Cough and cold:
Indications for: Promethazine DM
Cough and upper respiratory symptoms associated with allergy and common cold.
5mL every 4–6hrs; max 30mL/24hrs.
<2yrs: not recommended. 2–6yrs: 1.25–2.5mL every 4–6hrs; max 10mL/24hrs. 6–<12yrs: 2.5–5mL every 4–6hrs; max 20mL/24hrs.
Promethazine DM Contraindications:
Concomitant MAOIs. Comatose states. Lower respiratory tract symptoms. Asthma. Pediatric patients <2yrs.
Do not use in pediatric patients <2yrs due to the potential for fatal respiratory depression.
Promethazine DM Warnings/Precautions:
Pediatric patients ≥2yrs: caution; use lowest effective dose. Atopic children. Compromised respiratory function (eg, COPD, apnea), signs/symptoms of Reye's syndrome or hepatic disease in children: avoid. Discontinue immediately and treat appropriately if neuroleptic malignant syndrome occurs. Seizure disorder. Bone-marrow depression. Narrow-angle glaucoma. Prostatic hypertrophy. Stenosing peptic ulcer. Pyloroduodenal obstruction. Bladder-neck obstruction. Cardiovascular disease. Hepatic impairment. Debilitated. Elderly. Sedated patients or those confined to supine position. Avoid prolonged sun exposure. Labor & delivery. Pregnancy (Cat.C). Nursing mothers.
Promethazine DM Classification:
Antihistamine + antitussive.
Promethazine DM Interactions:
See Contraindications. Increased extrapyramidal effects with MAOIs. Avoid use with concomitant respiratory and CNS depressants (eg, alcohol, sedatives/hypnotics, narcotics, general anesthesia, tricyclics, tranquilizers); if unavoidable, may need to reduce dose. Concomitant epinephrine: not recommended. Caution with other anticholinergics. May get false pregnancy test results.
Drowsiness, dizziness, confusion, sedation, insomnia, convulsive seizures, hallucinations, hyperexcitability, GI upset, respiratory depression, cardiovascular effects; possible neuroleptic malignant syndrome, cholestatic jaundice, blood dyscrasias.
Renal. Half-life: 3–30 hours (dextromethorphan); 12-15 hours (promethazine).