Phenergan for anxiety
Benefits, Side Effects, and Interactions
Promethazine is a drug used to treat allergies, dizziness, nausea, and vomiting.
Doctors sometimes prescribe it to help people relax or fall asleep in hospital settings. Doctors may also prescribe it off-label to treat anxiety.
This article explores how promethazine works, as well as current research into its safety and effectiveness in treating anxiety.
Promethazine is an antihistamine. That means it blocks the effects of histamine, a chemical involved in allergic reactions.
Your immune system makes and releases histamine when it detects an allergen like pollen or pet dander. By blocking the effects of histamine, promethazine helps relieve allergy symptoms such as nasal congestion and itchy eyes.
Promethazine also has several other effects throughout the body. For example, it helps with motion sickness by blocking specific receptors in the medulla oblongata, a part of the brain involved in nausea and vomiting.
It also targets other brain receptors involved in blood pressure, sleep, and muscle tension.
There are no recent clinical studies assessing how effective promethazine is in treating anxiety. This makes it impossible to say how it compares to other anti-anxiety drugs.
With that said, it is approved by the Food and Drug Administration (FDA) for sedation. According to its label, it eases apprehension and triggers a gentle sleep.
Medical professionals may administer it in hospital settings to reduce anxiety and induce sleep before or after surgery. A 2015 review reports that when used prior to surgery, promethazine can relieve anxiety.
Other peer-reviewed articles suggest that, when used alongside other drugs, promethazine may help treat acute mental health issues.
For example, the authors of a 2019 article recommend promethazine use with the antipsychotic drug haloperidol to treat severe agitation in psychiatric care settings. In this case, promethazine protects against side effects caused by haloperidol.
A 2016 review states that there’s enough evidence to use haloperidol and promethazine to treat episodes of severe aggression caused by schizophrenia. The authors write that promethazine can help to cause drowsiness and reduce “nervous tension.”
There isn’t enough evidence to show that promethazine is useful in treating mild to moderate anxiety outside hospital settings. It’s also not FDA-approved for this use. But you can always talk with your doctor if you think promethazine might help with your symptoms.
The main side effect of promethazine is drowsiness. If you take it during the day, you might feel lethargic or have trouble staying awake. For this reason, you shouldn’t drive or operate heavy machinery after taking promethazine.
Some other possible side effects include:
- blurred vision
- confusion and disorientation
- constipation
- difficulty urinating
- dilated pupils
- dizziness
- dry mouth
- headaches
- muscle contractions
- nightmares
- poor coordination
- restlessness
- stiffness
Many adults can safely take promethazine as prescribed by a doctor.
It may pose increased risks for people who:
- are over the age of 65
- are trying to conceive
- have bone marrow depression
- have epilepsy
- have respiratory problems
Promethazine can interact with other drugs, especially:
- other sedatives
- monoamine oxidase inhibitors
- anticholinergics
- epinephrine
Be sure to tell your doctor or pharmacist if you’re taking other medications.
You should also avoid drinking alcohol while taking promethazine. It can make side effects like drowsiness and sedation worse.
Is promethazine safe for children?
Promethazine is not safe for children younger than 2 years, as it can cause severe respiratory problems and even death.
In children older than 2 years, promethazine should be used carefully according to a doctor’s instructions. Parents shouldn’t use it to treat nausea and vomiting that has an unknown cause.
Children under the age of 16 should not take promethazine medications with codeine or other pain relievers.
What is the typical dose for promethazine to treat anxiety?
According to StatPearls, the recommended dose of promethazine for adults to help with anxiety and sleep before or after surgery is 25 to 50 milligrams (mg). Your doctor will determine the appropriate dose of promethazine for you.
How quickly does promethazine work?
How quickly promethazine works depends on its method of administration. In general, it should work within 30 minutes. Injections may work slightly faster.
Can I take promethazine with other anxiety medications?
No, you should not take promethazine with other anxiety medications, as this could increase your risk of side effects. Talk with your doctor to learn more about which medications are safe to take with promethazine.
In what forms is promethazine available?
Promethazine is available in several forms, including:
- an injectable solution
- a drinkable solution
- a rectal suppository
- a syrup
- tablets
Is promethazine available over the counter?
Promethazine is not available over the counter in the United States.
You need a prescription from a doctor to take promethazine.
Promethazine is a prescription drug used to treat nausea, vomiting, and allergies. You may also receive it while in the hospital to relieve anxiety and trigger sleep.
When combined with the drug haloperidol, evidence suggests it can ease severe aggression and agitation.
The FDA has not approved promethazine for mild to moderate cases of anxiety outside of medical settings, and it’s unclear whether it’s effective for this use. It causes significant drowsiness, which could interfere with your ability to function during the daytime.
If you have anxiety, talk with your doctor to learn more about available medications and treatments.
Benefits, Side Effects, and Interactions
Promethazine is a drug used to treat allergies, dizziness, nausea, and vomiting.
Doctors sometimes prescribe it to help people relax or fall asleep in hospital settings. Doctors may also prescribe it off-label to treat anxiety.
This article explores how promethazine works, as well as current research into its safety and effectiveness in treating anxiety.
Promethazine is an antihistamine. That means it blocks the effects of histamine, a chemical involved in allergic reactions.
Your immune system makes and releases histamine when it detects an allergen like pollen or pet dander. By blocking the effects of histamine, promethazine helps relieve allergy symptoms such as nasal congestion and itchy eyes.
Promethazine also has several other effects throughout the body. For example, it helps with motion sickness by blocking specific receptors in the medulla oblongata, a part of the brain involved in nausea and vomiting.
It also targets other brain receptors involved in blood pressure, sleep, and muscle tension.
There are no recent clinical studies assessing how effective promethazine is in treating anxiety. This makes it impossible to say how it compares to other anti-anxiety drugs.
With that said, it is approved by the Food and Drug Administration (FDA) for sedation. According to its label, it eases apprehension and triggers a gentle sleep.
Medical professionals may administer it in hospital settings to reduce anxiety and induce sleep before or after surgery. A 2015 review reports that when used prior to surgery, promethazine can relieve anxiety.
Other peer-reviewed articles suggest that, when used alongside other drugs, promethazine may help treat acute mental health issues.
For example, the authors of a 2019 article recommend promethazine use with the antipsychotic drug haloperidol to treat severe agitation in psychiatric care settings. In this case, promethazine protects against side effects caused by haloperidol.
A 2016 review states that there’s enough evidence to use haloperidol and promethazine to treat episodes of severe aggression caused by schizophrenia. The authors write that promethazine can help to cause drowsiness and reduce “nervous tension.
”
There isn’t enough evidence to show that promethazine is useful in treating mild to moderate anxiety outside hospital settings. It’s also not FDA-approved for this use. But you can always talk with your doctor if you think promethazine might help with your symptoms.
The main side effect of promethazine is drowsiness. If you take it during the day, you might feel lethargic or have trouble staying awake. For this reason, you shouldn’t drive or operate heavy machinery after taking promethazine.
Some other possible side effects include:
- blurred vision
- confusion and disorientation
- constipation
- difficulty urinating
- dilated pupils
- dizziness
- dry mouth
- headaches
- muscle contractions
- nightmares
- poor coordination
- restlessness
- stiffness
Many adults can safely take promethazine as prescribed by a doctor. It may pose increased risks for people who:
- are over the age of 65
- are trying to conceive
- have bone marrow depression
- have epilepsy
- have respiratory problems
Promethazine can interact with other drugs, especially:
- other sedatives
- monoamine oxidase inhibitors
- anticholinergics
- epinephrine
Be sure to tell your doctor or pharmacist if you’re taking other medications.
You should also avoid drinking alcohol while taking promethazine. It can make side effects like drowsiness and sedation worse.
Is promethazine safe for children?
Promethazine is not safe for children younger than 2 years, as it can cause severe respiratory problems and even death.
In children older than 2 years, promethazine should be used carefully according to a doctor’s instructions. Parents shouldn’t use it to treat nausea and vomiting that has an unknown cause.
Children under the age of 16 should not take promethazine medications with codeine or other pain relievers.
What is the typical dose for promethazine to treat anxiety?
According to StatPearls, the recommended dose of promethazine for adults to help with anxiety and sleep before or after surgery is 25 to 50 milligrams (mg). Your doctor will determine the appropriate dose of promethazine for you.
How quickly does promethazine work?
How quickly promethazine works depends on its method of administration.
In general, it should work within 30 minutes. Injections may work slightly faster.
Can I take promethazine with other anxiety medications?
No, you should not take promethazine with other anxiety medications, as this could increase your risk of side effects. Talk with your doctor to learn more about which medications are safe to take with promethazine.
In what forms is promethazine available?
Promethazine is available in several forms, including:
- an injectable solution
- a drinkable solution
- a rectal suppository
- a syrup
- tablets
Is promethazine available over the counter?
Promethazine is not available over the counter in the United States. You need a prescription from a doctor to take promethazine.
Promethazine is a prescription drug used to treat nausea, vomiting, and allergies. You may also receive it while in the hospital to relieve anxiety and trigger sleep.
When combined with the drug haloperidol, evidence suggests it can ease severe aggression and agitation.
The FDA has not approved promethazine for mild to moderate cases of anxiety outside of medical settings, and it’s unclear whether it’s effective for this use. It causes significant drowsiness, which could interfere with your ability to function during the daytime.
If you have anxiety, talk with your doctor to learn more about available medications and treatments.
Phenergan (promethazine) - Bioteca - drug delivery service from Israel
Description drug
What is Fenergan and how is it applied?
Phenergan is a prescription drug used to treat symptoms allergic conditions, nausea, vomiting, motion sickness, before and after surgery sedation, as well as obstetric sedation. Phenergan may be used alone or with other medicines. nine0007
Fenergan refers to class of drugs called 1st generation antihistamines, antiemetics."
Pharmacological Properties
Promethazine is a phenothiazine derivative that is structurally different from antipsychotic phenothiazines by the presence of a branched side chain and no substitution in the ring.
This configuration is believed to be responsible for its relative absence (1/10 chlorpromazine) of antagonistic properties dopamine. nine0007
Promethazine is an agent blocking H 1 receptors. In addition to its antihistamine action, it has clinically useful sedative and antiemetic action.
Promethazine metabolized in the liver to various compounds; promethazine sulfoxides and N-demethylpromethazine are the predominant metabolites found with urine.
Indications
Fenergan suppositories (Promethazine HCl), USP used at:
Perennial and seasonal allergic rhinitis.
Vasomotor rhinitis.
Allergic conjunctivitis caused by inhaled allergens and food.
Mild uncomplicated skin allergic manifestations urticaria and angioedema.
Reduction allergic reactions to blood or plasma.
Dermographism.
Anaphylactic reactions as adjunctive therapy to epinephrine and other standard measures after relief of acute manifestations.
nine0007
Preoperative , postoperative or obstetric sedation.
Prevention and control of nausea and vomiting associated with certain types of anesthesia and surgical intervention.
Therapy in addition to meperidine or other analgesics to control postoperative pain.
Sedation as in children and adults, as well as the relief of anxious forebodings and drowsiness from which the patient can easily wake up.
Active and prophylactic treatment for motion sickness.
Antiemetic therapy in postoperative patients.
How to use and doses
Phenergan suppositories (Promethazine HCl) are contraindicated in children under 2 years of age.
Fenergan suppositories (Promethazine HCl) are for rectal use only.
Allergy
Average dose is 25 mg at bedtime; however, 12.5 mg can be taken before meals and if necessary after retirement. Single doses are usually sufficient 25 mg at bedtime or 6.
25 to 12.5 mg three times a day. After the start of treatment children or adults, the dosage should be adjusted to the minimum an amount sufficient to relieve symptoms. Introduction of promethazine hydrochloride at doses of 25 mg will control minor transfusion allergic reactions. nine0007
Seasickness
Average dose for adults is 25 mg twice daily. The initial dose should be taken half an hour to one hour before the intended journey and if necessary, repeated after 8-12 hours. On the following days of travel it is recommended to give 25 mg on waking and again before dinner. Children can prescribe rectal suppositories Fenergan (prometazine hydrochloride) from 12.5 to 25 mg twice a day.
Nausea and vomiting
Antiemetics drugs should not be used for vomiting of unknown etiology in children and adolescents (see WARNINGS - Use in Pediatric Patients).
Average effective dose of promethazine HCl for the active treatment of nausea and vomiting in children and adults is 25 mg.
If necessary, doses of 12.5 to 25 mg may be repeated with interval of 4 to 6 hours.
For nausea and vomiting in children, the usual dose is 0.5 mg per pound of body weight, and the dose should be adjusted for the age and weight of the patient, as well as the severity of the condition, which is being treated. nine0007
For prevention nausea and vomiting, both during surgery and in the postoperative period, the average dose is 25 mg at intervals of 4-6 hours, if necessary.
Sedation
This product relieves anxiety and promotes restful sleep, from which the patient can easily wake up. Administration of 12.5 to 25 mg of promethazine HCl rectally at bedtime will provide a sedative effect in children. Adults usually need 25 to 50 mg to remove sedatives at night, before surgery or obstetrics. nine0007
Pre- and postoperative use
Promethazine hydrochloride at doses of 12.5 to 25 mg for children and at doses of 50 mg for adults the day before surgery relieves anxiety and induces restful sleep.
For preoperative medication, children require doses of 0.5 mg per pound of body weight in combination with a correspondingly reduced dose of narcotic drugs or barbiturates and an appropriate dose of a drug like atropine. Usual Adult Dose is 50 mg of promethazine hydrochloride with a correspondingly reduced dose drug or barbiturate and the required amount of belladonna alkaloid. nine0007
Postoperative sedation and additional use of analgesics can be obtained prescribing 12.5 to 25 mg for children and 25 to 50 mg for adults.
Rectal suppositories Phenergan (Promethazine HCl) is not recommended for use in children under 2 years of age.
Medicinal form
Rectal suppositories Phenergan (Promethazine HCl), USP, available in boxes of 12:
12.5 mg, white bullet-shaped suppository wrapped in silver foil. nine0007
25 mg white suppository in the shape of a bullet, wrapped in silver foil.
Store in refrigerator at 2-8°C (36-46°F).
Side effects
Central nervous system system
Drowsiness - most pronounced effect of this drug on the central nervous system. sedation, drowsiness, blurred vision, dizziness; confusion, disorientation and extrapyramidal symptoms such as oculogyric crisis, torticollis, and protrusion of the tongue; lethargy, tinnitus, impaired coordination of movements, fatigue, euphoria, nervousness, diplopia, insomnia, tremor, convulsive seizures, agitation, catatonic states, hysteria. It was also reported about hallucinations. nine0007
Cardiovascular - High or low blood pressure, tachycardia, bradycardia, fainting.
Dermatological - dermatitis, photosensitivity, urticaria.
Hematological - leukopenia, thrombocytopenia, thrombocytopenic purpura, agranulocytosis.
Gastrointestinal tract. Dry mouth, nausea, vomiting, jaundice.
Respiratory organs - asthma, nasal congestion, respiratory depression (potentially fatal), and apnea (potentially fatal).
nine0007
Other - angioedema. Neuroleptic malignant disease has also been reported syndrome (potentially fatal) (see WARNINGS - Malignant neuroleptic syndrome).
Paradoxical reactions
hyperexcitability and abnormal movements in patients after a single administration of promethazine HCl. Consideration should be given to discontinuing promethazine hydrochloride and the use of other drugs if these occur reactions. Some of these patients also experienced respiratory depression, nightmares, delirium and agitation. nine0007
Drug interactions
CNS depressants - Fenergan suppositories (promethazine hydrochloride) may increase, prolong or enhance the sedative effect of other central nervous system depressants, such as alcohol, sedatives/hypnotics (including barbiturates), narcotics, narcotic analgesics, general anesthetics, tricyclic antidepressants., tranquilizers; Therefore, such agents should be avoided or given in reduced doses to patients receiving promethazine HCl.
With the simultaneous use with Fenergan suppositories (prometazine hydrochloride), the dose of barbiturates should be reduced by at least half, and the dose of drugs should be reduced a quarter or half. The dosage should be individual. excessive the amount of promethazine HCl compared to the narcotic drug can lead to restlessness and motor hyperactivity in a patient with pain; these symptoms usually disappear with adequate pain control. nine0007
Epinephrine - Due to the ability of promethazine HCl to reverse epinephrine's vasopressor effect, epinephrine should not be used to treat hypotension associated overdose with promethazine HCl suppositories.
Anticholinergics means - simultaneous reception of other drugs with anticholinergic properties should be used with caution.
Inhibitors monoamine oxidase (MAOI). With the simultaneous use of certain MAOIs and phenothiazines, drug interactions have been reported, including increased frequency of extrapyramidal effects.
This possibility should be considered when using Fenergan suppositories (Promethazine HCl). nine0007
Interaction with drugs / laboratory tests
In patients treated with promethazine HCl, the following may be affected: laboratory tests:
Pregnancy tests
Diagnostic tests for pregnancy based on immunological reactions between hCG and anti-hCG, may give false negative or false positive interpretations.
Tolerance test to glucose
Increase reported blood glucose levels in patients receiving promethazine HCl.
Phenergan Vc - instructions for use, dosage, composition, analogues, side effects / Pillintrip
WARNINGS
Promethazine
Promethazine may cause severe drowsiness. Patients with an outpatient disorder should be warned against activities such as driving or operating hazardous machinery until it is known that they are not becoming drowsy or dizzy from promethazine therapy. nine0007
The sedative effect of promethazine hydrochloride is additive to the sedative effects of central nervous system depressants; therefore, agents such as alcohol, narcotic analgesics, sedatives, hypnotics, and tranquilizers should either be avoided or administered at a reduced dosage in the presence of promethazine hydrochloride.
When co-administered with promethazine hydrochloride, the dose of barbiturates should be reduced by at least half, and the dose of analgesic depressants such as morphine or meperidine should be reduced by a quarter to a half. nine0007
Promethazine may lower the seizure threshold. This should be taken into account when given to individuals with known seizures or when taken in combination with drugs or local anesthetics that may also affect the seizure threshold. Sedatives or CNS depressants should be avoided in patients with a history of sleep apnea. Antihistamines should be used with caution in patients with narrow-angle glaucoma, stenosing peptic ulcer, pyloroduodenal obstruction, and bladder obstruction due to symptomatic prostatic hypertrophy and narrowing of the bladder neck. nine0007
Administration of promethazine has been associated with reported cholestatic jaundice.
Phenylephrine
Since phenylephrine is an acirenergic agent, it should be used with caution in patients with thyroid disease, diabetes mellitus and heart disease, or in those receiving tricyclic antidepressants.
Men with symptomatic benign prostatic hypertrophy may experience urinary retention with an oral or nasal decongestant. nine0007
Phenylephrine may cause a decrease in cardiac output and extreme caution should be exercised when the drug is administered parenterally or orally to patients with arteriosclerosis, the elderly and/or patients with initially poor cerebral or coronary circulation.
Phenylephrine should be used with caution in patients taking dietary drugs such as amphetamines or phenylpropanolamine because the synergistic adrenergic effects may lead to a severe hypertensive response and possible stroke. nine0007
PRECAUTIONS
Animal reproduction studies have not been conducted with the drug combination promethazine and phenylephrine. It is not known whether this drug combination can cause fetal harm when administered to a pregnant woman or affect fertility. Promethazine and phenylephrine should only be given to a pregnant woman when needed.
General
Promethazine should be used with caution in people with cardiovascular disease or impaired liver function.
Phenylephrine should be used with caution in patients with cardiovascular disease, especially those with hypertension. nine0007
Drugs / Laboratory Test Interactions
The following laboratory tests may be affected in patients who are receiving promethazine hydrochloride therapy.
Pregnancy tests: Diagnostic pregnancy tests based on immunological reactions between hCG and anti-hCG may lead to false negative or false positive interpretations.
Glucose tolerance test: An increase in blood glucose levels was noted in patients treated with promethazine. nine0007
Carcinogenesis, Mutagenesis, Impairment of Fertility
Promethazine: Long-term animal studies have not been conducted to evaluate the carcinogenic potential of promethazine, and there are no other animal or human data regarding carcinogenicity, mutagenicity or impairment of fertility with this drug. Promethazine was non-mutagenic in the Ames Salmonella test system.
Phenylephrine: a study that followed the development of cancer in 143,574 patients over a four-year period showed that 11 9Of the 81 patients treated with phenylephrine (systemic or topical), there was no statistically significant association between the drug and cancer at any or all sites. Long-term animal studies have not been conducted to evaluate the carcinogenic potential of phenylephrine, and there are no other animal or human mutagenicity data.
A study on the effect of adrenergic drugs on egg transport in rabbits showed that treatment with phenylephrine did not alter pregnancy rates; the number of implantations was significantly reduced when using high doses of the drug. nine0007
Pregnancy
Teratogenic effects
Pregnancy Category C:
ORITAZINS: Teratogenic effects were not demonstrated in rates of rats of rats in doses of 6.25 and 12.5 mg / kg of item or 12.5 mg / kg of orum . These doses are 8.
3 and 16.7 times the maximum recommended total daily dose of promethazine for a 50 kg subject. Specific studies to test the effect of the drug on childbirth, lactation and development of the newborn animals have not been conducted, but a general preliminary study in rats showed no effect on these parameters. Although antihistamines, including promethazine, have been found to cause fetal mortality in rodents, the pharmacological effects of histamine in rodents do not match those in humans. There are no adequate and well-controlled studies of promethazine in pregnant women. nine0007
Phenylephrine: A study in rabbits showed that continued moderate overexposure with phenylephrine (3mg/day) in the second half of pregnancy (22nd day of gestation to delivery) may contribute to perinatal losses, prematurity, premature labor, and, possibly fetal anomalies; when phenylephrine (3mg/day) was given to rabbits during the first half of pregnancy (3rd day after mating for seven days) a significant number gave birth to low birth weight litters.
