Prometazine is an antihistamine drug. It is used for symptomatic treatment of allergic diseases. Earlier it was also used to potentiate anesthesia.
Promethazine is used in the treatment of allergic diseases (urticaria, serum sickness, hay fever, etc.), in vasomotor and allergic rhinitis, in rheumatism with a pronounced allergic component, in allergic complications caused by penicillin, streptomycin and other drugs, as well as in itching dermatosis, Meniere’s disease, chorea, encephalitis and other CNS diseases accompanied by increased vascular permeability, in sea and air illness. In surgical practice promethazine is used as one of the main components of lytic mixtures used for potentiated anesthesia and hypothermia, for prevention and reduction of postoperative complications, during surgery and in the postoperative period. It is also used to enhance the effects of analgesics and local anesthetics.
Dosage and administration
When administered orally for adults, the daily dose is 75-100 mg. Maximal doses: when administered orally, single dose is 75 mg, daily dose is 500 mg; when administered intravenously, single dose is 50 mg, daily dose is 250 mg. V/v is used as part of lytic mixtures. Orally in children aged 1 to 2 years – 5-10 mg 1-2 times daily, 2 to 5 years – 5-10 mg 1-3 times daily, 5 to 10 years – 5-15 mg 1-3 times daily, over 10 years and adolescents 5-20 mg 1-3 times daily. When administered intravenously, the dose is 0.5-1 mg/kg, and the number of times a day is 3-5 times. In emergency cases (asthmatic status, false croup) the dose may be increased to 1-2 mg/kg. When administered intravenously (usually as part of a lytic cocktail), the dose is 1/3 of the dose for intravenous administration.
- Nervous system and sensory organs: sedation, dizziness, drowsiness, restlessness, agitation, nightmares, increased nighttime apnea; rarely, disorientation, confusion, extrapyramidal disorders, increased seizure activity (in children); accommodation and visual disturbances, tinnitus or ringing in ears.
- Cardiovascular system and blood (hematopoiesis, hemostasis): orthostatic hypotension (in intravenous administration), hypertension, tachycardia or bradycardia; rarely – leukopenia, thrombocytopenia, agranulocytosis.
- Gastrointestinal system: anesthesia and dry mouth, nausea, vomiting, cholestasis, constipation.
- Respiratory system: dryness in the nose, pharynx.
- Urinary system: rarely – difficult or painful urination.
- Allergic reactions: urticaria, dermatitis, asthma.
- Other: increased sweating, photosensitization, pain (when administered intravenously).
Symptoms: facial hyperemia, shortness of breath, dry mucous membranes, mydriasis, restlessness, motor hyperactivity, agitation, delirium (in children), extrapyramidal disorders, tremor, epileptiform seizures (rare), hypotension, respiratory depression, loss of consciousness.
Treatment: induction of vomiting, gastric lavage, prescription of activated charcoal, saline laxatives (if oral), intravenous fluid administration; monitoring and maintenance of vital functions; symptomatic therapy: vasoconstrictors (for hypotension), oxygen (to maintain adequate oxygenation).
It is not recommended to use analeptics (may cause seizures) and epinephrine (may increase hypotension). If extrapyramidal reactions develop, anticholinergic agents used to treat parkinsonism, diphenhydramine or barbiturates are used. Dialysis is ineffective.