Oral Promethazine side effects: an analysis
Promethazine, a generic prescription medication, is commonly used to treat year-round allergies, seasonal allergies, mild allergic skin reactions, nausea and vomiting after surgery, motion sickness, and pain after surgery when used along with other medications. However, it's essential to be aware of its potential side effects, particularly for oral tablet, syrup, and solution forms.
In both adults and children, the more common side effects of promethazine include drowsiness (due to its sedating antihistamine properties), dry mouth, sleep disturbances (including nightmares), dizziness, restlessness, nervousness, excitability (especially in some children, who may show paradoxical hyperexcitability), blurred vision, stuffy nose, tiredness and headaches, ringing in ears, and urinary retention (anticholinergic effect, more so in elderly and infants).
Less common or rare but serious side effects include severe respiratory depression (especially dangerous in young children), low blood pressure (hypotension), irregular heart rate, palpitations, arrhythmias, extrapyramidal symptoms (muscle stiffness, spasms, tic-like movements, uncoordinated movements), confusion, disorientation, hallucinations, seizures, neuroleptic malignant syndrome (rare, potentially fatal: fever, muscle cramps, confusion, abnormal heartbeat, excessive sweating), allergic reactions including swelling of face or extremities, severe rash, anaphylaxis, blood disorders including hemolytic anemia (rare), jaundice, and photosensitive skin reactions.
Children are particularly vulnerable to both sedation and paradoxical excitation. Severe respiratory depression, including slowed or stopped breathing, has been reported in pediatric patients using oral solutions or syrups, warranting careful monitoring. Elderly patients are more susceptible to anticholinergic effects like confusion and urinary retention. Drowsiness and sedation effects are also prominent.
If you experience dry mouth while taking promethazine, talk with your doctor or pharmacist. They may be able to recommend ways to ease this side effect, such as using lozenges or mouthwash made to help ease dry mouth. It's not recommended to drink alcohol while you're taking promethazine, as drinking alcohol while taking promethazine may increase the risk of side effects caused by the drug, alcohol, or both.
Promethazine is typically used short term. If you or your child is taking promethazine and notice any trouble breathing or slow, shallow breaths, go to the hospital right away or call 911 or your local emergency number.
In most cases, the promethazine side effects that occur in children are the same as those that occur in adults. However, promethazine can cause respiratory depression (trouble breathing) in young children, and it's not recommended for children younger than 2 years old to take promethazine. Mild side effects that have been reported with promethazine include sleepiness, blurry vision or double vision, dizziness, confusion, ringing of the ears, sun sensitivity, paradoxical reaction, vomiting, nausea, dry mouth, insomnia, and mild allergic reaction.
If you're pregnant, planning to become pregnant, or breastfeeding, talk with your doctor before taking promethazine. It's not known whether it's safe to take promethazine while pregnant or breastfeeding. If your symptoms are serious and you think you're having a medical emergency, immediately call 911 or your local emergency number. For mild symptoms of an allergic reaction, call your doctor right away. They may recommend ways to ease your symptoms and determine whether you should keep taking promethazine.
To summarise, the side effects of promethazine in both adults and children, particularly for oral tablet, syrup, and solution forms, include:
| Side Effect Category | Oral Tablet & Syrup & Solution (Adults & Children) | |---------------------------------|------------------------------------------------------------------| | Very Common | Drowsiness, dry mouth, sleep disturbances, dizziness | | Common | Restlessness, blurred vision, headache, tiredness, nasal stuffiness | | Less Common/Rare | Respiratory depression (children), hypotension, arrhythmia, confusion, muscle spasms, hallucinations, allergic reactions, blood dyscrasias, jaundice | | Serious, require urgent care | Neuroleptic malignant syndrome, seizures, severe allergic reactions |
Medical advice should be sought promptly if severe effects such as breathing difficulties, severe confusion, seizures, or allergic reactions occur.
[1] MedlinePlus: Promethazine [2] Drugs.com: Promethazine [4] Mayo Clinic: Promethazine [5] RxList: Promethazine
- Promethazine, a drug often used for gastrointestinal issues like nausea and vomiting after surgery, also treats year-round allergies, seasonal allergies, and mild allergic skin reactions.
- Some common side effects of promethazine include drowsiness, dry mouth, sleep disturbances, dizziness, restlessness, and blurred vision, which can affect both adults and children.
- Although rare, severe side effects such as severe respiratory depression, low blood pressure, irregular heart rate, hallucinations, and seizures are possible, particularly in the elderly and young children.
- It's essential to consult a health-and-wellness professional or pharmacist about managing potential side effects, such as dry mouth, which can be alleviated using lozenges or mouthwash made for dry mouth.
- Promethazine should not be taken with alcohol, as it may increase the risk of side effects caused by the drug, alcohol, or both.
- The use of promethazine should be short-term, and immediate medical attention should be sought if trouble breathing or slow, shallow breaths are noticed.
- Pregnant women, those planning to become pregnant, and breastfeeding mothers should consult their doctor before taking promethazine, as its safety during pregnancy and breastfeeding is not well-established.
