Uses of Shillergen: - Nausea - Vomiting Allergic conditions, Nausea and vomiting, Motion sickness, Insomnia Patients in coma or suffering from CNS depression of any cause. Childn <2 yr. SC and intra-arterial admin. Concurrent use w/ or w/in 14 days of MAOI use.

Anti-emetic drugs, Miscellaneous sedatives & hypnotics, Sedating Anti-histamine

Promethazine is a phenothiazine derivative which blocks postsynaptic mesolimbic dopaminergic receptors in the brain. It exhibits strong α-adrenergic blocking effect and depresses the release of hypothalamic and hypophyseal hormones. It competes with histamine for the H1-receptor; muscarinic blocking effect may be responsible for antiemetic activity. It also reduces stimuli to the brainstem reticular system.Promethazine is well absorbed from the gastrointestinal tract. Clinical effects are apparent within 20 minutes after oral administration and generally last four to six hours, although they may persist as long as 12 hours. Promethazine is metabolized by the liver to a variety of compounds; the sulfoxides of promethazine and N-demethylpromethazine are the predominant metabolites appearing in the urine.

How to use Promethazine Hydrochloride: Take this medicine in the dose and duration as advised by your doctor. Swallow it as a whole. Do not chew, crush or break it. Promethazine Hydrochloride may be taken with or without food, but it is better to take it at a fixed time. Administration: May be taken with or without food. Adult Dose: Oral Allergic conditions Adult: As promethazine HCl: 25 mg at night, increase to 25 mg bid if necessary. Alternatively, 10-20 mg 2-3 times daily. Prophylaxis of motion sickness Adult: As promethazine HCl: 20 mg or 25 mg the night before travelling, followed by a similar dose the following morning if necessary. As promethazine teoclate: 25 mg given on the night or 1-2 hr before travelling. Short-term management of insomnia Adult: As promethazine HCl: 20-50 mg at night. Parenteral Allergic conditions; Sedation Adult: As promethazine HCl: 25-50 mg, by deep IM, IV inj or IV infusion at a rate of not more than 25 mg/min. Max: 100 mg. Nausea and vomiting Adult: As promethazine HCl: 12.5-25 mg, repeated at intervals of not less than 4 hr. Max: 100 mg daily. Child Dose: Oral Allergic conditions Child: As promethazine HCl: 2-5 yr 5-15 mg daily in 1 or 2 divided doses; >5-10 yr 10-25 mg daily in 1 or 2 divided doses. Prophylaxis of motion sickness Child: As promethazine HCl: 2-5 yr 5 mg; >5-10 yr 10 mg. Doses are given the night before the journey and repeated on the following morning (6-8 hr later) if necessary. Short-term management of insomnia Child: As promethazine HCl: 2-5 yr 15-20 mg; >5-10 yr 20-25 mg. Parenteral Allergic conditions; Sedation Child: As promethazine HCl: 5-10 yr 6.25-12.5 mg by deep IM. Renal Dose: Renal impairment: Dose reduction may be required.

Masks ototoxicity of aminoglycoside antibiotics. May enhance the sedative effects of CNS depressants like alcohol, hypnotics, barbiturates and opioids. Potentially Fatal: Ventricular arrhythmias when used with drugs that prolong QT interval. Increased risk of extrapyramydal effects w/ MAOIs.

Patients in coma or suffering from CNS depression of any cause. Childn <2 yr. SC and intra-arterial admin. Concurrent use w/ or w/in 14 days of MAOI use.

Common - Dryness in mouth - Blurred vision - Headache - Dizziness Neuroleptic Malignant Syndrome (NMS); CV effects (e.g. bradycardia, tachycardia, transient HTN, hypotension; jaundice, blood dyscrasias, extrapyramidal effects; IV inj: Severe tissue injury (e.g. gangrene), pain and burning, paralysis, thrombophlebitis, severe spasm of distal vessels, necrosis. Sedation, Confusion, Disorientation, Blurred vision, Hallucinations, Dystonias, Catatonic states, Euphoria, Excitation, Impotence, Urinary retention Potentially Fatal: Resp depression and apnoea esp in childn.

There is epidemiological evidence for the safety of promethazine in pregnancy and animal studies have shown no hazard, nevertheless, it should not be used in pregnancy unless the physician considers it essential. The use of Phenergan is not recommended in the two weeks prior to delivery in view of the risk of irritability and excitement in the neonate. Available evidence suggests that the amount excreted in milk is insignificant. However there are risks of neonatal irritability and excitement.

Precaution: Patient w/ asthma, bronchitis or bronchiectasis; severe coronary artery disease, narrow-angle glaucoma, epilepsy, bladder neck or pyloro-duodenal obstruction, Reye's syndrome, bone marrow depression, Hepatic and renal impairment. Pregnancy and lactation. Patient Counselling This drug may cause marked drowsiness, if affected, do not drive or operate machinery. Avoid prolonged exposure to sunlight. Monitoring Parameters Monitor mental status; signs and symptoms of tissue injury (IV inj). Lactation: Not known whether drug crosses into breast milk; discontinue drug, or do not nurse

Symptoms of severe over dosage are variable. They are characterised in children by various combinations of excitation, ataxia, incoordination, athetosis and hallucinations, while adults may become drowsy and lapse into coma. Convulsions may occur in both adults and children; coma or excitement may precede their occurrence. Tachycardia may develop. Cardiorespiratory depression is uncommon. If the patient is seen soon enough after ingestion, it should be possible to induce vomiting with ipecacuanha despite the antiemetic efect of promethazine; alternatively, gastric lavage may be used. Treatment is otherwise supportive with attention to maintenance of adequate respiratory and circulatory status. Convulsions should be treated with diazepam or other suitable anticonvulsant.

Protect from light. Do not use later than the date of expiry. Keep all medicines out of the reach of children. To be dispensed only on the prescription of a registered physician

Anti-emetic drugs, Miscellaneous sedatives & hypnotics, Sedating Anti-histamine

Promethazine, a phenothiazine derivative, blocks postsynaptic dopaminergic receptors in the brain and has a strong alpha-adrenergic blocking effect. It competitively binds to H1-receptors.

There is epidemiological evidence for the safety of promethazine in pregnancy and animal studies have shown no hazard, nevertheless, it should not be used in pregnancy unless the physician considers it essential. The use of Phenergan is not recommended in the two weeks prior to delivery in view of the risk of irritability and excitement in the neonate. When promethazine has been given in high doses during late pregnancy, promethazine has caused prolonged neurological disturbances in the infant. Promethazine should be used in pregnancy only if the potential benefts to the patient are weighed against the possible risk to the fetus. Promethazine is excreted in breastmilk. There are risks of neonatal irritability and excitement.