PHENERGAN

Adults:

The usual dose is 25 – 50 mg. Maximum parenteral dose 100 mg.

Elderly:

No specific dosage recommendations. 5 mg for children from 5 – 10 years by deep intramuscular injection. 3). Method of administration Deep intramuscular injection. 5% solution to 10 times its volume with water for injections immediately before use.

The following CIOMS frequency rating is used:

Very common (≥1/10); common (≥1/100 to <1/10); uncommon (≥1/1000 to <1/100); rare (≥1/10,000 to ≥1/1000); very rare (<1/10 000), not known (cannot be estimated from the available data).

Immune system disorders Frequency not known:

Allergic reactions, including anaphylactic reaction, urticaria, angioedema.

Skin and subcutaneous tissue disorders Frequency not known:

Rash, photosensitivity reaction.

Nervous system disorders Very common:

Sedation or somnolence Frequency not known: Dizziness, headaches, extrapyramidal effects including restless legs syndrome, muscle spasms and tic-like movements of the head and face.

Frequency not known:

Dystonia, including oculogyric crisis, usually transitory are commoner in children and young adults, and usually occur within the first 4 days of treatment or after dosage increases.

Frequency not known:

Anticholinergic effects such as ileus paralytic, risk of urinary retention, dry mouth, constipation, accommodation disorder. The elderly are particularly susceptible to the anticholinergic effects and confusion due to promethazine.

Psychiatric disorders Frequency not known:

Agitation, confusional state, anxiety. 4), nasal congestion Hepatobiliary disorders Frequency not known: Jaundice cholestatic Blood and lymphatic system disorders Frequency not known: Blood dyscrasias including haemolytic anaemia, agranulocytosis, leukopenia, eosinophilia, thrombocytopenia (including thrombocytopenic purpura).

Hypersensitivity reactions including anaphylaxis, urticaria and angioedema have been reported with Phenergan use. 8). Phenergan should be avoided in patients with liver or renal dysfunction, Parkinson’s disease, hypothyroidism, cardiac failure, pheochromocytoma, myasthenia gravis, or prostate hypertrophy, or in patients with a history of narrow angle glaucoma or agranulocytosis.

Caution must be exercised when using H1-antihistamines such as Phenergan due to the risk of sedation. 5). Intravenous injection should be performed with extreme care to avoid extravasation or inadvertent intra-arterial injection, which could lead to necrosis and peripheral gangrene.

If a patient complains of pain during intravenous injection, stop the injection immediately, as this may be a sign of extravasation or inadvertent intra- arterial injection. Intramuscular injection must also be performed carefully to avoid inadvertent subcutaneous injection, which could lead to local necrosis.

Close monitoring is required in patients with epilepsy or a history of seizures, as phenothiazines may lower the seizure threshold. Phenergan Injection may increase glucose tolerance. Caution should be used in patients with: • asthma, bronchitis or bronchiectasis.

Phenergan may thicken or dry lung secretions and impair expectoration. g. salicylates. It may also delay the early diagnosis of intestinal obstruction or raised intracranial pressure through the suppression of vomiting. QT prolongation Phenothiazine derivatives may potentiate QT interval prolongation which increases the risk of onset of serious ventricular arrhythmias of the torsade de pointes type, which is potentially fatal (sudden death).

e. drug induced) QT prolongation. 8). Photosensitivity reactions Due to the risk of photosensitivity, exposure to strong sunlight or ultraviolet light should be avoided during or shortly after treatment. 3). The use of promethazine should be avoided in children and adolescents with signs and symptoms suggestive of Reye’s Syndrome.

• Phenergan should not be given to patients with a known hypersensitivity to promethazine, other phenothiazines, or to other ingredients in the formulation of Phenergan. • Phenergan should not be used in patients in coma or suffering from CNS depression of any cause.

• Promethazine is contraindicated for use in children less than two years of age because of the potential for fatal respiratory depression. • Phenergan should be avoided in patients taking monoamine oxidase inhibitors up to 14 days previously.