Methods of administration of promethazine

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Because the chemical structure of promethazine is different from that of other antipsychotic agents of the phenothiazine group, it has a weaker antipsychotic effect. In therapeutic doses it has no effect on the cardiovascular system. Clinical effects occur 20 min after oral administration (15-60 min on average), 2 min after I/M administration or 3-5 min after I/V administration and usually last for 4-6 h (sometimes lasting up to 12 h). Intensively metabolized in the liver on “first pass” mainly by S-oxidation. Promethazine sulfoxides and N-demethyl-promethazine are the main metabolites that are determined in the urine. The T1/2 of promethazine is 7-15 h. It is excreted mainly by the kidneys; to a lesser extent by the intestine.

Indications for use of Prometazine

Methods of administration of promethazine
  • Allergic diseases (including urticaria, serum sickness, hay fever, allergic rhinitis, allergic conjunctivitis, angioedema, pruritus);
  • adjuvant therapy of anaphylactic reactions (after the acute manifestations are stopped by other means, for example, epinephrine /adrenaline/);
  • As a sedative in the pre- and postoperative period;
  • to prevent or relieve nausea and vomiting associated with anesthesia and/or occurring in the postoperative period;
  • Postoperative pain (in combination with analgesics);
  • kinetosis (to prevent and relieve dizziness and nausea during transportation);
  • as a component of lytic mixtures used to potentiate anesthesia in surgical practice (for parenteral use).

Dosage regimen

Methods of administration of promethazine

It is administered orally, intramuscularly and intravenously.

Maximal daily dose for adults is 150 mg.
Intramuscularly – adults 25 mg once a day, if necessary 12.5-25 mg every 4-6 hours.
In treatment of allergic diseases Prometazine is prescribed orally in a dose of 25 mg once a day in the evening or 25 mg twice a day (morning and evening). The drug should be prescribed in the minimum effective dose.
For prevention and treatment of nausea and vomiting the drug is prescribed orally or intramuscularly in a single dose of 25 mg. If necessary, 25 mg may be administered every 4-6 hours. As a sedative in surgery on the eve of surgery, it is prescribed orally or intramuscularly in a dose of 25-50 mg once at night. For preoperative preparation 2.5 hours before surgery 50 mg Prometazine is administered as part of lytic mixtures, if necessary in 1 hour the administration can be repeated.

For induction of anesthesia and analgesia in certain diagnostic and surgical interventions such as repeated bronchoscopy, ophthalmic surgery, Prometazine may be administered v/v in doses of 0.15-0.3 mg/kg body weight.
In children over 2 months old the drug can be administered 3 to 5 times per day in a dose of 0.5 to 1 mg/kg of body weight. In severe cases the single dose for intravenous injection may be increased to 1-2 mg/kg of body weight.
Children aged 6 to 14 years are prescribed orally in dose of 25 mg (1 tablet) 3 to 4 times daily. It is not recommended to divide the tablet tablet in half; therefore, this dosage form is not indicated for children under 6 years of age.

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