sipping warm broths, teas, or lemon-honey drinks can soothe coughs and promote hydration.

Non-drug remedies like cough drops, hydration, nasal saline and honey have milder side effect profiles. They may be tried first, using stronger OTC medications like guaifenesin or dextromethorphan for resistant coughs under the guidance of a pharmacist or doctor.


Promethazine syrup is an antihistamine medication commonly used for treating coughs and upper respiratory symptoms associated with colds, allergies, and the flu. It provides cough suppression by acting directly on the brain’s cough center as well as having anti-allergy, anticholinergic, sedative, and local anesthetic effects. The maximum adult dosing is around 10mL every 4-6 hours as needed. Side effects like sedation and confusion are possible, especially in older adults. Promethazine syrup should be used cautiously and under medical supervision due to risks of dependence with long-term use, impairment with activities, and complications in children and pregnant women. Safer alternatives for cough relief include expectorants like guaifenesin, demulcents like honey, and non-drug remedies like saline nasal spray and humidification. Promethazine cough syrup is best reserved for stubborn coughs under the guidance of a doctor or pharmacist.

Leave a Comment