Phenergan 12.5mg Suppositories

Promethazine is a phenothiazine derivative that acts as a potent H1-receptor antagonist. It also possesses significant anticholinergic, antidopaminergic, and weak alpha-adrenergic blocking activity. Its antiemetic effects are thought to be due to its central anticholinergic action and its ability to block dopamine receptors in the chemoreceptor trigger zone (CTZ). Its sedative effects are due to its H1-blocking and anticholinergic properties.

Urgent Side Effects: Seek Medical Help Right Away

Although rare, some people may experience severe and potentially life-threatening side effects while taking this medication. If you notice any of the following symptoms, contact your doctor or seek medical attention immediately:

Signs of an allergic reaction, such as:
+ Rash
+ Hives
+ Itching
+ Red, swollen, blistered, or peeling skin with or without fever
+ Wheezing
+ Tightness in the chest or throat
+ Trouble breathing, swallowing, or talking
+ Unusual hoarseness
+ Swelling of the mouth, face, lips, tongue, or throat
Signs of high or low blood pressure, including:
+ Severe headache
+ Dizziness
+ Passing out
+ Changes in eyesight
Abnormal heart rhythms, such as:
+ Fast or slow heartbeat
Neurological problems, including:
+ Trouble controlling body movements
+ Twitching
+ Changes in balance
+ Difficulty swallowing or speaking
+ Shakiness
+ Trouble moving around
+ Stiffness
Confusion or altered mental state
Feeling nervous or excitable
Hallucinations (seeing or hearing things that are not there)
Mood changes
Ringing in the ears
Seizures
Unexplained bruising or bleeding
Yellowing of the skin or eyes
Changes in eyesight
Neuroleptic malignant syndrome (NMS), a potentially life-threatening condition characterized by:
+ Fever
+ Muscle cramps or stiffness
+ Dizziness
+ Severe headache
+ Confusion
+ Changes in thinking
+ Fast or irregular heartbeat
+ Excessive sweating
Severe breathing problems, including:
+ Slow, shallow, or labored breathing
Low white blood cell counts, which may increase the risk of infection; seek medical help if you experience:
+ Fever
+ Chills
+ Sore throat

Other Possible Side Effects

While many people may not experience any side effects or only minor ones, it's essential to be aware of the following potential side effects:

Dizziness
Drowsiness
Fatigue
Weakness
Blurred vision
Dry mouth
Upset stomach or vomiting
Trouble sleeping
* Stuffy nose

If you experience any of these side effects or any other unusual symptoms, contact your doctor or seek medical attention. Not all side effects are listed here, so if you have concerns, don't hesitate to reach out to your doctor.

Reporting Side Effects

You can report side effects to the FDA at 1-800-332-1088 or online at https://www.fda.gov/medwatch. Your doctor is also available to provide guidance on managing side effects and answering any questions you may have.

Before Taking This Medication: Important Information to Share with Your Doctor

It is essential to inform your doctor about the following:

Any allergies you have, including allergies to this medication, its components, or other substances, such as foods or drugs. Be sure to describe the allergic reaction you experienced, including any symptoms that occurred.
If you have a history of respiratory problems, including:
+ Asthma
+ Chronic obstructive pulmonary disease (COPD)
+ Sleep apnea (breathing difficulties during sleep)
If you have been diagnosed with:
+ Liver problems
+ Reye's syndrome

Please note that this is not an exhaustive list of all potential interactions between this medication and other health conditions or drugs. Therefore, it is crucial to discuss the following with your doctor and pharmacist:

All prescription and over-the-counter (OTC) medications you are currently taking
Any natural products or vitamins you are using
Your complete medical history, including any health problems you are experiencing

To ensure your safety, do not start, stop, or modify the dosage of any medication without first consulting your doctor. It is vital to verify that it is safe to take this medication in conjunction with your other medications and health conditions.

It is essential to inform all your healthcare providers, including doctors, nurses, pharmacists, and dentists, that you are taking this medication.

Before operating a vehicle or engaging in any activity that requires alertness and clear vision, wait until you understand how this medication affects you.

This drug may interfere with the accuracy of certain pregnancy tests. If you are undergoing pregnancy testing, consult with your doctor.

If you have diabetes (high blood sugar), it is crucial to closely monitor your blood sugar levels while taking this medication.

Prior to consuming alcohol, using marijuana or other cannabis products, or taking prescription or over-the-counter medications that may impair your reactions, discuss the potential risks with your doctor.

You may be more susceptible to sunburn while taking this medication. To minimize this risk, avoid exposure to direct sunlight, sunlamps, and tanning beds. Use protective measures such as sunscreen, clothing, and eyewear that provide adequate protection against the sun.

This medication may increase the risk of seizures, particularly in individuals with a history of seizure disorders. Consult with your doctor to determine if you are at a higher risk of experiencing seizures while taking this medication.

If you are 65 years or older, exercise caution when using this medication, as you may be more prone to experiencing side effects.

If you are pregnant, planning to become pregnant, or breastfeeding, inform your doctor. It is necessary to discuss the potential benefits and risks of this medication to both you and your baby.

• MAO inhibitors (concurrent use or within 14 days of MAOI discontinuation)
• Other CNS depressants (in children < 2 years old)

• CNS depressants (e.g., opioids, benzodiazepines, alcohol, barbiturates, tricyclic antidepressants) - increased sedation and respiratory depression
• Anticholinergic drugs (e.g., atropine, scopolamine, tricyclic antidepressants) - increased anticholinergic effects (dry mouth, blurred vision, urinary retention, constipation)
• QT-prolonging drugs (e.g., antiarrhythmics, certain antipsychotics, macrolide antibiotics) - theoretical risk of additive QT prolongation
• Dopamine agonists (e.g., bromocriptine, cabergoline) - promethazine's antidopaminergic effects may antagonize their action
• Epinephrine - promethazine may reverse the vasopressor effect of epinephrine, leading to a further decrease in blood pressure

• Antihypertensives - additive hypotensive effects
• Metoclopramide - additive extrapyramidal symptoms
• Phenytoin - promethazine may increase phenytoin levels
• Antidiabetic agents - promethazine may mask symptoms of hypoglycemia

• Not available

• Excessive drowsiness
• Dizziness
• Confusion
• Difficulty breathing
• Dry mouth
• Blurred vision
• Urinary retention
• Constipation
• Restlessness
• Involuntary muscle movements (extrapyramidal symptoms)

Category C. Should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus. Limited human data, but animal studies show some adverse effects. Use near term may cause respiratory depression or extrapyramidal symptoms in the neonate.

Excreted into breast milk. Use with caution. The American Academy of Pediatrics considers promethazine to be compatible with breastfeeding, but monitor infant for sedation, irritability, or poor feeding. Avoid use in preterm infants or those with respiratory issues.

Contraindicated in children younger than 2 years of age due to the risk of fatal respiratory depression. Use with extreme caution in children 2 years of age and older, and avoid in those with a history of sleep apnea, family history of SIDS, or acute illness (e.g., asthma, pneumonia) that could compromise respiratory function. Lower doses and careful monitoring are essential.

Elderly patients are more susceptible to the anticholinergic effects (e.g., dry mouth, blurred vision, urinary retention, constipation) and CNS effects (e.g., sedation, confusion, dizziness, orthostatic hypotension) of promethazine. Use lower initial doses and titrate carefully. Avoid in patients with dementia or cognitive impairment.

• Promethazine suppositories are useful when oral administration is not feasible due to severe nausea/vomiting.
• Due to the risk of severe respiratory depression, promethazine is contraindicated in children younger than 2 years of age.
• Exercise extreme caution when administering promethazine to pediatric patients 2 years of age and older, and avoid in those with compromised respiratory function.
• Warn patients about significant sedation and advise against driving or operating machinery.
• Advise patients to avoid alcohol and other CNS depressants due to additive effects.
• Monitor for anticholinergic side effects, especially in elderly patients.
• Promethazine can cause photosensitivity; advise patients to use sun protection.
• Rectal administration may cause local irritation.

• For nausea/vomiting: Ondansetron, Granisetron, Dimenhydrinate, Metoclopramide
• For allergy: Diphenhydramine, Loratadine, Cetirizine, Fexofenadine
• For sedation: Diphenhydramine, Hydroxyzine, Benzodiazepines (e.g., lorazepam, midazolam)

If your symptoms or health issues persist or worsen, it's essential to contact your doctor for further guidance. To ensure your safety, never share your medication with others or take someone else's medication. Some medications may come with an additional patient information leaflet, so be sure to check with your pharmacist for more information. If you have any questions or concerns about your medication, don't hesitate to reach out to your doctor, nurse, pharmacist, or other healthcare provider. In the event of a suspected overdose, immediately call your local poison control center or seek medical attention. When seeking help, be prepared to provide details about the medication taken, the amount, and the time it happened.