Promethazine Theoclate
Indications
Promethazine Theoclate is used for:
Nausea and vomiting, Motion sickness, Vertigo
Adult Dose
Oral
Nausea and vomiting
Adult: As teoclate: 25 mg at night, may be increased to 50 or 75 mg at night or to 25 mg bid/tid, if needed.
Max: 100 mg daily.
Prophylaxis of motion sickness
Adult: As teoclate: 25 mg at night or 25 mg 1-2 hr before travelling.
Child Dose
Oral
Nausea and vomiting
Child: As teoclate: 5-10 yr: 12.5-37.5 mg daily.
Prophylaxis of motion sickness
Child: As teoclate: 5-10 yr: 12.5 mg daily starting either on the night before long journeys or 1-2 hr before short journeys.
Renal Dose
Renal impairment: Dose reduction may be required.
Administration
May be taken with or without food.
Contra Indications
Hypersensitivity, coma, porphyria, cardiac disease, hypokalaemia, intra-arterial or SC inj.
Precautions
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
Pregnancy-Lactation
Pregnancy category: C
Lactation: Not known whether drug crosses into breast milk; discontinue drug, or do not nurse
Interactions
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.
Adverse Effects
Side effects of Promethazine Theoclate :
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.
Mechanism of Action
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.