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Promethazine and Phenylephrine


Pronunciation

 (proe METH a zeen & fen il EF rin)


Synonyms

 Phenylephrine and Promethazine


Generic Available

 Yes


Use

 Temporary relief of upper respiratory symptoms associated with allergy or the common cold


Pregnancy Risk Factor

 C


Pregnancy Implications

 Refer to Promethazine monograph.


Lactation

 Excretion in breast milk unknown/not recommended


Drug Interactions

 Promethazine: Substrate (major) of CYP2B6, 2D6; Inhibits CYP2D6 (weak)

Also see individual agents.


Pharmacodynamics/Kinetics

 See individual agents.


Dosage

 Oral:

Children:

2-6 years: 1.25 mL every 4-6 hours, not to exceed 7.5 mL in 24 hours

6-12 years: 2.5 mL every 4-6 hours, not to exceed 15 mL in 24 hours

Children >12 years and Adults: 5 mL every 4-6 hours, not to exceed 30 mL in 24 hours


Dietary Considerations

 Increase dietary intake of riboflavin.


Patient Education

 See individual agents. Pregnancy/breast-feeding precautions: Inform prescriber if you are or intend to become pregnant. Breast-feeding is not recommended.


Nursing Implications

 May cause drowsiness


Dental Health: Effects on Dental Treatment

 Key adverse event(s) related to dental treatment: Phenylephrine: Tachycardia, palpitations, xerostomia (normal salivary flow resumes upon discontinuation); use vasoconstrictor with caution. Although promethazine is a phenothiazine derivative, extrapyramidal reactions or tardive dyskinesias are not seen with the use of this drug.


Dental Health: Vasoconstrictor/Local Anesthetic Precautions

Phenylephrine: Use with caution since phenylephrine is a sympathomimetic amine which could interact with epinephrine to cause a pressor response

Promethazine: No information available to require special precautions


Mental Health: Effects on Mental Status

 May cause drowsiness


Mental Health: Effects on Psychiatric Treatment

 Concurrent use with psychotropics may produce additive sedation


Dosage Forms

 Syrup: Promethazine hydrochloride 6.25 mg and phenylephrine hydrochloride 5 mg per 5 mL (120 mL, 473 mL) [contains alcohol]


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