Several practitioners were also concerned that preparing promethazine in a saline bag and administering it over 10 minutes or more would require the use of an infusion pump, potentially leading staff to believe they do not need to remain at the bedside to observe the IV site. Before administration of the drug, tell patients to let you know immediately if burning or pain occurs during or after the injection. Require further dilution of the 25 mg/mL strength to reduce vesicant effects and enable slow administration. The preferred parenteral route of administration is by deep intramuscular injection.Promethazine hydrochloride injection is contraindicated in patients who have demonstrated an idiosyncratic reaction or hypersensitivity to promethazine or other phenothiazines.Because of the risk of potentially fatal respiratory depression, use of promethazine hydrochloride injection in patients with compromised respiratory function or patients at risk for respiratory failure (e.g. For example, one pharmacist reported that patients receive ranitidine and dexamethasone preoperatively, and dolasetron 30 minutes before the end of surgery. Whenever possible, they use an IV site on the back of the arm unless the patient has a central line.Several hospitals have told us about nausea and vomiting prevention protocols they use to reduce the use of IV promethazine. The average adult dose is 25 …

In the event that a patient complains of pain during intravenous injection of PHENERGAN Injection, the injection should be stopped immediately to evaluate for possible arterial injection or perivascular extravasation.

Parenteral drug products should be inspected visually for particulate matter and discoloration prior to administration, whenever solution and container permit. It is recommended that the lowest effective dose of promethazine hydrochloride be used in pediatric patients 2 years of age and older and concomitant administration of other drugs with respiratory depressant effects be avoided (seeProtect from light. The use of promethazine hydrochloride injection 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 hydrochloride injection, in pediatric patients may cause sudden death (see Since therapeutic requirements for sedative drugs tend to be less in geriatric patients, the dosage should be reduced for these patients.Promethazine hydrochloride injection is contraindicated in pediatric patients less than 2 years of age, because of the potential for fatal respiratory depression. EPINEPHRINE SHOULD NOT BE USED, since its use in a patient with partial adrenergic blockade may further lower the blood pressure. For example, 5-hydroxytryptamine type 3 (5-HT3) receptor antagonists may be used for both prophylaxis and as a rescue antiemetic. In the event that vasopressors are considered for the management of severe hypotension which does not respond to intravenous fluids and repositioning, the administration of norepinephrine or phenylephrine should be considered. Because animal reproduction studies are not always predictive of human response, promethazine hydrochloride injection should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus.Adequate studies to determine the action of the drug on parturition, lactation and development of the animal neonate have not been conducted.Promethazine hydrochloride injection administered to a pregnant woman within two weeks of delivery may inhibit platelet aggregation in the newborn.Promethazine hydrochloride injection may be used alone or as an adjunct to narcotic analgesics during labor (see It is not known whether promethazine hydrochloride injection is excreted in human milk. After initiation of treatment, dosage should be adjusted to the smallest amount adequate to relieve symptoms.