Phenergan tablets and elixir contain the active ingredient promethazine, which is a type of medicine called a sedating antihistamine. It works by preventing the actions of histamine.

What is it used for?

  • Relieving the symptoms of allergic conditions such as hay fever (allergic rhinitis) and nettle rash (urticaria).
  • Treating life-threatening allergic reactions (anaphylaxis).
  • Preventing travel sickness.
  • Producing sedation before surgery (preoperative sedation).
  • Short-term use as a sedative in children.
  • Short-term treatment of sleeping difficulties (insomnia) in adults.

How does it work?

  • Phenergan tablets and elixir contain the active ingredient promethazine, which is a type of medicine called a sedating antihistamine. It works by preventing the actions of histamine.
  • Histamine is a substance produced by the body as part of its defence mechanisms. It causes the symptoms of allergic reactions.
These can include inflammation of the airways or skin, nasal congestion, narrowing of the airways, rashes, and itching of the skin, eyes or nose. Promethazine blocks histamine from binding to its receptors in various parts of the body and this stops it causing the symptoms of an allergic reaction.
  • Histamine may be released from and act in a small (localised) area of the body such as the nose. Alternatively, histamine can cause more serious, sometimes life-threatening reactions such as anaphylaxis. Promethazine is used for treating localised allergies such as hay fever and nettle rash, as well more serious allergic reactions such as anaphylaxis.
  • Promethazine also blocks histamine receptors in an area of the brain called the vomiting centre. The vomiting centre is responsible for causing feelings of sickness and for the vomiting reflex. It is activated when it receives nerve messages from the vestibular apparatus in the middle ear.
  • The vestibular apparatus provides constant feedback to the brain about our body position. When something disturbs the vestibular apparatus, such as movements of the head when travelling by boat or car, nerve signals are sent from the vestibular apparatus to the vomiting centre. This can cause the symptoms of motion sickness, such as nausea, dizziness or spinning sensations (vertigo) and vomiting. Promethazine can be used to prevent motion sickness, because by blocking the histamine receptors in the vomiting centre, it prevents disturbances in the middle ear from activating the vomiting centre.
  • Promethazine is known as a sedating antihistamine because it enters the brain in significant quantities and causes drowsiness. This effect of the medicine is used to produce sedation before minor procedures or surgery, and can also be used to provide short-term help for people with sleeping difficulties (insomnia).
  • How do I take it?

    • The dose of this medicine that is required and how often the medicine needs to be taken will depend on the condition being treated and the age of the person being treated. It is important to follow the instructions in the leaflet or packaging provided with this medicine, or the instructions given by your doctor.
    • Do not exceed the recommended dose.
    • Phenergan tablets and elixir can be taken either with or without food. The tablets should be swallowed whole with a drink of water.
    • If symptoms persist despite treatment, seek medical advice from your doctor or pharmacist.
    • This medicine should not be used for longer than seven days without getting medical advice from your doctor.

    Use with caution in

    • Elderly people.
    • Decreased kidney function.
    • Decreased liver function.
    • Asthma.
    • Bronchitis.
    • A condition called bronchiectasis, in which there is persistent and progressive widening of the airways due to lung infections or lung disease, such as cystic fibrosis.
    • Severe coronary artery disease (heart disease).
    • Closed angle glaucoma.
    • Epilepsy.
    • People with a blockage of the opening from the stomach into the intestines (pyloro-duodenal obstruction).
    • People with a blockage of the drainage of urine out of the bladder (bladder neck obstruction), for example due to an enlarged prostate gland.

    Not to be used in

    • Children under two years of age.
    • People with reduced awareness, slow reactions or extreme drowsiness due to medicines or illness that reduce activity in the central nervous system (CNS depression).
    • People in a comatose state.
    • People who have taken a type of medicine called a monoamine oxidase inhibitor (MAOI) in the past 14 days.
    • This medicine should be avoided in children and adolescents with signs and symptoms suggestive of Reye's syndrome. These include being sick and confused following a viral illness.
    • Phenergan tablets contain lactose and should not be taken by people with rare hereditary problems of galactose intolerance, the Lapp lactase deficiency or glucose-galactose malabsorption.
    • Phenergan elixir contains maltitol (hydrogenated glucose syrup) and is not suitable for people with rare hereditary problems of fructose intolerance.

    This medicine should not be used if you are allergic to any of its ingredients. Please inform your doctor or pharmacist if you have previously experienced such an allergy.

    If you feel you have experienced an allergic reaction, stop using this medicine and inform your doctor or pharmacist immediately.

    Pregnancy and breastfeeding

    Certain medicines should not be used during pregnancy or breastfeeding. However, other medicines may be safely used in pregnancy or breastfeeding providing the benefits to the mother outweigh the risks to the unborn baby. Always inform your doctor if you are pregnant or planning a pregnancy, before using any medicine.

    • If you are pregnant you should not take this medicine without consulting your doctor first. This medicine can be used with caution during pregnancy, but only if the expected benefit to the mother outweighs any potential risks to the developing baby. However, this medicine should not be used during the last two weeks of pregnancy, because if taken during this time it may cause irritability or excitement in the baby after birth. Seek further medical advice from your doctor.
    • Small amounts of this medicine may pass into breast milk. This is not expected to be harmful to a nursing infant, but the manufacturer states that there is a risk that it may cause irritability or excitement in a newborn baby. If you are breastfeeding you should not take this medicine without getting medical advice from your doctor first.

    Side effects

    Medicines and their possible side effects can affect individual people in different ways. The following are some of the side effects that are known to be associated with this medicine. Just because a side effect is stated here it does not mean that all people using this medicine will experience that or any side effect.

    • Drowsiness.
    • Dizziness.
    • Restlessness.
    • Headache.
    • Nightmares.
    • Tiredness.
    • Feeling disorientated.
    • Blurred vision.
    • Dry mouth.
    • Difficulty passing urine (urinary retention).
    • Confusion.
    • Unexpected increase in excitability in children.
    • Rash or itching.
    • Loss of appetite.
    • Awareness of your heartbeat (palpitations).
    • Low blood pressure (hypotension).
    • Abnormal movements of the hands, legs, face, neck and tongue, eg tremor, twitching, rigidity (extrapyramidal effects).
    • Increased sensitivity of the skin to sunlight (photosensitivity). You should avoid sun lamps and strong sunlight while you are taking this medicine - see the warning section above.
    • Yellowing of the skin and whites of the eyes (jaundice).
    • Disturbances in the normal numbers of blood cells in the blood.

    The side effects listed above may not include all of the side effects reported by the medicine's manufacturer.

    For more information about any other possible risks associated with this medicine, please read the information provided with the medicine or consult your doctor or pharmacist.

    How can this medicine affect other medicines?

    It is important to tell your doctor or pharmacist what medicines you are already taking, including those bought without a prescription and herbal medicines, before you start taking this medicine. Similarly, check with your doctor or pharmacist before taking any new medicines while taking this one, to make sure that the combination is safe.

    The manufacturer states that this medicine should not be taken by anyone who is taking a type of antidepressant called a monoamine oxidase inhibitor (MAOI), eg phenelzine, tranylcypromine, isocarboxazid, or who has taken an MAOI in the previous 14 days.

    There may be an increased risk of drowsiness if this medicine is taken with any of the following (which can also cause drowsiness):

    • alcohol
    • antipsychotics, eg haloperidol, chlorpromazine
    • barbiturates, eg phenobarbital, amobarbital
    • benzodiazepines, eg diazepam, temazepam
    • other sedating antihistamines, eg hydroxyzine, chlorphenamine
    • sleeping tablets, eg zopiclone
    • strong opioid painkillers, eg morphine, codeine, tramadol
    • tricyclic antidepressants, eg amitriptyline.

    There may be an increased risk of side effects such as dry mouth, constipation, difficulty passing urine or confusion if promethazine is taken with other medicines that have anticholinergic effects, such as the following:

    • anticholinergic medicines for Parkinson's symptoms, eg procyclidine, orphenadrine, trihexiphenidyl
    • anticholinergic medicines for urinary incontinence, eg tolterodine, oxybutynin
    • antipsychotics, eg chlorpromazine, clozapine
    • antispasmodics, eg hyoscine, atropine
    • muscle relaxants, eg baclofen
    • tricyclic antidepressants, eg amitriptyline, imipramine.

    Antihistamines may oppose the effect of histamine (used to treat leukaemia) and are not recommended for people having this treatment.

    Antihistamines may also oppose the effect of betahistine (used to treat Ménière's disease).

    References:

    https://www.drugs.com/cdi/phenergan-tablets.html

    http://www.netdoctor.co.uk/medicines/allergy-and-asthma/a7343/phenergan-promethazine/

    https://www.drugs.com/phenergan.html

    https://www.medicines.org.uk/emc/medicine/20687

     

     

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