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Author: Admin | 2025-04-28
Disease of the newborn† [off-label] (erythroblastosis fetalis) when administered during pregnancy in Rh-sensitized women, but the safety and efficacy of the drug for this use have not been clearly established; other methods of management are preferred. Promethazine should be used during pregnancy only when the potential benefits justify the possible risks to the fetus.FertilityThere are no animal or human data concerning the effect of promethazine on fertility.LactationIt is not known whether promethazine is distributed into milk. Because many drugs are distributed in human milk and because of the potential for serious adverse reactions to promethazine in nursing infants if it were distributed, a decision should be made whether to discontinue nursing or the drug, taking into account the importance of the drug to the woman. Drug InteractionsCNS DepressantsPromethazine hydrochloride is additive with or may potentiate the sedative and respiratory depressant actions of opiates or other analgesics and other CNS depressants such as barbiturates or other sedatives, antihistamines, tranquilizers, or alcohol. When promethazine is used concomitantly with other depressant drugs, caution should be used to avoid overdosage. When promethazine is used concomitantly with barbiturates or opiates, dosage of these drugs should be reduced by at least 50 or 25–50%, respectively.EpinephrineAlthough reversal of the vasopressor effect of epinephrine has not been reported with promethazine, such possibility should be considered. If patients receiving promethazine require a vasopressor agent, norepinephrine or phenylephrine should be used; epinephrine should not be used since it may further decrease blood pressure in patients with partial adrenergic blockade.Anticholinergic AgentsCaution should be used during concomitant use of promethazine with drugs having anticholinergic properties.Monoamine Oxidase (MAO) InhibitorsAn increased incidence of extrapyramidal effects has been reported in patients receiving phenothiazines concomitantly with MAO inhibitors. Laboratory Test InterferencesPromethazine may interfere with several immunologic urinary pregnancy tests. The drug may elicit a false-positive Gravindex test and false-negative Prepurex and Dap test. Promethazine may interfere with blood grouping in the ABO system. The drug significantly alters the flare response in intradermal allergen tests.Acute ToxicityManifestationsIn adults, overdosage of promethazine may range from mild depression of the CNS and cardiovascular system to profound hypotension, respiratory depression, seizures,
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