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promethazine

promethazine

Brand names: Phenergan

Form	Strength
SOLUTION, INJECTABLE	25 mg/mL
SUPPOSITORY, RECTAL	12.5 mg; 25 mg; 50 mg
SYRUP, ORAL	6.25 mg/5 mL
TABLET, ORAL	25 mg

Display First Generation Antihistamines, Phenothiazines, Anxiolytics, Sedatives, and Hypnotics, Miscellaneous Class: 040400, 28160824, 282492

High Alert Drug : Policy

Medication comments:

Refrigerator item (suppository)

High Alert Drug: IV promethazine
• Dosing/administration guidelines. • Not to be given by IV push. • To be infused over at least 10 minutes. Maximum dose of 12.5mg. • No infusion in hand or wrist veins. • Autosubstitution to prochlorperazine unless ordered as “do not substitute.” • Pregnant patients will not be automatically substituted to prochlorperazine. • Stored in dispensing cabinet with warning alert “not for IV push” and reference to policy.

High Alert Drug: IV promethazine

• Dosing/administration guidelines.
• Not to be given by IV push.
• To be infused over at least 10 minutes. Maximum dose of 12.5mg.
• No infusion in hand or wrist veins.
• Autosubstitution to prochlorperazine unless ordered as “do not substitute.”
• Pregnant patients will not be automatically substituted to prochlorperazine.
• Stored in dispensing cabinet with warning alert “not for IV push” and reference to policy.

Per policy, use of these medications is restricted as noted below:
generic (Brand)	Restrictions
promethazine IV (Phenergan)	Intravenous promethazine is restricted to Obstetric patients with hyperemesis ONLY, where other treatments have failed.

Per policy, orders for these non-formulary agents will be changed to formulary equivalents.
Non-Formulary Agent	Formulary Equivalent
promethazine (Phenergan) 12.5 mg IV push	prochlorperazine (Compazine) 5 mg IV push Intravenous Promethazine is restricted to Obstetric patients with hyperemesis ONLY, where other treatments have failed.
promethazine (Phenergan) 25 mg IV push	prochlorperazine (Compazine) 10 mg IV push Intravenous Promethazine is restricted to Obstetric patients with hyperemesis ONLY, where other treatments have failed.

Available ED To-Go medications.
Description (Qty)
promethazine (Phenergan) 25 mg tablets (#4)

Adult Extravasation Management
promethazine (Phenergan)

Agent type:	Non-Chemotherapeutic
Vesicant/Irritant:	Vesicant
Local Care:	Warm or cold compress
Antidote:	None
Comments:	• Refractory cases: Consider Nitroglycerin 2% topical or hyaluronidase (200 units/ml)

Last updated: Jun. 18, 2025

Therapeutic Interchange Policy prochlorperazine (Compazine) (IV push)
Black Box Warnings Patients < 2 years; severe tissue injury

UpToDate Lexidrug

Pharmacy Contact Info:

Main Inpatient Pharmacy: ext 4599, 3503
Fax: 704-878-7283

Director of Pharmacy - Randi Raynor, PharmD: ext 4501
Clinical Coordinator - Laura Rollings, PharmD: ext 4597
Pharmacy Informaticist - Stephen Pringle, PharmD: ext 7645
Pharmacy Technician Supervisor - Amy Wingler, CPhT: ext 7385
Pharmacy Automation Coordinator (Omnicell) - Melissa Fulford, CPhT: ext 3556

This site is intended for the staff of Iredell Health System. While others may view accessible pages, Iredell Health System makes no warranty, express or implied, as to the use of this information outside of Iredell Health System. The content of this policy and procedure document serves as guidance to the delivery of quality patient care. Care providers are expected to exercise critical thinking and situational awareness skills, and in specific situations to take such action as is necessary for the delivery of quality patient care.