Last Updated on May 30, 2023
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The active ingredient Promethazine is an antipsychotic (neuroleptic) from the group of phenothiazines. Antipsychotics are agents which are mainly used for mental disorders. Promethazine is however now used mainly for its calming effect and also because of its anti-allergic properties. Here you can read everything of interest to Promethazine, dosage and side effects.
How Promethazine works
As an antipsychotic medication Promethazine affects the central nervous system. It works by blocking the docking sites (receptors) of the neurotransmitter substance dopamine, so that it can no longer bind and exert its effect. With an excess of it leads to a loss of reality, psychosis and schizophrenia. With antipsychotics So can the loss of reality be counteracted. The active ingredient Promethazine, however, affects only weak antipsychotic: It has only about 50 percent of the potency of the parent drug chlorpromazine
Another medicine often-utilized effect of Promethazine is its antihistamine effect: Histamine is a chemical messenger that plays an important role, inter alia, in allergic reactions. By blocking histamine receptors, the stimuli transmitted by the histamine will no longer be forwarded. This helps against allergic reactions, but also relieves nausea and has a calming, sleep-inducing effect.
Pharmacokinetics and metabolism of Promethazine
After taking Promethazine it is almost completely absorbed from the intestine into the blood, but then dismantled immediately in the liver three-quarters into inactive metabolites. The degradation products are primarily excreted by the kidneys in the urine, only a very small portion of the drug is excreted unchanged.
When should you use Promethazine?
The drug Promethazine is approved for the treatment of restlessness and agitation under psychiatric underlying disease and of acute allergic reactions, if an additional reassurance of the patient is required.
It can be used when no drug alternatives for the treatment of nausea, vomiting or difficulty sleeping exist in adults.
The duration of treatment depends on the underlying disease.
How is Promethazine used?
The active ingredient is in the form of drops or tablets Promethazine commercially, in acute cases it can also be administered as an injection solution. The ingestion of drops and tablets is usually once daily in the evening with a glass of water. Treatment is usually started at a dosage of 25 milligrams of Promethazine and increased if necessary up to 100 milligrams. For very severe restlessness or agitation, the Promethazine dosage may be increased in the short term up to 200 milligrams per day.
What are the side effects Promethazine?
The intake resulted in more than one in ten patients Promethazine side effects such as dry mouth and drowsiness.
Further possible side effects are as blood dyscrasias, cardiac arrhythmias, seizures, Parkinson-like symptoms and urinary retention.
In very rare cases (less than one in 10,000 patients) can occur during the treatment with Promethazine in the first few weeks to a so-called neuroleptic malignant syndrome. Here occur muscle stiffness, immobility, views cramps, elevated temperature, profuse sweating, rapid heartbeat, impaired consciousness to the flashy and laboratory findings (enzyme value increases, increased white blood cell count) on.
What should I watch for while taking Promethazine?
The intake of Promethazine with other drugs such as antidepressants Duloxetine, tranylcypromine and moclobemide or selegiline Parkinson agents inhibit Promethazine-degrading enzymes and thus lead at the same dose to elevated blood levels. As a result, the effect and increase side effects.
The revenue with agents such as sulpiride (another antipsychotic medicine), cisapride (gastrointestinal agents), Ciprofloxacin (antibiotic) or octreotide (in certain tumors and the growth disorder acromegaly) amplified leading to cardiac arrhythmias.
Certain forwarding disturbances of the heart (QT interval prolongation) occur in the treatment with Promethazine on amplified. If the active compound in combination with other medicines that have this effect, it may lead to life-threatening cardiac arrhythmias. Examples of such agents are certain antibiotics, malaria, antihistamines (allergy remedies) and antidepressants.
If at the same time other depressants or alcohol, their effect may potentiate. Examples include some antidepressants, benzodiazepines (sleeping pills and tranquilizers), barbiturates (sleeping pills), opiates and opioids (painkillers and cough suppressants).
Furthermore, Promethazine influence the effect of high blood pressure medications. Typically, these are increased in their effect, and it is mainly used as position changes when you stand up to increased fraud.
Elderly and children (from two years) and adolescents can be treated with Promethazine in a correspondingly reduced dose.
So far, there are few studies on the treatment of pregnant women with Promethazine, but where there have been no malformations in the child. Nevertheless, Promethazine should be used in pregnancy only in urgent cases.
Breastfeeding should not take the drug or – if a dose is necessary -. abstillen previously because it is excreted into breast milk and may cause the infant to a respiratory arrest
How to get medicines with Promethazine
Medicines with the active ingredient Promethazine are only available on prescription and thus relate only with a doctor’s prescription for the pharmacy.
Since when Promethazine is known?
The active ingredient Promethazine is already used since the 1940s as clinically antihistamine and calm. Only later also the weak antipsychotic effect was discovered.