Promethazine Indications and Dosage
- allergic rhinitis †
- motion sickness
- nausea/vomiting
- pruritus
- sedation induction
† non-FDA-approved indication
Promethazine Indications and Dosage
For the prevention of motion sickness:
Oral or Rectal dosage:
Adults: 25 mg PO or PR 30 - 60 minutes before departure, then every 12 hours as needed.
Elderly: Sedating drugs may cause confusion and over-sedation in the elderly; therefore, elderly patients should generally be started on low doses of promethazine and closely observed.
Children >= 2 years: 0.5 mg/kg (max: 25 mg) PO or PR 30 - 60 minutes before departure, then every 12 hours as needed. According to the manufacturer, the usual dose for children is 12.5 - 25 mg. The lowest possible effective dose should be given, and the concomitant use of other respiratory depressants should be avoided.
Children < 2 years: Use is contraindicated.
For the treatment of nausea/vomiting:
Oral or Rectal dosage:
Adults: 12.5 - 25 mg PO or PR every 4 - 6 hours as needed.
Elderly: Sedating drugs may cause confusion and over-sedation in the elderly; therefore, elderly patients should generally be started on low doses of promethazine and closely observed.
Children >= 2 years: 0.5 mg/pound PO or PR (max: 25 mg/dose) every 4 - 6 hours as needed. Adjust according to age, weight, and severity of condition. According to the manufacturer, the average effective dose is 25 mg. The lowest possible effective dose should be given, and the concomitant use of other respiratory depressants should be avoided.
Children < 2 years: Use is contraindicated.
Intramuscular or Intravenous dosage:
Adults: 12.5 - 25 mg IM or IV every 4 - 6 hours as needed.
Elderly: Sedating drugs may cause confusion and over-sedation in the elderly; therefore, elderly patients should generally be started on low doses and closely observed.
Children >= 2 years: 6.25 - 12.5 mg IM or IV every 4 - 6 hours as needed. Dosage should not exceed one-half of the recommended adult dosage. The lowest possible effective dose should be given, and the concomitant use of other respiratory depressants should be avoided.
Children < 2 years: Use is contraindicated.
For the treatment of allergic manifestations, such as pruritus:
Oral or rectal dosage:
Adults: The average dose is 25 mg PO or PR at bedtime. However, 12.5 mg PO or PR may be given before meals and at bedtime, if necessary.
Elderly: Sedating drugs may cause confusion and over-sedation in the elderly; therefore, elderly patients should generally be started on low doses of promethazine and closely observed.
Children >= 2 years: 6.25 - 12.5 mg PO or PR may be given three times per day and at bedtime, if necessary. Maximum dose, usually given at bedtime, is 25 mg. The lowest possible effective dose should be given, and the concomitant use of other respiratory depressants should be avoided.
Children < 2 years: Use is contraindicated.
- for the treatment of allergic rhinitis † :
Oral dosage:
Adults: The average dose is 12.5 mg PO given before meals and at bedtime, as needed. Alternatively, give 25 mg PO at bedtime as needed.
Elderly: Sedating drugs may cause confusion and over-sedation in the elderly; therefore, elderly patients should generally be started on low doses of promethazine and closely observed.
Children >= 2 years: Doses of 6.25 - 12.5 mg PO three times per day as needed have been used. The lowest possible effective dose should be given, and the concomitant use of other respiratory depressants should be avoided.
Children < 2 years: Use is contraindicated.
For sedation induction:
- for routine preoperative or postoperative sedation induction, as an adjunct to analgesics:
Oral, intramuscular or intravenous dosage:
Adults: 25 - 50 mg PO, IM, or IV as a single dose.
Elderly: Sedating drugs may cause confusion and over-sedation in the elderly; therefore, elderly patients should generally be started on low doses of promethazine and closely observed.
Children >= 2 years: 12.5 - 25 mg PO, IM, or IV as a single dose. The lowest possible effective dose should be given, and the concomitant use of other respiratory depressants should be avoided.
Children < 2 years: Use is contraindicated.
- for sedation in obstetrics:
Intramuscular or Intravenous dosage:
Adults: 25 - 50 mg IM or IV during the early stages of labor and 25 - 75 mg after labor is established; repeat every 2 - 4 hours as needed.
Elderly: Sedating drugs may cause confusion and over-sedation in the elderly; therefore, elderly patients should generally be started on low doses of promethazine and closely observed.
- for relief of apprehension and to induce quiet sleep from which the patient can be easily aroused:
Oral, rectal or intramuscular or intravenous dosage:
Adults: 25 - 50 mg PO, PR, IM, or IV at bedtime.
Elderly: Sedating drugs may cause confusion and over-sedation in the elderly; therefore, elderly patients should generally be started on low doses of promethazine and closely observed.
Children >= 2 years: 12.5 - 25 mg PO, PR, IM, or IV at bedtime. The lowest possible effective dose should be given, and the concomitant use of other respiratory depressants should be avoided.
Children < 2 years: Use is contraindicated.
Patients with hepatic impairment:
Those with significant hepatic disease should be monitored closely. Dosage adjustments may be required in these patients but no quantitative recommendations as available.
Patients with renal impairment:
No dosage adjustments are needed.
[ Last revised: 5/24/2006 8:56:00 PM ]
References
. Hyde JS, Arora NV, Kumar CM, et al. Chronic rhinitis in the pre-school child. Ann Allergy 1978;41:216 - 9.
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