HealthyCanada.com

Brand Name:Phenergan Cream, Histantil, PMS-Promethazine syrup

Prescription needed: Yes, In Some Cases

What is this drug used for?

Is there any reason not to take this drug?

You should not take this drug if you have a known sensitivity to promethazine, prochlorperazine or chlorpromazine

Always disclose your full medical history with the medical team that is taking care of you, in order for them to provide you with the safest and most effective care.

Tell your doctor if you have or have ever had:

• Asthma or any other breathing difficulties
• blood disease
• history of brain-related disease
• difficulty urinating due to enlarged prostate or urinary retention
• Epilepsy or other seizure disorders—promethazine may raise the risk of seizures
• Glaucoma—promethazine may worsen the condition by slightly increasing pressure in the eye
• heart or blood vessel disease—promethazine may cause more serious conditions to develop
• constipation or intestinal blockage
• jaundice
• kidney or liver disease
• Parkinson’s disease
• Reye's syndrome
• sleep apnea -- promethazine may make this condition much worse

What about possible side effects?

This medication is usually well tolerated but you should be aware of some potential side effects. The following list of more common side effects can be quite bothersome, but unless they are severe, you should continue taking as prescribed. Contact your doctor or pharmacist to get advice on how to manage these side effects:

• blurred vision
• drowsiness
• tiredness
• dry mouth
• difficulty urinating
• constipation
• mild skin irritation
• increased skin sensitivity to sun

Less common side effects that tend to go away with time include:

• tender breasts or milk production
• unstable blood sugars – if you are a diabetic, just monitor you blood sugars more frequently
• ringing in the ears
• grayish skin discolouration – speak to your doctor about this at your next appointment

If you experience any of the following less common symptoms, stop taking promethazine and call your doctor as soon as possible:

• heart palpitations
• hallucinations
• tremors or problems with movement (e.g. involuntary movements or difficulty initiating movements such as walking)

Rare but potentially serious side effects include:

• severe skin rash, difficulty breathing or swallowing, hives all over the body or near the face and throat – signs of an allergic reaction - stop taking and get emergency medical help immediately
• convulsions – stop taking and get emergency medical help immediately
• yellowing of the skin or eyes and stomach pain – stop taking and get emergency help immediately
• muscle rigidity, fever and confusion – stop taking and get emergency medical help right away
• signs of infection (e.g. fever, feeling unwell, lack of appetite, lack of energy) that do not improve after a reasonable period of time

This is not a complete list of side effects. If you are concerned about these or other unusual symptoms while taking this medication, ask your doctor and/or pharmacist for more information and advice.

What if I am taking other drugs?

Always provide your doctor with a list of all other drugs you are taking (including over-the-counter medications and herbal/natural products) as they may interact with and/or may change the safety or effectiveness of either drug. Tell your doctor specifically if you are taking any of these drugs as these are the most common interactions and he/she may need to make changes or monitor you more closely:

• drugs that can cause tiredness, sedation, dizziness or increase the chances of having the same side effects - talk to your doctor or pharmacist if you are taking any of the following drugs:
• opioid pain medications (e.g. codeine, oxycodone, morphine, hydromorphone)
• opioid cough medications (e.g. hydrocodone, codeine)
• some antidepressants (e.g. amitriptyline, doxepin, venlafaxine)
• medications for anxiety and insomnia (e.g. lorazepam, diazepam, oxazepam, temazepam, zopiclone)
• antipsychotics (e.g. risperidone, haloperidol)
• muscle relaxants (e.g. cyclobenzaprine, orphenadrine, baclofen)
• drugs for epilepsy (gabapentin, phenytoin, phenobarbital, carbamazepine, valproic acid)
• other antihistamines (e.g. diphenhydramine, chlorpheniramine, dimenhydrinate) – avoid combining other products that treat colds, flu or to help with sleep
• alcoholic beverages, including wine, liquors, beer
• herbal products (e.g. valerian, St John’s Wort)
  
• drugs that can cause dry mouth, dry eyes, problems urinating or constipation (e.g. amitriptyline, desipramine, imipramine; ask your doctor or pharmacist) - increase your chances of having similar side effects
• MAO inhibitors may prolong and intensify the side effects of antihistamines, in particular causing fainting and dizziness
• MAO inhibitors include phenelzine (brand name Nardil), tranylcypromine (brand name Parnate), moclobemide (brand name Manerix, generics available) isocarboxazid (available in the U.S.A. under the brand name Marplan) and others not available in Canada
• low doses of the MAO inhibitor selegeline (brand name Deprenyl, generics available) may be safe but always be cautious and seek advice from your doctor
• betahistine – antihistamines may reduce the effects
• carbamazepine, phenytoin, rifampin – may reduce effects of promethazine
• amiodarone, cimetidine, chlorpromazine, fluoxetine, paroxetine, quinidine, terbinafine, clomipramine, clozapine, desipramine, diphenhydramine, haloperidol, ketoconazole, methadone, sertraline, ticlopidine, trazodone – may interfere with how the body processes promethazine, resulting in increased effects
• donepezil, galantamine, rivastigmine – effects may be reduced

This is not a complete list of drug interactions. Ask your doctor or pharmacist to review your list of medications.

Other information:

Special Instructions

If you are planning on having any skin tests for allergies, tell your doctor that you are taking this medication as it may affect the results of your allergy test.

Your skin may become more sensitive to sunlight while taking promethazine. Avoid use of artificial tanning lamps. Wear sunblock and protective clothing while outdoors.

Dietary: Promethazine may be taken with or without food.

Children: Not recommended for those under the age of 2. Older children will need to take a reduced dose. Other drugs which may slow breathing rate should not be used (e.g. some prescription cough medications)

Seniors: Not recommended for use in seniors due to higher risk of side effects – consult with doctor about safer choices. The promethazine cream is safe for use.

Pregnancy: Safely used in pregnancy at normal doses but better options are available. Discuss with your doctor.

Women who are nursing: Promethazine passes into breast milk and may cause your infant to appear drowsy or irritable. Speak to your doctor before taking promethazine while breastfeeding. This does not apply to promethazine cream, which may be safely applied to skin areas without any effect on the infant.

People who drive or operate machinery: Promethazine may cause you to become quite drowsy or dizzy. Should not attempt these activities until you know how promethazine affects you personally.

Alcohol: Do not drink alcohol while taking promethazine, you may feel very dizzy or drowsy.

Overdose: A large overdose of this medicine could cause significant drowsiness, slowed breathing, dry mouth, or anxiety. If you experience any unusual reactions or if suspect an overdose, call911.

Stopping the drug: Can be safely stopped when no longer required.

If you miss a dose: Take it as soon as you remember then alter the timing of your next dose accordingly. Do not take a double dose.

Storage conditions: Closed container; cool, dry location away from excess moisture (not in the bathroom) and light; always out of reach of children.