Promethazine Hydrochloride

Promethazine Hydrochloride

Promethazine Hydrochloride Recall

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Questions & Answers

Side Effects & Adverse Reactions

PROMETHAZINE HCl SHOULD NOT BE USED IN PEDIATRIC PATIENTS LESS THAN 2 YEARS OF AGE BECAUSE OF THE POTENTIAL FOR FATAL RESPIRATORY DEPRESSION.

POSTMARKETING CASES OF RESPIRATORY DEPRESSION, INCLUDING FATALITIES, HAVE BEEN REPORTED WITH USE OF PROMETHAZINE HCl IN PEDIATRIC PATIENTS LESS THAN 2 YEARS OF AGE. A WIDE RANGE OF WEIGHT-BASED DOSES OF PROMETHAZINE HCl HAVE RESULTED IN RESPIRATORY DEPRESSION IN THESE PATIENTS.

CAUTION SHOULD BE EXERCISED WHEN ADMINISTERING PROMETHAZINE HCl TO PEDIATRIC PATIENTS 2 YEARS OF AGE AND OLDER. IT IS RECOMMENDED THAT THE LOWEST EFFECTIVE DOSE OF PROMETHAZINE HCl BE USED IN PEDIATRIC PATIENTS 2 YEARS OF AGE AND OLDER AND CONCOMITANT ADMINISTRATION OF OTHER DRUGS WITH RESPIRATORY DEPRESSANT EFFECTS BE AVOIDED.

 

Promethazine HCl tablets may impair the mental and/or physical abilities required for the performance of potentially hazardous tasks, such as driving a vehicle or operating machinery. The impairment may be amplified by concomitant use of other central-nervous-system depressants such as alcohol, sedatives/hypnotics (including barbiturates), narcotics, narcotic analgesics, general anesthetics, tricyclic antidepressants, and tranquilizers; therefore, such agents should either be eliminated or given in reduced dosage in the presence of promethazine HCl (see PRECAUTIONS: Information for Patients and Drug Interactions).

 

Promethazine HCl tablets may lead to potentially fatal respiratory depression.

Use of promethazine HCl tablets in patients with compromised respiratory function (e.g., COPD, sleep apnea) should be avoided.

 

Promethazine HCl tablets may lower seizure threshold. It should be used with caution in persons with seizure disorders or in persons who are using concomitant medications, such as narcotics or local anesthetics, which may also affect seizure threshold.

 

Promethazine HCl tablets should be used with caution in patients with bone-marrow depression. Leukopenia and agranulocytosis have been reported, usually when promethazine HCl has been used in association with other known marrow-toxic agents.

 

A potentially fatal symptom complex sometimes referred to as Neuroleptic Malignant Syndrome (NMS) has been reported in association with promethazine HCl alone or in combination with antipsychotic drugs. Clinical manifestations of NMS are hyperpyrexia, muscle rigidity, altered mental status and evidence of autonomic instability (irregular pulse or blood pressure, tachycardia, diaphoresis and cardiac dysrhythmias).

The diagnostic evaluation of patients with this syndrome is complicated. In arriving at a diagnosis, it is important to identify cases where the clinical presentation includes both serious medical illness (e.g., pneumonia, systemic infection, etc.) and untreated or inadequately treated extrapyramidal signs and symptoms (EPS). Other important considerations in the differential diagnosis include central anticholinergic toxicity, heat stroke, drug fever and primary central nervous system (CNS) pathology.

The management of NMS should include 1) immediate discontinuation of promethazine HCl, antipsychotic drugs, if any, and other drugs not essential to concurrent therapy, 2) intensive symptomatic treatment and medical monitoring, and 3) treatment of any concomitant serious medical problems for which specific treatments are available. There is no general agreement about specific pharmacological treatment regimens for uncomplicated NMS.

Since recurrences of NMS have been reported with phenothiazines, the reintroduction of promethazine HCl should be carefully considered.

 

PROMETHAZINE HCl TABLETS ARE CONTRAINDICATED FOR THE USE IN PEDIATRIC PATIENTS LESS THAN TWO YEARS OF AGE.

CAUTION SHOULD BE EXERCISED WHEN ADMINISTERING PROMETHAZINE HCl TABLETS TO PEDIATRIC PATIENTS 2 YEARS OF AGE AND OLDER BECAUSE OF THE POTENTIAL FOR FATAL RESPIRATORY DEPRESSION. RESPIRATORY DEPRESSION AND APNEA,SOMETIMES ASSOCIATED WITH DEATH, ARE STRONGLY ASSOCIATED WITH PROMETHAZINE PRODUCTS AND ARE NOT DIRECTLY RELATED TO INDIVIDUALIZED WEIGHT-BASED DOSING, WHICH MIGHT OTHERWISE PERMIT SAFE ADMINISTRATION, CONCOMITANT ADMINISTRATION OF PROMETHAZINE PRODUCTS WITH OTHER RESPIRATORY DEPRESSANTS HAS AN ASSOCIATION WITH RESPIRATORY DEPRESSION, AND SOMETIMES DEATH, IN PEDIATRIC PATIENTS.

ANTIEMETICS ARE NOT RECOMMENDED FOR TREATMENT OF UNCOMPLICATED VOMITING IN PEDIATRIC PATIENTS, AND THEIR USE SHOULD BE LIMITED TO PROLONGED VOMITING OF KNOWN ETIOLOGY. THE EXTRAPYRAMIDAL SYMPTOMS WHICH CAN OCCUR SECONDARY TO PROMETHAZINE HCl TABLETS ADMINISTRATION MAY BE CONFUSED WITH THE CNS SIGNS OF UNDIAGNOSED PRIMARY DISEASE, e.g., ENCEPHALOPATHY OR REYE'S SYNDROME. THE USE OF PROMETHAZINE HCl TABLETS SHOULD BE AVOIDED IN PEDIATRIC PATIENTS WHOSE SIGNS AND SYMPTOMS MAY SUGGEST REYE'S SYNDROME OR OTHER HEPATIC DISEASES.

Excessively large dosages of antihistamines, including promethazine HCl tablets in pediatric patients may cause sudden death (see OVERDOSAGE). Hallucinations and convulsions have occurred with therapeutic doses and overdoses of promethazine HCl in pediatric patients. In pediatric patients who are acutely ill associated with dehydration, there is an increased susceptibility to dystonias with the use of promethazine HCl.

 

Administration of promethazine HCl has been associated with reported cholestatic jaundice.

 

Legal Issues

There is currently no legal information available for this drug.

FDA Safety Alerts

There are currently no FDA safety alerts available for this drug.

Manufacturer Warnings

There is currently no manufacturer warning information available for this drug.

FDA Labeling Changes

There are currently no FDA labeling changes available for this drug.

Uses

Promethazine hydrochloride tablets are useful for:

Perennial and seasonal allergic rhinitis.

Vasomotor rhinitis.

Allergic conjunctivitis due to inhalant allergens and foods.

Mild, uncomplicated allergic skin manifestations of urticaria and angiodema. Amelioration of allergic reactions to blood or plasma.

Dermographism.

Anaphylactic reactions as adjunctive therapy to epinephrine and other standard measures after the acute manifestations have been controlled.

Preoperative, postoperative, or obstetric sedation.

Prevention and control of nausea and vomiting associated with certain types of anesthesia and surgery.

Therapy adjunctive to meperidine or other analgesics for control of postoperative pain.

Sedation in both children and adults as well as relief of apprehension and production of light sleep from which the patient can be easily aroused.

Active and prophylactic treatment of motion sickness.

Antiemetic therapy in postoperative patients.

 

History

There is currently no drug history available for this drug.

Other Information

Promethazine hydrochloride, a phenothiazine derivative, is designated chemically as 10H-Phenothiazine-10-ethanamine, N,N,α-trimethyl-,monohydrochloride, (±)- with the following structural formula:

MM1

Promethazine hydrochloride is a racemic compound; the molecular formula is C17H20N2S • HCl and its molecular weight is 320.88.

Promethazine hydrochloride occurs as a white to faint yellow, practically odorless, crystalline powder which slowly oxidizes and turns blue on prolonged exposure to air. It is freely soluble in water and soluble in alcohol.

Each tablet for oral administration contains 12.5 mg, 25 mg or 50 mg promethazine hydrochloride, USP. The inactive ingredients include: hypromellose, lactose monohydrate, magnesium stearate, and microcrystalline cellulose. The 12.5 mg contains FD&C Yellow No.6 aluminum lake.  The 50 mg contains D&C Red Lake Blend No.27 aluminum lake and D & C Red No. 30 aluminum lake.

 

Promethazine Hydrochloride Manufacturers


  • Remedyrepack Inc.
    Promethazine Hydrochloride Tablet [Remedyrepack Inc. ]
  • Northwind Pharmaceuticals
    Promethazine Hydrochloride Tablet [Northwind Pharmaceuticals]
  • Major Pharmaceuticals
    Promethazine Hydrochloride Tablet [Major Pharmaceuticals]
  • Cardinal Health
    Promethazine Hydrochloride Injection, Solution [Cardinal Health]
  • Blenheim Pharmacal, Inc.
    Promethazine Hydrochloride Tablet [Blenheim Pharmacal, Inc.]
  • Direct Rx
    Promethazine Hydrochloride Tablet [Direct Rx]
  • Preferred Pharmaceuticals, Inc.
    Promethazine Hydrochloride Tablet [Preferred Pharmaceuticals, Inc.]
  • Remedyrepack Inc.
    Promethazine Hydrochloride Tablet [Remedyrepack Inc. ]
  • Tya Pharmaceuticals
    Promethazine Hydrochloride Tablet [Tya Pharmaceuticals]
  • Apotheca, Inc
    Promethazine Hydrochloride Tablet [Apotheca, Inc]
  • Baxter Healthcare Corporation
    Promethazine Hydrochloride Injection, Solution [Baxter Healthcare Corporation]
  • West-ward Pharmaceutical Corp
    Promethazine Hydrochloride Injection [West-ward Pharmaceutical Corp]
  • Dispensing Solutions Inc.
    Promethazine Hydrochloride Injection, Solution [Dispensing Solutions Inc.]
  • Qualitest Pharmaceuticals
    Promethazine Hydrochloride Tablet [Qualitest Pharmaceuticals]
  • Global Pharmaceuticals, Division Of Impax Laboratories Inc.
    Promethazine Hydrochloride Tablet [Global Pharmaceuticals, Division Of Impax Laboratories Inc.]
  • State Of Florida Doh Central Pharmacy
    Promethazine Hydrochloride Tablet [State Of Florida Doh Central Pharmacy]
  • State Of Florida Doh Central Pharmacy
    Promethazine Hydrochloride Tablet [State Of Florida Doh Central Pharmacy]
  • Physicians Total Care, Inc.
    Promethazine Hydrochloride Tablet [Physicians Total Care, Inc.]
  • Physicians Total Care, Inc.
    Promethazine Hydrochloride Injection [Physicians Total Care, Inc.]
  • Rebel Distributors Corp
    Promethazine Hydrochloride Tablet [Rebel Distributors Corp]
  • Lake Erie Medical Dba Quality Care Products Llc
    Promethazine Hydrochloride Tablet [Lake Erie Medical Dba Quality Care Products Llc]
  • Rebel Distributors Corp
    Promethazine Hydrochloride Tablet [Rebel Distributors Corp]
  • Watson Laboratories, Inc.
    Promethazine Hydrochloride Tablet [Watson Laboratories, Inc.]
  • Blenheim Pharmacal, Inc.
    Promethazine Hydrochloride Tablet [Blenheim Pharmacal, Inc.]
  • Zydus Pharmaceuticals (Usa) Inc.
    Promethazine Hydrochloride Tablet [Zydus Pharmaceuticals (Usa) Inc.]
  • Cadila Healthcare Limited
    Promethazine Hydrochloride Tablet [Cadila Healthcare Limited]
  • Hospira, Inc.
    Promethazine Hydrochloride Injection, Solution [Hospira, Inc.]
  • Hospira, Inc.
    Promethazine Hydrochloride Injection, Solution [Hospira, Inc.]
  • Caraco Pharmaceutical Laboratories, Ltd.
    Promethazine Hydrochloride (Promethazine Hydrochloride) Solution [Caraco Pharmaceutical Laboratories, Ltd.]
  • Major Pharmaceuticals
    Promethazine Hydrochloride Tablet [Major Pharmaceuticals]
  • West-ward Pharmaceutical Corp.
    Promethazine Hydrochloride Injection [West-ward Pharmaceutical Corp.]
  • Pd-rx Pharmaceuticals, Inc.
    Promethazine Hydrochloride Tablet [Pd-rx Pharmaceuticals, Inc.]
  • Lake Erie Medical Dba Quality Care Products Llc
    Promethazine Hydrochloride Tablet [Lake Erie Medical Dba Quality Care Products Llc]
  • Amneal Pharmaceuticals
    Promethazine Hydrochloride Tablet [Amneal Pharmaceuticals]
  • Pd-rx Pharmaceuticals, Inc.
    Promethazine Hydrochloride Tablet [Pd-rx Pharmaceuticals, Inc.]
  • Life Line Home Care Services, Inc.
    Promethazine Hydrochloride Tablet [Life Line Home Care Services, Inc.]
  • Rebel Distributors Corp
    Promethazine Hydrochloride Tablet [Rebel Distributors Corp]
  • H.j. Harkins Company, Inc.
    Promethazine Hydrochloride Tablet [H.j. Harkins Company, Inc.]
  • Stat Rx Usa Llc
    Promethazine Hydrochloride Tablet [Stat Rx Usa Llc]
  • Mckesson Contract Packaging
    Promethazine Hydrochloride Tablet [Mckesson Contract Packaging]
  • Mckesson Contract Packaging
    Promethazine Hydrochloride Tablet [Mckesson Contract Packaging]
  • Major Pharmaceuticals
    Promethazine Hydrochloride Tablet [Major Pharmaceuticals]
  • Stat Rx Usa Llc
    Promethazine Hydrochloride Tablet [Stat Rx Usa Llc]
  • Mylan Institutional Inc.
    Promethazine Hydrochloride Tablet [Mylan Institutional Inc.]
  • West-ward Pharmaceutical Corp.
    Promethazine Hydrochloride Injection [West-ward Pharmaceutical Corp.]
  • West-ward Pharmaceutical Corp.
    Promethazine Hydrochloride Injection [West-ward Pharmaceutical Corp.]
  • West-ward Pharmaceutical Corp.
    Promethazine Hydrochloride Injection [West-ward Pharmaceutical Corp.]
  • West-ward Pharmaceutical Corp.
    Promethazine Hydrochloride Injection [West-ward Pharmaceutical Corp.]
  • Bryant Ranch Prepack
    Promethazine Hydrochloride Tablet [Bryant Ranch Prepack]
  • Remedyrepack Inc.
    Promethazine Hydrochloride Tablet [Remedyrepack Inc. ]
  • Remedyrepack Inc.
    Promethazine Hydrochloride Tablet [Remedyrepack Inc. ]
  • Ncs Healthcare Of Ky, Inc Dba Vangard Labs
    Promethazine Hydrochloride Tablet [Ncs Healthcare Of Ky, Inc Dba Vangard Labs]
  • Remedyrepack Inc.
    Promethazine Hydrochloride Tablet [Remedyrepack Inc. ]
  • Remedyrepack Inc.
    Promethazine Hydrochloride Tablet [Remedyrepack Inc. ]
  • Pd-rx Pharmaceuticals, Inc.
    Promethazine Hydrochloride Tablet [Pd-rx Pharmaceuticals, Inc.]
  • Pd-rx Pharmaceuticals, Inc.
    Promethazine Hydrochloride Tablet [Pd-rx Pharmaceuticals, Inc.]
  • Remedyrepack Inc.
    Promethazine Hydrochloride Injection, Solution [Remedyrepack Inc. ]
  • Cardinal Health
    Promethazine Hydrochloride Injection, Solution [Cardinal Health]
  • Cardinal Health
    Promethazine Hydrochloride Injection [Cardinal Health]
  • Remedyrepack Inc.
    Promethazine Hydrochloride Tablet [Remedyrepack Inc. ]
  • General Injectables & Vaccines, Inc
    Promethazine Hydrochloride Injection, Solution [General Injectables & Vaccines, Inc]
  • Remedyrepack Inc.
    Promethazine Hydrochloride Tablet [Remedyrepack Inc. ]
  • Remedyrepack Inc.
    Promethazine Hydrochloride Tablet [Remedyrepack Inc. ]
  • Unit Dose Services
    Promethazine Hydrochloride Tablet [Unit Dose Services]
  • Clinical Solutions Wholesale
    Promethazine Hydrochloride Tablet [Clinical Solutions Wholesale]
  • A-s Medication Solutions Llc
    Promethazine Hydrochloride Tablet [A-s Medication Solutions Llc]
  • A-s Medication Solutions Llc
    Promethazine Hydrochloride Tablet [A-s Medication Solutions Llc]
  • Dispensing Solutions, Inc.
    Promethazine Hydrochloride Tablet [Dispensing Solutions, Inc.]
  • American Health Packaging
    Promethazine Hydrochloride Tablet [American Health Packaging]
  • Clinical Solutions Wholesale
    Promethazine Hydrochloride Tablet [Clinical Solutions Wholesale]
  • Amneal Pharmaceuticals, Llc
    Promethazine Hydrochloride (Promethazine) Solution [Amneal Pharmaceuticals, Llc]
  • Pd-rx Pharmaceuticals, Inc.
    Promethazine Hydrochloride (Promethazine Hydrochloride) Tablet [Pd-rx Pharmaceuticals, Inc.]
  • Remedyrepack Inc.
    Promethazine Hydrochloride Tablet [Remedyrepack Inc. ]
  • General Injectables & Vaccines, Inc
    Promethazine Hydrochloride Injection, Solution [General Injectables & Vaccines, Inc]
  • Remedyrepack Inc.
    Promethazine Hydrochloride Tablet [Remedyrepack Inc. ]
  • Liberty Pharmaceuticals, Inc.
    Promethazine Hydrochloride Tablet [Liberty Pharmaceuticals, Inc.]
  • Cardinal Health
    Promethazine Hydrochloride Injection, Solution [Cardinal Health]
  • Remedyrepack Inc.
    Promethazine Hydrochloride Tablet [Remedyrepack Inc. ]
  • Remedyrepack Inc.
    Promethazine Hydrochloride Tablet [Remedyrepack Inc. ]
  • Bluepoint Laboratories
    Promethazine Hydrochloride Tablet [Bluepoint Laboratories]
  • Teva Parenteral Medicines, Inc.
    Promethazine Hydrochloride Injection, Solution [Teva Parenteral Medicines, Inc.]
  • Remedyrepack Inc.
    Promethazine Hydrochloride Injection [Remedyrepack Inc. ]
  • Remedyrepack Inc.
    Promethazine Hydrochloride Tablet [Remedyrepack Inc. ]
  • Preferred Pharmaceuticals, Inc
    Promethazine Hydrochloride Tablet [Preferred Pharmaceuticals, Inc]
  • Preferred Pharmaceuticals, Inc.
    Promethazine Hydrochloride Tablet [Preferred Pharmaceuticals, Inc.]
  • Medvantx, Inc.
    Promethazine Hydrochloride Tablet [Medvantx, Inc.]
  • Aidarex Pharmaceuticals Llc
    Promethazine Hydrochloride Tablet [Aidarex Pharmaceuticals Llc]
  • Sandoz Inc
    Promethazine Hydrochloride Tablet [Sandoz Inc]
  • Readymeds
    Promethazine Hydrochloride Tablet [Readymeds]
  • Cardinal Health
    Promethazine Hydrochloride Tablet [Cardinal Health]
  • Bryant Ranch Prepack
    Promethazine Hydrochloride Tablet [Bryant Ranch Prepack]
  • Northwind Pharmaceuticals
    Promethazine Hydrochloride Tablet [Northwind Pharmaceuticals]
  • Northwind Pharmaceuticals
    Promethazine Hydrochloride Tablet [Northwind Pharmaceuticals]
  • Cardinal Health
    Promethazine Hydrochloride Tablet [Cardinal Health]
  • Northwind Pharmaceuticals
    Promethazine Hydrochloride Tablet [Northwind Pharmaceuticals]
  • Cardinal Health
    Promethazine Hydrochloride Tablet [Cardinal Health]
  • Caraco Pharmaceutical Laboratories, Ltd.
    Promethazine Hydrochloride Tablet [Caraco Pharmaceutical Laboratories, Ltd.]
  • Northwind Pharmaceuticals
    Promethazine Hydrochloride Tablet [Northwind Pharmaceuticals]
  • Kvk-tech, Inc.
    Promethazine Hydrochloride Tablet [Kvk-tech, Inc.]
  • Direct Rx
    Promethazine Hydrochloride Tablet [Direct Rx]
  • Direct Rx
    Promethazine Hydrochloride (Promethazine Hydrochloride Tablet) Tablet [Direct Rx]
  • Remedyrepack Inc.
    Promethazine Hydrochloride Injection [Remedyrepack Inc. ]
  • Bryant Ranch Prepack
    Promethazine Hydrochloride Tablet [Bryant Ranch Prepack]
  • Renaissance Pharma, Inc.
    Promethazine Hydrochloride (Promethazine Hydrochloride) Suppository [Renaissance Pharma, Inc.]
  • Renaissance Pharma, Inc.
    Promethazine Hydrochloride (Promethazine Hydrochloride) Suppository [Renaissance Pharma, Inc.]
  • Golden State Medical Supply, Inc.
    Promethazine Hydrochloride Tablet [Golden State Medical Supply, Inc.]
  • Tya Pharmaceuticals
    Promethazine Hydrochloride Tablet [Tya Pharmaceuticals]
  • X-gen Pharmaceuticals, Inc.
    Promethazine Hydrochloride Injection, Solution [X-gen Pharmaceuticals, Inc.]
  • Proficient Rx Lp
    Promethazine Hydrochloride Tablet [Proficient Rx Lp]
  • Preferred Pharmaceuticals Inc.
    Promethazine Hydrochloride Tablet [Preferred Pharmaceuticals Inc.]

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