phenergan for travel sickness adults

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Phenergan (Promethazine) against motion sickness and nausea

The unpleasant symptoms of travel sickness (aeroplane, ship, car or bus) can be prevented by a drug called Phenergan. Its active ingredient is called Promethazine. It is an antihistamine that helps to prevent the effects of histamine in the body, helping you to avoid many unpleasant symptoms associated with travelling. It must be taken as a preventative measure to get the best possible effect to make the trip to the destination as easy going as possible.

What’s on this page?

How does phenergan work.

The active ingredient in this medicine is Promethazine. The focus of the treatment is the class of sedative antihistamines (calming antihistamine), after taking the pill it therefore prevents histamine from affecting. It can reduce the irritating symptoms associated with movement disorders such as nausea and dizziness. In order to fully understand how this drug works, we must first look at what the antihistamines are and how they work in the body.

How do antihistamines work in motion?

Histamines are natural substances in the body, usually found from the immune system. When the body experiences imbalance it releases histamine that binds to different receptors. This can then cause disturbing symptoms. For someone who is allergic to histamines, they can cause itching around the eyes and a runny nose, while others may have symptoms of motion sickness such as, nausea, vomiting and dizziness. Imbalance occurs when the eye sees a different movement than what the inner ear feels.

Antihistamines inhibit histamines from binding to certain receptors, so there is no “space” for histamines. When histamines cannot bind to these receptors, the symptoms of motion sickness are prevented.

The effect is best when the antihistamines are taken before the symptoms develop. In this way, histamines cannot bind in certain areas. However, it may also be helpful if the drug is taken after the onset of symptoms because the antihistamines are so powerful that they can push the histamine away from the receptors.

Sedative or soothing effect

Phenergan belongs to the category of sedative antihistamines, so it is not suitable to be used if you plan to drive a car. It can only be used if you are a passenger in a car or a ship, plane, train or bus. However, it should be noted that everyone feels the effects of Phenergan differently, so some might still be close to their normal state while others might feel very sleepy.

Phenergan 25 mg: How should I use it?

This medicine is available in various forms, both in tablets and as an oral solution. The oral solution is typically used by children – however, only according to the doctor’s instructions. The tablets for adults contain 25 mg of the active substance and are taken with a glass water.

For the best effect, it is best to take the tablet before the start of the movement, i.e. about 30 to 60 minutes before the expected start. The effects of the medicine last around 5 to 14 hours in the blood stream and therefore it lasts during the whole trip for most people.

Remember that you may become very drowsy and your muscles may become tired after taking the medicine. However, the effect may differ between people and after you have used it a couple of times. After use, you can quickly understand how much the medicine affects you.

Alcohol can weaken the effects of the drug and therefore it is not recommended to drink alcohol and use the medicine simultaneously.

Are there any side effects?

All medicines can cause side effects to some extent. This is, among other things, the reason why most medicines can only be purchased with a prescription from a doctor. This also applies to Phenergan, although most do not experience any side effects. The most common side effects are a dry mouth and feeling fatigue, as mentioned earlier. Some have side effects such as dizziness, lack of urination, blurred vision and confusion. Rare side effects include anemia and allergic reactions. If you notice any serious side effects, contact your doctor immediately.

Is Phenergan suitable for me?

Most people who suffer from motion sickness while travelling either on the sea or in the air can take advantage of this medicine. However, care should be taken with regard to the simultaneous use of other medicines or other conditions you might be experiencing. This applies to situations in which you have sleep apnea, impaired hepatic or renal function or glaucoma. In addition, it may also affect with many antidepressants and sedatives.

Is there other natural options for Phenergan?

In addition to preventative medicines, there are other measures you can take to reduce discomfort during the movement:

• make sure you get enough rest before your trip
• drink a lot of water
• if possible, get fresh air – stop the car and have breaks while driving, spend time up on the deck while on a ship or try to go out from the airport
• be sure to look out from the window and avoid reading

Can I buy Phenergan online?

Phenergan is a prescription medication. You can visit your doctor and get a prescription that you can then use in a pharmacy when buying the medicine. Another possibility is to purchase the drug through an approved online clinic where your doctor will digitally assess whether the medicine is suitable for you or not. If the drug is right for you, you get a digital prescription and the medication can be sent to your home. This process saves you a lot of time, as you do not have to book a time from the doctor or go to the clinic physically.

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ANDREW BRAINARD, MD, MPH, AND CHIP GRESHAM, MD

Am Fam Physician. 2014;90(1):41-46

Patient information : See related handout on motion sickness , written by the authors of this article.

Author disclosure: No relevant financial affiliations.

Motion sickness is a common syndrome that occurs upon exposure to certain types of motion. It is thought to be caused by conflict between the vestibular, visual, and other proprioceptive systems. Although nausea is the hallmark symptom, it is often preceded by stomach awareness, malaise, drowsiness, and irritability. Early self-diagnosis should be emphasized, and patients should be counseled about behavioral and pharmacologic strategies to prevent motion sickness before traveling. Patients should learn to identify situations that will lead to motion sickness and minimize the amount of unpleasant motion they are exposed to by avoiding difficult conditions while traveling or by positioning themselves in the most stable part of the vehicle. Slow, intermittent exposure to the motion can reduce symptoms. Other behavioral strategies include watching the true visual horizon, steering the vehicle, tilting their head into turns, or lying down with their eyes closed. Patients should also attempt to reduce other sources of physical, mental, and emotional discomfort. Scopolamine is a first-line medication for prevention of motion sickness and should be administered transdermally several hours before the anticipated motion exposure. First-generation antihistamines, although sedating, are also effective. Nonsedating antihistamines, ondansetron, and ginger root are not effective in the prevention and treatment of motion sickness.

Motion sickness is a syndrome that occurs when a patient is exposed to certain types of motion and usually resolves soon after its cessation. It is a common response to motion stimuli during travel. Although nausea is a hallmark symptom, the syndrome includes symptoms ranging from vague malaise to completely incapacitating illness. These symptoms, which can affect the patient's recreation, employment, and personal safety, can occur within minutes of experiencing motion and can last for several hours after its cessation.

Nearly all persons will have symptoms in response to severe motion stimuli, and a history of motion sickness best predicts future symptoms. 1 Females, children two to 15 years of age, and persons with conditions associated with nausea (e.g., early pregnancy, migraines, vestibular syndromes) report increased susceptibility.

The pathogenesis of motion sickness is not clearly understood, but it is thought to be related to conflict between the vestibular, visual, and other proprioceptive systems. 2 Rotary, vertical, and low-frequency motions produce more symptoms than linear, horizontal, and high-frequency motions. 1

Clinical Presentation

Although nausea may be the first recognized symptom of motion sickness, it is almost always preceded by other subtle symptoms such as stomach awareness (i.e., a sensation of fullness in the epigastrium), malaise, drowsiness, and irritability. Failure to attribute early symptoms to motion sickness may lead to delays in diagnosis and treatment. Although mild symptoms are common, severely debilitating symptoms are rare 2 ( Table 1 1 , 2 ) .

Behavioral Interventions

Prevention of motion sickness is more effective than treating symptoms after they have occurred. Therefore, patients should learn to identify situations that may lead to motion sickness and be able to initiate behavioral strategies to prevent or minimize symptoms 1 , 2 ( Table 2 1 – 13 ) .

MINIMIZE VESTIBULAR MOTION

Patients should be advised to avoid traveling in difficult weather conditions. If they must travel, they should sit in the part of the vehicle with the least amount of rotational and vertical motion. 2 This is usually the lowest level in trains and buses, close to water level and in the center of boats, and over the wing on airplanes.

HABITUATE TO MOTION

With continuous exposure to motion, symptoms of motion sickness will usually subside in one to two days. Alternatively, slow, intermittent habituation to motion is an effective strategy to reduce symptoms. 1 For example, spending the first night aboard a boat in the marina, followed by a day acclimating in the harbor, is preferable to going straight into the open ocean.

SYNCHRONIZE THE VISUAL SYSTEM WITH THE MOTION

A small study found that focusing on the true horizon (skyline) minimized symptoms of motion sickness. 5 A survey of 3,256 bus passengers suggested that forward vision was helpful in reducing symptoms. 3 Another study indicated that forward vision in a car can reduce symptoms. 4

ACTIVELY SYNCHRONIZE THE BODY WITH THE MOTION

Actively steering the vehicle is an accepted strategy for reducing symptoms of motion sickness, although evidence is limited. 7 Additionally, a small study of automobile passengers found that actively tilting the head into turns was effective in preventing symptoms. 6 A survey of 260 cruise ship passengers supported the common advice to recline and passively stabilize themselves if they are unable to initiate active movements. 8

REDUCE OTHER SOURCES OF PHYSICAL, MENTAL, AND EMOTIONAL DISCOMFORT

Frequent consumption of light, soft, bland, low-fat, and low-acid food can minimize symptoms of motion sickness. 2 Treating gastritis is useful, 2 as is avoiding nausea-inducing stimuli (e.g., alcohol, noxious odors). Discussing symptoms with others can exacerbate the condition. Passengers should be well rested, well hydrated, well fed, and comfortable before beginning travel. Small studies have shown that cognitive behavior therapy, mindful breathing, and listening to music may also reduce symptoms of motion sickness. 9 , 10 , 13

Medications

Medications are most effective when taken prophylactically before traveling, or as soon as possible after the onset of symptoms 2 ( Table 3 1 , 2 , 14 – 23 ) . Medications are most effective when combined with behavioral strategies. To familiarize themselves with common side effects, patients should first take medications in a comfortable environment before using them for motion sickness during travel.

SCOPOLAMINE

Scopolamine, an anticholinergic, is a first-line option for preventing motion sickness in persons who wish to maintain wakefulness during travel. 2 , 20 , 24 A Cochrane review of 14 randomized controlled trials (RCTs) showed that scopolamine is effective for the prevention of motion sickness. 14 A more recent RCT of 76 naval crew members showed that transdermal scopolamine is more effective and has fewer side effects than the antihistamine cinnarizine (not available in the United States). 15 If the recommended dose of scopolamine does not adequately relieve symptoms, the dose may be doubled. Adding a second patch of transdermal scopolamine was well tolerated in a small RCT of 20 sailors. 25

ANTIHISTAMINES

First-generation antihistamines have been used to treat motion sickness since the 1940s. 1 They are generally recommended for patients who can tolerate their sedative effects. 2 , 20 Cyclizine (Marezine), dimenhydrinate, promethazine, and meclizine (Antivert) demonstrated effectiveness in small RCTs of varying quality. 16 – 19 Nonsedating antihistamines are not effective in preventing or treating motion sickness. 26

OTHER MEDICATIONS

Benzodiazepines are occasionally administered for severe symptoms of motion sickness and have been proven effective in a single small study. 27 The serotonin agonist rizatriptan (Maxalt) reduced motion sickness symptoms in a single RCT of 25 patients with recurrent migraines. 28 The serotonin antagonist ondansetron (Zofran) is ineffective for the prevention and treatment of motion sickness. 29 , 30

COMPLEMENTARY AND ALTERNATIVE THERAPIES

Although ginger root is often reported to prevent motion sickness, it had no statistically significant effects in an RCT of 80 naval cadets. 31 A single RCT of pregnant women showed that stimulation of the P6 acupressure point on the anterior wrist increased their tolerance of motion stimuli. 32 Controlled trials of behavioral, pharmacologic, or alternative therapies for motion sickness have demonstrated strong placebo effects. Therefore, treatments are likely to be most effective if the patient believes that they will work. 11 , 12

Data Sources : PubMed was searched using the MeSH headings motion sickness, ships, movement, space motion sickness, and travel. Additional searches were performed in Essential Evidence Plus, UpToDate, Medscape, and BMJ Clinical Evidence. Search dates: March 2012 through March 2014.

Golding JF. Motion sickness susceptibility. Auton Neurosci. 2006;129(1–2):67-76.

Shupak A, Gordon CR. Motion sickness: advances in pathogenesis, prediction, prevention, and treatment. Aviat Space Environ Med. 2006;77(12):1213-1223.

Turner M, Griffin MJ. Motion sickness in public road transport: the relative importance of motion, vision and individual differences. Br J Psychol. 1999;90(pt 4):519-530.

Griffin MJ, Newman MM. Visual field effects on motion sickness in cars. Aviat Space Environ Med. 2004;75(9):739-748.

Bos JE, MacKinnon SN, Patterson A. Motion sickness symptoms in a ship motion simulator: effects of inside, outside, and no view. Aviat Space Environ Med. 2005;76(12):1111-1118.

Wada T, Konno H, Fujisawa S, Doi S. Can passengers' active head tilt decrease the severity of carsickness? Effect of head tilt on severity of motion sickness in a lateral acceleration environment. Hum Factors. 2012;54(2):226-234.

Rolnick A, Lubow RE. Why is the driver rarely motion sick? The role of controllability in motion sickness. Ergonomics. 1991;34(7):867-879.

Gahlinger PM. Cabin location and the likelihood of motion sickness in cruise ship passengers. J Travel Med. 2000;7(3):120-124.

Dobie TG, May JG. The effectiveness of a motion sickness counselling programme. Br J Clin Psychol. 1995;34(pt 2):301-311.

Yen Pik Sang FD, Billar JP, Golding JF, Gresty MA. Behavioral methods of alleviating motion sickness: effectiveness of controlled breathing and a music audiotape. J Travel Med. 2003;10(2):108-111.

Horing B, Weimer K, Schrade D, et al. Reduction of motion sickness with an enhanced placebo instruction: an experimental study with healthy participants. Psychosom Med. 2013;75(5):497-504.

Eden D, Zuk Y. Seasickness as a self-fulfilling prophecy: raising self-efficacy to boost performance at sea. J Appl Psychol. 1995;80(5):628-635.

Denise P, Vouriot A, Normand H, Golding JF, Gresty MA. Effect of temporal relationship between respiration and body motion on motion sickness. Auton Neurosci. 2009;151(2):142-146.

Spinks A, Wasiak J. Scopolamine (hyoscine) for preventing and treating motion sickness. Cochrane Database Syst Rev. 2011;6:CD002851.

Gil A, Nachum Z, Tal D, Shupak A. A comparison of cinnarizine and transdermal scopolamine for the prevention of seasickness in naval crew: a double-blind, randomized, crossover study. Clin Neuropharmacol. 2012;35(1):37-39.

Estrada A, LeDuc PA, Curry IP, Phelps SE, Fuller DR. Airsickness prevention in helicopter passengers. Aviat Space Environ Med. 2007;78(4):408-413.

Brand JJ, Colquhoun WP, Gould AH, Perry WL. (—)-Hyoscine and cyclizine as motion sickness remedies. Br J Pharmacol Chemother. 1967;30(3):463-469.

Weinstein SE, Stern RM. Comparison of marezine and dramamine in preventing symptoms of motion sickness. Aviat Space Environ Med. 1997;68(10):890-894.

Paul MA, MacLellan M, Gray G. Motion-sickness medications for aircrew: impact on psychomotor performance. Aviat Space Environ Med. 2005;76(6):560-565.

Sherman CR. Motion sickness: review of causes and preventive strategies. J Travel Med. 2002;9(5):251-256.

Zajonc TP, Roland PS. Vertigo and motion sickness. Part II: pharmacologic treatment. Ear Nose Throat J. 2006;85(1):25-35.

Gordon CR, Shupak A. Prevention and treatment of motion sickness in children. CNS Drugs. 1999;12(5):369-381.

McDonald K, Trick L, Boyle J. Sedation and antihistamines: an update. Review of inter-drug differences using proportional impairment ratios. Hum Psychopharmacol. 2008;23(7):555-570.

Nachum Z, Shupak A, Gordon CR. Transdermal scopolamine for prevention of motion sickness: clinical pharmacokinetics and therapeutic applications. Clin Pharmacokinet. 2006;45(6):543-566.

Bar R, Gil A, Tal D. Safety of double-dose transdermal scopolamine. Pharmacotherapy. 2009;29(9):1082-1088.

Cheung BS, Heskin R, Hofer KD. Failure of cetirizine and fexofenadine to prevent motion sickness. Ann Pharmacother. 2003;37(2):173-177.

McClure JA, Lycett P, Baskerville JC. Diazepam as an anti-motion sickness drug. J Otolaryngol. 1982;11(4):253-259.

Furman JM, Marcus DA, Balaban CD. Rizatriptan reduces vestibular-induced motion sickness in migraineurs. J Headache Pain. 2011;12(1):81-88.

Muth ER, Elkins AN. High dose ondansetron for reducing motion sickness in highly susceptible subjects. Aviat Space Environ Med. 2007;78(7):686-692.

Hershkovitz D, Asna N, Shupak A, Kaminski G, Bar R, Tal D. Ondansetron for the prevention of seasickness in susceptible sailors: an evaluation at sea. Aviat Space Environ Med. 2009;80(7):643-646.

Grøntved A, Brask T, Kambskard J, Hentzer E. Ginger root against seasickness. A controlled trial on the open sea. Acta Otolaryngol. 1988;105(1–2):45-49.

Alkaissi A, Ledin T, Odkvist LM, Kalman S. P6 acupressure increases tolerance to nauseogenic motion stimulation in women at high risk for PONV. Can J Anaesth. 2005;52(7):703-709.

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Promethazine (Phenergan) - Other brand names: Avomine, Sominex

On this page.

• About promethazine
• Who can and cannot take promethazine
• How and when to take promethazine
• Side effects
• How to cope with side effects of promethazine
• Pregnancy and breastfeeding
• Cautions with other medicines
• Common questions about promethazine

1. About promethazine

Promethazine is an antihistamine medicine that relieves the symptoms of allergies.

It's known as a drowsy (sedating) antihistamine, so it's more likely to make you feel sleepy than other antihistamines.

Promethazine is used for:

• short-term sleep problems ( insomnia ) – including when a cough, cold or itching is keeping you awake at night
• allergies, including hay fever and hives (urticaria)
• feeling and being sick (vomiting) – due to motion sickness or vertigo
• cold symptoms, such as coughing and a runny nose

You can buy promethazine from pharmacies, where it's often sold as Avomine, Phenergan or Sominex. Promethazine is also available on prescription.

It comes as tablets, capsules and a liquid that you swallow.

You can also buy promethazine mixed with other medicines, such as paracetamol , dextromethorphan or pseudoephedrine, to treat coughs and colds or pain.

2. Key facts

• Do not drink alcohol while taking promethazine. Alcohol increases the risks of side effects.
• To help you sleep, take promethazine 20 minutes before you go to bed. It normally takes about 30 minutes to work.
• To prevent motion sickness, take promethazine the night before a long journey or 1 to 2 hours before a short journey.
• Common side effects of promethazine include drowsiness, headaches, nightmares and feeling dizzy, restless or confused.
• When promethazine is mixed with other medicines, it's also known by the brand names Fedril and Night Nurse.

3. Who can and cannot take promethazine

Promethazine can be taken by most adults.

Children under 6 should not be given cough and cold medicines containing promethazine if they have been bought at a pharmacy. These medicines should only be given if prescribed by a doctor.

Some types of promethazine medicines are not suitable for children over 6. Some are labelled 12+ and some are labelled 16+. Your doctor or pharmacist will advise which are the safest for children.

Promethazine is not suitable for some adults. To make sure it's safe for you, tell your doctor or pharmacist if you:

• have ever had an allergic reaction to promethazine or any other medicine
• have an eye problem called primary angle closure glaucoma
• have problems peeing or emptying your bladder
• have epilepsy or any other health problem that causes seizures or fits
• are due to have an allergy test. Promethazine can affect your results, so you may need to stop taking it a few days before your test. Ask the clinic where you are due to have your allergy test
• are unable to have any alcohol – some liquid promethazine products contain a very small amount of alcohol, so check the ingredients and the packaging carefully
• are trying to get pregnant. Promethazine can affect home pregnancy tests. If you think you're pregnant, speak to your doctor so they can arrange a blood test instead

4. How and when to take promethazine

If you or your child have been prescribed promethazine, follow your doctor's instructions about how and when to take it.

Only take promethazine when you need it – for example, if you're unable to sleep because you're worrying about something or your cold symptoms are keeping you awake.

If you have bought promethazine or any medicine containing promethazine from a pharmacy, follow the instructions that come with it, or ask a pharmacist for advice.

Dosage and strength

Promethazine comes in 10mg, 20mg and 25mg tablets. Your dose depends on why you're taking it:

• short-term insomnia – you'll usually take 20mg to 50mg at night
• hay fever – you'll usually take from 10mg twice a day to 20mg, 3 times a day
• hives – you'll usually take from 10mg twice a day to 20mg 3 times a day
• preventing motion sickness – you'll usually take 25mg 1 to 2 hours before a short journey or 25mg the night before a long journey
• treating motion sickness – take 25mg as soon as possible and 25mg the same evening, followed by 25mg the following evening (if you need it)
• vertigo – the dose can vary from 25mg a day to 25mg 4 times a day

If you're taking liquid which contains 5mg of promethazine in 5ml, follow the instructions that come with the medicine for how much to take.

Doses are lower for children. Your doctor will use your child's age to work out the right dose.

Promethazine mixed with other medicines

Promethazine can come mixed with other medicines, such as paracetamol. This is usually used to treat cough and cold symptoms. Your dose will depend on the type of medicine you're taking.

Check the instructions on the packaging carefully, or ask your pharmacist or doctor if you're unsure.

How to take it

You can take promethazine tablets, capsules and liquid with or without food.

How to take tablets and capsules

Always take your promethazine tablets or capsules with a drink of water. Swallow them whole. Do not chew them.

How to take liquid

Liquid medicines containing promethazine come with a plastic syringe or spoon to help you measure out the right dose.

If you do not have a syringe or spoon, ask your pharmacist for one. Do not use a kitchen teaspoon as you will not get the right amount.

What if I forget to take it?

For motion sickness, take it as soon as you remember.

For anything else, skip the missed dose and take your next dose at the usual time.

Never take 2 doses at the same time. Never take an extra dose to make up for a forgotten one.

If you often forget doses, it may help to set an alarm to remind you. You could also ask your pharmacist for advice on other ways to help you remember to take your medicine.

What if I take too much?

Too much promethazine can be dangerous.

If you take more than your usual dose, you may:

• feel very sleepy
• have a very fast, irregular or pounding heartbeat (palpitations)
• have breathing problems

In serious cases, you can become unconscious or have seizures or fits and may need emergency treatment in hospital.

If your child takes too much promethazine, they may also:

• move unsteadily or stumble
• have uncontrolled movements, especially in their hands or feet
• see or hear things that are not there (hallucinations)
• have an irregular heartbeat

Urgent advice: Contact 111 for advice if:

• you take more than your usual dose of promethazine

Go to 111.nhs.uk or call 111

If you need to go to A&E do not drive yourself. Get someone else to drive you or call for an ambulance.

Take the promethazine packet or leaflet inside it, plus any remaining medicine, with you.

5. Side effects

Common side effects.

Like all medicines, promethazine can cause side effects, although not everyone gets them.

Talk to your pharmacist or doctor if these side effects bother you or do not go away:

• feeling tired during the daytime
• feeling dizzy or unsteady on your feet, or having difficulty concentrating

Promethazine can sometimes make your skin more sensitive to sunlight. Keep out of direct or strong sunlight and follow sun safety advice .

If you're over 65, you're more likely to get side effects such as:

• feeling confused
• blurred vision
• difficulty peeing

Talk to a doctor or call 111 straight away if you have these side effects.

Children are more likely to get side effects such as feeling restless or excited.

Serious side effects

Call your doctor straight away if:

• the whites of your eyes or your skin turn yellow, although this may be less obvious on black or brown skin – these can be signs of liver problems
• you notice more bruising or bleeding than normal
• you have muscle stiffness or shaking, or unusual face or tongue movements

Serious allergic reaction

In rare cases, it's possible to have a serious allergic reaction ( anaphylaxis ) to promethazine.

Immediate action required: Call 999 now if:

• your lips, mouth, throat or tongue suddenly become swollen
• you're breathing very fast or struggling to breathe (you may become very wheezy or feel like you're choking or gasping for air)
• your throat feels tight or you're struggling to swallow
• your skin, tongue or lips turn blue, grey or pale (if you have black or brown skin, this may be easier to see on the palms of your hands or soles of your feet)
• you suddenly become very confused, drowsy or dizzy
• someone faints and cannot be woken up
• a child is limp, floppy or not responding like they normally do (their head may fall to the side, backwards or forwards, or they may find it difficult to lift their head or focus on your face)

You or the person who's unwell may also have a rash that's swollen, raised, itchy, blistered or peeling.

These can be signs of a serious allergic reaction and may need immediate treatment in hospital.

These are not all the side effects of promethazine. For a full list, see the leaflet inside your medicine packet.

You can report any suspected side effect using the Yellow Card safety scheme.

Visit Yellow Card for further information .

6. How to cope with side effects of promethazine

What to do about:

• feeling sleepy during the daytime – this usually wears off 12 hours after a dose. Do not drive, cycle or use tools or machinery if you're feeling this way.
• nightmares – speak to your pharmacist or doctor if these do not go away or are troubling you.
• feeling dizzy or unsteady on your feet, or having difficulty concentrating – stop what you're doing and sit or lie down until you feel better. If the feeling does not go away or is troubling you, do not take any more medicine and speak to a pharmacist or doctor.
• headaches – make sure you rest and drink plenty of fluids. Talk to your doctor if the headaches last longer than a week or are severe.

7. Pregnancy and breastfeeding

Promethazine and pregnancy.

Promethazine can be used in pregnancy. There is no good evidence that it is harmful to your baby, but it can have side effects such as drowsiness.

For the treatment of hay fever your doctor or pharmacist may recommend a non-drowsy antihistamine ( loratadine ).

Promethazine and breastfeeding

If your doctor or health visitor says your baby is healthy, promethazine can be used during breastfeeding. If you are prescribed promethazine, it's better to take occasional doses or only for a short time.

It's not known how much promethazine passes into breast milk but it is likely to be a small amount. It has been used for many years without causing babies to have side effects. However, promethazine is a drowsy antihistamine, so may also make your baby sleepy too. It may also reduce the amount of milk you produce.

If you're breastfeeding or planning to breastfeed, talk to your doctor or pharmacist, as other medicines might be better while you're breastfeeding.

If your baby is not feeding as well as usual, seems unusually sleepy, or seems irritable, or if you have any other concerns about your baby, talk to your doctor, pharmacist, health visitor or midwife.

Non-urgent advice: Tell your doctor if you're:

• trying to get pregnant
• breastfeeding

Find out more about how promethazine can affect you and your baby during pregnancy on the Best Use of Medicines in Pregnancy (BUMPs) website.

8. Cautions with other medicines

Some medicines and promethazine can affect each other and increase the chance of having side effects.

Tell your pharmacist or doctor if you're taking:

• a type of antidepressant called a monoamine oxidase inhibitor, such as phenelzine
• a type of painkiller called an opioid, such as codeine , morphine or oxycodone
• any medicine that makes you drowsy, gives you a dry mouth, or makes it difficult for you to pee – taking promethazine might make these side effects worse

If you're taking a cough or cold remedy or a painkiller containing promethazine, check carefully what the other ingredients are.

For example, promethazine often comes mixed with paracetamol . If you take 2 medicines that both contain paracetamol, there's a risk of overdose.

Ask your pharmacist for advice before you take this medicine together with any other painkillers or medicines.

Mixing promethazine with herbal remedies and supplements

There might be a problem taking some herbal remedies and supplements alongside promethazine, especially ones that cause side effects such as sleepiness, a dry mouth or making it difficult to pee.

Ask your pharmacist for advice.

Important: Medicine safety

Tell your doctor or pharmacist if you're taking any other medicines, including herbal medicines, vitamins or supplements.

9. Common questions about promethazine

Promethazine is a medicine called an antihistamine . It's classed as a drowsy (sedating) antihistamine.

When you come into contact with something you're allergic to, such as pollen or animal hair, your body produces a chemical called histamine. This can cause symptoms such as a runny nose or skin rashes.

Promethazine blocks the effects of histamine in your brain and this reduces symptoms.

It enters the brain in large quantities and this can make you feel drowsy.

Promethazine also blocks the effects of a chemical called dopamine, and this stops you feeling sick.

Promethazine blocks the effects of a natural chemical called acetylcholine.

This can help dry up a cough or runny nose, but can also cause side effects such as a dry mouth and dry nose.

Some cough and cold remedies claim to suppress your cough or stop you bringing up phlegm.

Although some people find them helpful, they're not usually recommended.

This is because there's little evidence that they're any more effective than simple home remedies and they're not suitable for everyone.

Promethazine will start to make you feel sleepy around 20 minutes after you take it and may work for up to 12 hours.

If you're taking it for a cough or cold, allergies or feeling sick (nausea), your symptoms should start to improve within 20 minutes. The medicine should work for around 4 to 6 hours.

Only take promethazine for a short time, unless your doctor says it's OK for you to take it for longer.

Speak to your pharmacist or doctor before taking promethazine for longer than the medicine leaflet recommends.

Ask them for advice if you're unsure how long you should take it for.

It's unlikely that you'll get addicted to promethazine. But it's best that you only take it for a very short time, unless your doctor tells you to take it for longer.

If you have bought a medicine containing promethazine, do not take it for longer than recommended on the packet without speaking to your pharmacist or doctor first.

If you have taken promethazine for a long time and suddenly stop taking it, it's possible you might feel dizzy, sweaty or sick, have a racing heart and have trouble sleeping.

Coming off promethazine slowly can help prevent this.

Speak to your doctor if you have taken promethazine for a long time and want to stop taking it.

Promethazine is known as a drowsy (sedating) antihistamine as it makes you sleepy.

Non-drowsy antihistamines are less likely to have this effect. These include cetirizine , fexofenadine and loratadine .

Most people prefer to take a non-drowsy antihistamine as it's less likely to interfere with their everyday routine.

You might choose to take a drowsy antihistamine, however, if you're having problems falling asleep, or if symptoms like itching or coughing are keeping you awake.

There is not enough information available to say whether one antihistamine is better than another for treating allergies.

You may need to try a few different medicines to find what works best for you. Ask your pharmacist or doctor for advice if you're unsure.

You can take 2 different antihistamines at a time, if your doctor says it's OK. If you have a severe itchy skin rash, your doctor may recommend 2 different antihistamines together for a few days.

You could take a non-drowsy antihistamine (such as cetirizine , fexofenadine or loratadine ) during the day, and a drowsy antihistamine at night if itching is making it difficult to sleep.

Do not take another drowsy antihistamine together with promethazine. It'll make you very tired and sleepy.

Other drowsy antihistamines include chlorphenamine (Piriton) and diphenhydramine (Nytol Original).

Do not take 2 antihistamines together unless you have been advised to by your doctor.

Yes. If you take it for insomnia or take it at bedtime, promethazine will help you sleep.

If you take it during the day for other conditions, such as allergies, it might make you feel sleepy during the day as well.

Yes, you can take promethazine together with some painkillers, such as paracetamol or ibuprofen .

If you take promethazine with painkillers that contain codeine (such as co-codamol or other prescription painkillers), you may feel very tired and sleepy.

It's important to check the packaging or label of your medicine carefully. This is because some promethazine products already contain a painkiller.

Do not take extra painkillers if this is the case, as there's a risk of overdose.

Speak to your pharmacist if you're not sure whether a medicine already contains a painkiller.

Do not drive a car or ride a bike if promethazine makes you sleepy during the daytime, gives you blurred vision or makes you feel dizzy, clumsy or unable to concentrate or make decisions.

This may be more likely when you first start taking promethazine, but could happen at any time (for example, when starting another medicine).

It's an offence to drive a car if your ability to drive safely is affected. It's your responsibility to decide if it's safe to drive. If you're in any doubt, do not drive.

Talk to your doctor or pharmacist if you're unsure whether it's safe for you to drive while taking promethazine. GOV.UK has more information on the law on drugs and driving .

There's no evidence to suggest that taking promethazine reduces fertility in either men or women.

But speak to a pharmacist or doctor before taking it if you're trying to get pregnant.

Promethazine does not affect any type of contraception, including the combined pill and emergency contraception .

Do not drink alcohol while you're taking promethazine.

Alcohol and promethazine together can make you sleep very deeply.

You will not be able to breathe properly and may have difficulty waking up.

You can eat normally while taking promethazine.

However, do not drink alcohol. And if you take promethazine to help you sleep, try not to have drinks that contain caffeine, like coffee, tea, cola or energy drinks. Caffeine has the opposite effect to promethazine and can stop the medicine working.

Yes, it's dangerous to take promethazine with recreational drugs. This is because it can slow or stop your heart and lungs.

Mixing promethazine and codeine in large amounts slows down the central nervous system (brain and spinal cord), which can slow breathing and heart rate.

It's even more dangerous when taken with alcohol or other drugs and has caused people to die.

Find out more about the side effects of some recreational drugs on the Frank website .

Promethazine will only help you sleep while you're taking it, so there are a number of things you can do instead to help yourself have a good night's sleep :

• set regular times for going to bed and waking up
• relax before bedtime – try taking a warm bath or listening to calming music
• use thick curtains or blinds, an eye mask and earplugs to stop you being woken up by light and noise
• avoid caffeine, cigarettes or vapes, alcohol, heavy meals and exercise for a few hours before bedtime
• do not watch TV or use phones, tablets or computers before going to bed
• do not nap during the day
• make a list of your worries and any ideas for how to solve them before you go to bed – this can help you forget about them until the morning

If you have hay fever , it helps if you do not spend too much time outside if the pollen count is high.

Tips for when you're outside

• Do not cut grass or walk on grass.
• Wear wraparound sunglasses to stop pollen getting into your eyes.
• Put Vaseline around your nostrils to help trap pollen.
• Shower and change your clothes after you have been outside to wash off pollen.

Tips for when you're inside

• Keep windows and doors shut as much as possible.
• Vacuum regularly and dust with a damp cloth.
• Do not keep fresh flowers in the house.
• Do not smoke or be around smoke as it makes hay fever symptoms worse.

The best way to prevent any sort of allergic reaction is to avoid the substance that you're allergic to, if you can.

There are some practical steps you can follow to help prevent allergies .

Related conditions

• Contact dermatitis
• Motion sickness

Useful resources

• Allergy UK: charity
• Healthtalk: videos of real stories about sleep problems
• Itchy Sneezy Wheezy: website for parents

Page last reviewed: 27 October 2021 Next review due: 27 October 2024

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Motion sickness

Travel sickness.

Peer reviewed by Dr Hayley Willacy, FRCGP Last updated by Dr Colin Tidy, MRCGP Last updated 16 Mar 2023

Meets Patient’s editorial guidelines

In this series: Health advice for travel abroad Travelling to remote locations Ears and flying Jet lag Altitude sickness

Motion sickness (travel sickness) is common, especially in children. It is caused by repeated unusual movements during travelling, which send strong (sometimes confusing) signals to the balance and position sensors in the brain.

In this article :

What causes motion sickness, how long does motion sickness last, motion sickness symptoms, how to stop motion sickness, natural treatments for motion sickness, motion sickness medicines, what can a doctor prescribe for motion sickness, what should i do if i'm actually sick, what is mal de debarquement syndrome.

Continue reading below

Motion sickness is a normal response to repeated movements, such as going over bumps or around in a circle, send lots of messages to your brain. If you are inside a vehicle, particularly if you are focused on things that are inside the vehicle with you then the signals that your eyes send to the brain may tell it that your position is not changing, whilst your balance mechanisms say otherwise.

Your balance mechanisms in your inner ears sense different signals to those that your eyes are seeing which then sends your brain mixed, confusing messages. This confusion between messages then causes people to experience motion sickness.

Is motion sickness normal?

Motion sickness is a normal response that anyone can have when experiencing real or perceived motion. Although all people can develop motion sickness if exposed to sufficiently intense motion, some people are rarely affected while other people are more susceptible and have to deal with motion sickness very often.

Triggers for motion sickness

Motion sickness can also be triggered by anxiety or strong smells, such as food or petrol. Sometimes trying to read a book or a map can trigger motion sickness. Both in children and adults, playing computer games can sometimes cause motion sickness to occur.

Motion sickness is more common in children and also in women. Fortunately, many children grow out of having motion sickness. It is not known why some people develop motion sickness more than others. Symptoms can develop in cars, trains, planes and boats and on amusement park rides, etc.

Symptoms typically go when the journey is over; however, not always. In some people they last a few hours, or even days, after the journey ends.

There are various symptoms of motion sickness including::

Feeling sick (nausea and vomiting).

Sweating and cold sweats.

Increase in saliva.

Headaches .

Feeling cold and going pale.

Feeling weak.

Some general tips to avoid motion sickness include the following.

Prepare for your journey

Don't eat a heavy meal before travelling. Light, carbohydrate-based food like cereals an hour or two before you travel is best.

On long journeys, try breaking the journey to have some fresh air, drink some cold water and, if possible, take a short walk.

For more in-depth advice on travelling generally, see the separate leaflets called Health Advice for Travel Abroad , Travelling to Remote Locations , Ears and Flying (Aeroplane Ear) , Jet Lag and Altitude Sickness .

Plan where you sit

Keep motion to a minimum. For example, sit in the front seat of a car, over the wing of a plane, or on deck in the middle of a boat.

On a boat, stay on deck and avoid the cafeteria or sitting where your can smell the engines.

Breathe fresh air

Breathe fresh air if possible. For example, open a car window.

Avoid strong smells, particularly petrol and diesel fumes. This may mean closing the window and turning on the air conditioning, or avoiding the engine area in a boat.

Use your eyes and ears differently

Close your eyes (and keep them closed for the whole journey). This reduces 'positional' signals from your eyes to your brain and reduces the confusion.

Don't try to read.

Try listening to an audio book with your eyes closed. There is some evidence that distracting your brain with audio signals can reduce your sensitivity to the motion signals.

Try to sleep - this works mainly because your eyes are closed, but it is possible that your brain is able to ignore some motion signals when you are asleep.

Do not read or watch a film.

It is advisable not to watch moving objects such as waves or other cars. Don't look at things your brain expects to stay still, like a book inside the car. Instead, look ahead, a little above the horizon, at a fixed place.

If you are the driver you are less likely to feel motion sickness. This is probably because you are constantly focused on the road ahead and attuned to the movements that you expect the vehicle to make. If you are not, or can't be, the driver, sitting in the front and watching what the driver is watching can be helpful.

Treat your tummy gently

Avoid heavy meals and do not drink alcohol before and during travelling. It may also be worth avoiding spicy or fatty food.

Try to 'tame your tummy' with sips of a cold water or a sweet, fizzy drink. Cola or ginger ale are recommended.

Try alternative treatments

Sea-Bands® are acupressure bands that you wear on your wrists to put pressure on acupressure points that Chinese medicine suggests affects motion sickness. Some people find that they are effective.

Homeopathic medicines seem to help some people, and will not make you drowsy. The usual homeopathic remedy is called 'nux vom'. Follow the instructions on the packet.

All the techniques above which aim to prevent motion sickness will also help reduce it once it has begun. Other techniques, which are useful on their own to treat motion sickness but can also be used with medicines if required, are:

Breathe deeply and slowly and, while focusing on your breathing, listening to music. This has been proved to be effective in clinical trials.

Ginger - can improve motion sickness in some people (as a biscuit or sweet, or in a drink).

There are several motion sickness medicines available which can reduce, or prevent, symptoms of motion sickness. You can buy them from pharmacies or, in some cases, get them on prescription. They work by interfering with the nerve signals described above.

Medicines are best taken before the journey. They may still help even if you take them after symptoms have begun, although once you feel sick you won't absorb medicines from the stomach very well. So, at this point, tablets that you put against your gums, or skin patches, are more likely to be effective.

Hyoscine is usually the most effective medicine for motion sickness . It is also known as scopolamine. It works by preventing the confusing nerve messages going to your brain.

There are several brands of medicines which contain hyoscine - they also come in a soluble form for children. You should take a dose 30-60 minutes before a journey; the effect can last up to 72 hours. Hyoscine comes as a patch for people aged 10 years or over. (This is only available on prescription - see below.) Side-effects of hyoscine include dry mouth , drowsiness and blurred vision.

Side-effects of motion sickness medicines

Some medicines used for motion sickness may cause drowsiness. Some people are extremely sensitive to this and may find that they are so drowsy that they can't function properly at all. For others the effects may be milder but can still impair your reactions and alertness. It is therefore advisable not to drive and not to operate heavy machinery if you have taken them. In addition, some medicines may interfere with alcohol or other medication; your doctor or the pharmacist can advise you about this.

Antihistamines

Antihistamines can also be useful , although they are not quite as effective as hyoscine. However, they usually cause fewer side-effects. Several types of antihistamine are sold for motion sickness. All can cause drowsiness, although some are more prone to cause it than others; for example, promethazine , which may be of use for young children on long journeys, particularly tends to cause drowsiness. Older children or adults may prefer one that is less likely to cause drowsiness - for example, cinnarizine or cyclizine.

Remember, if you give children medicines which cause drowsiness they can sometimes be irritable when the medicines wear off.

See the separate article called How to manage motion sickness .

There are a number of anti-sickness medicines which can only be prescribed by your doctor. Not all of them always work well for motion sickness, and finding something that works may be a case of trial and error. All of them work best taken up to an hour before your journey, and work less well if used when you already feel sick. See also the separate leaflet called Nausea (Causes, Symptoms, and Treatment) for more detailed information about these medicines .

Hyoscine patch

Hyoscine, or scopolamine, patches are suitable for adults and for children over 10 years old. The medicine is absorbed through your skin, although this method of medicine delivery is slow so the patch works best if applied well before your journey.

You should stick the patch on to the skin behind the ear 5-6 hours before travelling (often this will mean late on the previous night) and remove it at the end of the journey.

Prochlorperazine

Prochlorperazine is a prescription-only medicine which works by changing the actions of the chemicals that control the tendency to be sick (vomit), in your brain. One form of prochlorperazine is Buccastem®, which is absorbed through your gums and does not need to be swallowed. Buccastem® tastes rather bitter but it can be effective for sickness when you are already feeling sick, as it doesn't have to be absorbed by the stomach.

Metoclopramide

Metoclopramide is a tablet used to speed up the emptying of your tummy. Slow emptying of the tummy is something that happens when you develop nausea and vomiting, so metoclopramide can help prevent this. It prevents nausea and vomiting quite effectively in some people. It can occasionally have unpleasant side-effects, particularly in children (in whom it is not recommended). Metoclopramide is often helpful for those who tend to have gastric reflux, those who have slow tummy emptying because of previous surgery, and those who have type 1 diabetes. Your GP will advise whether metoclopramide is suitable for you.

Domperidone

Domperidone , like metoclopramide, is sometimes used for sickness caused by slow tummy emptying. It is not usually recommended for motion sickness but is occasionally used if other treatments don't help. Domperidone is not a legal medicine in some countries, including the USA.

Ondansetron

Ondansetron is a powerful antisickness medicine which is most commonly used for sickness caused by chemotherapy, and occasionally used for morning sickness in pregnancy. It is not usually effective for motion sickness. This, and its relatively high cost means that it is not prescribed for motion sickness alone. However, for those undergoing chemotherapy, and for those who have morning sickness aggravated by travel, ondansetron may be helpful.

If you're actually sick you may find that this relieves your symptoms a little, although not always for very long. If you've been sick:

Try a cool flannel on your forehead, try to get fresh air on your face and do your best to find a way to rinse your mouth to get rid of the taste.

Don't drink anything for ten to twenty minutes (or it may come straight back), although (very) tiny sips of very cold water, coke or ginger ale may help.

After this, go back to taking all the prevention measures above.

Once you reach your destination you may continue to feel unwell. Sleep if you can, sip cold iced water, and - when you feel ready - try some small carbohydrate snacks. Avoid watching TV (more moving objects to watch!) until you feel a little better.

The sensation called 'mal de debarquement' (French for sickness on disembarking) refers to the sensation you sometimes get after travel on a boat, train or plane, when you feel for a while as though the ground is rocking beneath your feet. It is probably caused by the overstimulation of the balance organs during your journey. It usually lasts only an hour or two, but in some people it can last for several days, particularly after a long sea journey. It does not usually require any treatment.

Persistent mal de debarquement syndrome is an uncommon condition in which these symptoms may persist for months or years.

Dr Mary Lowth is an author or the original author of this leaflet.

Further reading and references

• Spinks A, Wasiak J ; Scopolamine (hyoscine) for preventing and treating motion sickness. Cochrane Database Syst Rev. 2011 Jun 15;(6):CD002851.
• Lackner JR ; Motion sickness: more than nausea and vomiting. Exp Brain Res. 2014 Aug;232(8):2493-510. doi: 10.1007/s00221-014-4008-8. Epub 2014 Jun 25.
• Leung AK, Hon KL ; Motion sickness: an overview. Drugs Context. 2019 Dec 13;8:2019-9-4. doi: 10.7573/dic.2019-9-4. eCollection 2019.
• Zhang LL, Wang JQ, Qi RR, et al ; Motion Sickness: Current Knowledge and Recent Advance. CNS Neurosci Ther. 2016 Jan;22(1):15-24. doi: 10.1111/cns.12468. Epub 2015 Oct 9.
• Van Ombergen A, Van Rompaey V, Maes LK, et al ; Mal de debarquement syndrome: a systematic review. J Neurol. 2016 May;263(5):843-854. doi: 10.1007/s00415-015-7962-6. Epub 2015 Nov 11.

Article History

The information on this page is written and peer reviewed by qualified clinicians.

Next review due: 14 Mar 2028

16 mar 2023 | latest version.

Last updated by

Peer reviewed by

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Promethazine hydrochloride

Interactions.

View interactions for promethazine

Medicinal forms and pricing

There can be variation in the licensing of different medicines containing the same drug.

Forms available from special-order manufacturers include: oral suspension, oral solution.

View all medicinal forms and pricing information

Or jump straight to:

• Oral tablet
• Oral solution
• Solution for injection

Indications and dose

For promethazine hydrochloride, symptomatic relief of allergy such as hay fever and urticaria, insomnia associated with urticaria and pruritus for promethazine hydrochloride, sedation (short-term use) for promethazine hydrochloride, sedation in intensive care for promethazine hydrochloride, by mouth, or by slow intravenous injection, or by deep intramuscular injection, nausea, vomiting, vertigo, labyrinthine disorders, motion sickness for promethazine hydrochloride, unlicensed use, unlicensed use for promethazine hydrochloride.

Not licensed for use for sedation in children under 2 years.

Important safety information

Important safety information for promethazine hydrochloride, mhra/chm advice: over-the-counter cough and cold medicines for children (april 2009).

Children under 6 years should not be given over-the-counter cough and cold medicines containing promethazine.

Contra-indications

Contra-indications for promethazine hydrochloride.

Neonate (due to significant antimuscarinic activity) (in neonates); should not be given to children under 2 years, except on specialist advice, due to the potential for fatal respiratory depression

Cautions For promethazine hydrochloride

General cautions:.

Epilepsy; pyloroduodenal obstruction; severe coronary artery disease; susceptibility to angle-closure glaucoma; susceptibility to QT interval prolongation; urinary retention

Specific cautions:

With intravenous use.

Avoid extravasation with intravenous injection

Side-effects

Side-effects for promethazine hydrochloride, general side-effects:, frequency not known.

Arrhythmias; blood disorder; confusion; dizziness; drowsiness; dry mouth; headache; hypotension; jaundice; movement disorders; palpitations; photosensitivity reaction; QT interval prolongation; urinary retention; vision blurred

Specific side-effects:

With oral use.

Agranulocytosis; angle closure glaucoma; anticholinergic syndrome; anxiety; insomnia; leucopenia; nasal congestion; nausea; rash; seizure; thrombocytopenia; tinnitus; tremor; vomiting

With parenteral use

Appetite decreased; epigastric discomfort; fatigue; haemolytic anaemia; hypersensitivity; muscle spasms; nightmare; restlessness; skin reactions

Pregnancy For promethazine hydrochloride

Most manufacturers of antihistamines advise avoiding their use during pregnancy; however, there is no evidence of teratogenicity.

Use in the latter part of the third trimester may cause adverse effects in neonates such as irritability, paradoxical excitability, and tremor.

Breast feeding

Breast feeding for promethazine hydrochloride.

Most antihistamines are present in breast milk in varying amounts; although not known to be harmful, most manufacturers advise avoiding their use in mothers who are breast-feeding.

Hepatic impairment

Hepatic impairment for promethazine hydrochloride.

Manufacturer advises caution.

Renal impairment

Renal impairment for promethazine hydrochloride.

Use with caution. M

Patient and carer advice

Patient and carer advice for promethazine hydrochloride, driving and skilled tasks.

Drowsiness may affect the performance of skilled tasks (e.g. cycling or driving); sedating effects enhanced by alcohol.

Profession specific information

Profession specific information for promethazine hydrochloride, dental practitioners' formulary.

Promethazine Hydrochloride Tablets 10 mg or 25 mg may be prescribed.

Promethazine Hydrochloride Oral Solution (elixir) 5 mg/5 mL may be prescribed.

Less suitable for prescribing

Less suitable for prescribing for promethazine hydrochloride.

Promethazine is less suitable for prescribing for sedation.

Exceptions to legal category

Exceptions to legal category for promethazine hydrochloride.

Prescription only medicine restriction does not apply to promethazine hydrochloride injection where administration is for saving life in emergency.

Medicinal forms

Related treatment summaries.

• Hypnotics and anxiolytics
• Nausea and labyrinth disorders

Other drugs in class

Other drugs in class sedating antihistamines.

• Alimemazine tartrate
• Chlorphenamine maleate
• Cinnarizine
• Hydroxyzine hydrochloride
• Paracetamol with buclizine hydrochloride and codeine phosphate
• Promethazine teoclate

The content on the NICE BNFC site (BNFC) is the copyright of BMJ Publishing Group Ltd, the Royal Pharmaceutical Society of Great Britain, and RCPCH Publications Ltd. By using BNFC, you agree to the licence set out in the BNF Publications End User Licence Agreement .

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PHENERGAN 25 MG TABLETS - patient leaflet, side effects, dosage

• R06AD02 promethazine

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Table of contents

Sources: Original (products.mhra.gov.uk)

Patient leaflet - PHENERGAN 25 MG TABLETS

Phenergan 25 mg

promethazine hydrochloride

Sanofi >3.

• Is this leaflet hard to see or read? PhOn Phone 0800 035 2525 for help Read all of this leaflet carefully before you start taking this medicine because it contains important information for you. Always take this medicine exactly as described in this leaflet or as your doctor or pharmacist has told you.
• Keep this leaflet. You may need to read it again
• Ask your pharmacist if you need more information or advice
• If you get any side effects, talk to your doctor or pharmacist. This includes any possible side effects not listed in this leaflet. See section 4 .
• You must talk to a doctor if you do not feel better or if you feel worse after 7 days.

1. What Phenergan Tablets are and what they are used for

2. What you need to know before you take Phenergan Tablets

3. How to take Phenergan Tablets

4. Possible side effects

5. How to store Phenergan Tablets

6. Contents of the pack and other Information

1. What Phenergan Tablets are and what they are used for

Phenergan Tablets contain a medicine called promethazine hydrochloride. This belongs to a group of medicines called phenothiazines. It works by blocking a natural substance (histamine) that your body makes during an allergic reaction. It also works directly on the brain to help you feel more relaxed.

What Phenergan Tablets are used for

Phenergan Tablets are used to treat the following conditions:

• For short term use: to treat adults with difficulty sleeping (insomnia)
• To treat allergic conditions such as hay fever or rashes (like nettle rash or hives)
• To treat or stop you feeling sick (nausea) or being sick (vomiting) such as travel sickness
• For short term use: as a sedative for children aged 5 years and above

2. what you need to know before you take phenergan tablets

Do not take this medicine if:.

X The person taking the medicine is under 5 years of age

X You are allergic (hypersensitive) to promethazine hydrochloride or any of the other ingredients of Phenergan Tablets (listed in Section 6 below). The signs of an allergic reaction include: a rash, swallowing or breathing problems, swelling of your lips, face, throat or tongue

X You are taking a medicine for depression called a monoamine oxidase inhibitor (MAOI). Also do not take Phenergan Tablets if you have stopped taking one of these MAOI medicines within the last 14 days. If you are not sure ask your doctor or pharmacist (see “Taking other medicines” section below)

X The person is unconscious (in a coma) or suffers from severe dizziness, drowsiness or headache

Do not take this medicine if any of the above applies to you. If you are not sure, talk to your doctor or pharmacist before taking Phenergan Tablets.

Warnings and precautions

Check with your doctor or pharmacist before taking your medicine if

A  You have difficulty breathing, wheezing, tightness in the chest (asthma) or an infection in your lungs (bronchitis)

A  You have epilepsy

A  You have any serious heart problems

A  You have liver or kidney problems

A  You have a stomach blockage or __ difficulty passing water

A  You have hearing problems

A  You have increased pressure in the eye (narrow angle glaucoma)

A  You have had something called Reye’s Syndrome or possible Reye’s Syndrome – signs include being sick and confused following a viral illness

If you are not sure if any of the above apply to you, talk to your doctor or pharmacist before taking Phenergan Tablets.

S   I Other medicines and Phenergan S Tablets

Please tell your doctor or pharmacist if you are taking or have recently taken any other medicines. This includes medicines you can buy without prescription, including herbal medicines. This is because Phenergan Tablets can affect the way some medicines work. Also some medicines can affect the way Phenergan Tablets work.

Do not take this medicine, and tell your doctor, if you are taking or have taken the following in the last 2 weeks:

• Some medicines for depression called monoamine oxidase inhibitors (MAOIs). If you are not sure ask your doctor or pharmacist

Tell your doctor or pharmacist if you are taking any of the following:

• Anticholinergic medicines – includes some medicines used for irritable bowel syndrome, asthma or weak bladder. These can increase the risk of dizziness, dry mouth and blurred eyesight
• Medicines for depression (such as amitriptyline)
• Medicines to help you to sleep or feel more relaxed (such as diazepam or zolpidem)
• Medicines such as aspirin (for arthritis and pain in your joints). Phenergan Tablets may hide the side effects of these medicines

Phenergan Tablets with food and drink Do not drink alcohol while you are taking Phenergan Tablets. This is because it can affect the way the medicine works.

Pregnancy and breast-feeding

Talk to your doctor or pharmacist before taking this medicine if you are pregnant, might become pregnant, or think you may be pregnant. Phenergan Tablets should not be taken 2 weeks before birth.

You should not take Phenergan Tablets if you are breast-feeding. This is because small amounts may pass into mothers’ milk. This can be harmful to your baby.

If you are breast-feeding or planning to breast-feed, talk to your doctor or pharmacist before taking any medicine.

Driving and using machines

You may feel drowsy or sleepy after taking this medicine or the morning after taking this medicine. If this happens, do not drive or use any tools or machines.

Phenergan Tablets contains lactose:

• If you have been told by your doctor that you have an intolerance to some sugars, contact your doctor before taking this medicinal product

3. how to take phenergan tablets

Always use this medicine exactly as described in this leaflet or as your doctor or pharmacist has told you. Check with your doctor or pharmacist if you are not sure.

The amount you need to take depends on the reason you are taking Phenergan Tablets. The following information will help you to decide how much you need to take.

Taking this medicine

• Take this medicine by mouth
• Do not take for longer than 7 days.

If your symptoms worsen or do not improve after 7 days talk to your doctor or pharmacist

• If you feel the effect of your medicine is too weak or too strong, do not change the dose yourself, but ask your doctor

How much to take

The recommended dose is:

For allergies (such as hay fever, rashes and hives)

Children 2–5 years:

• Phenergan Elixir should be given in this age group

Children 5–10 years:

• A single tablet (25mg) given at night
• DO NOT give more than 25mg each day

Children over 10 years and adults

(including the elderly):

• Start with one tablet (25mg) taken at night
• This may be increased to a maximum of one tablet (25mg) twice a day if necessary

For treatment and prevention of feeling sick or being sick (such as travel sickness)

• Phenergan Elixir or Phenergan 10mg Tablets should be given in this age group
• A single tablet (25 mg) to be taken the night before the journey
• This may be repeated after 6–8 hours if necessary

As a short term paediatric sedative and for short term treatment of insomnia in adults

• One or two tablets (25mg-50mg) taken at night

Use this medicine only as recommended. Do not exceed the recommended dose.

Exposure to sunlight

Phenergan Tablets can make your skin more sensitive to sunlight. Keep out of direct sunlight while taking this medicine.

If you take more Phenergan Tablets than you should

If you or your child takes more Phenergan Tablets than you should, tell a doctor or go to a hospital casualty department straight away. Take the medicine pack with you. This is so the doctor knows what you or your child has taken.

The following effects may happen:

In children: Excitation, moving unsteadily or stumbling, uncontrolled writhing movements especially of the hands or feet, hallucinations, fits (seizures), loss of consciousness, uneven heart beat and breathing difficulties.

In adults: Feeling sleepy or drowsy, fits, loss of consciousness, uneven heart beat and breathing difficulties.

If you forget to take Phenergan Tablets Do not take a double dose to make up for a forgotten dose

• If you are taking Phenergan Tablets for an allergic condition – take your medicine as soon as you remember, then carry on as before
• If you are taking Phenergan Tablets for sedation or sleeping problems – miss that dose and take the next evening’s dose as usual

If you have any further questions on the use of this product, ask your doctor or pharmacist.

Taking Phenergan Tablets may affect the results of certain tests. These include some pregnancy tests and skin tests. Phenergan Tablets should not be taken at least 3 days before the start of a skin test.

4. possible side effects

Like all medicines, Phenergan Tablets can cause side effects, although not everybody gets them.

Stop taking Phenergan Tablets and see a doctor or go to a hospital straight away if you notice any of the following side effects:

An allergic reaction. The signs may include: a rash, swallowing or breathing problems, swelling of your lips, face, throat or tongue

• Liver problems that may cause the eyes or skin to go yellow (jaundice)
• Muscle stiffness or shaking
• Being unable to control some muscles in your head or face
• You notice unusual movements of the tongue, facial muscle spasms, rolling eyes and trembling
• Very fast, uneven or forceful heartbeat (palpitations)
• Irregular heartbeat
• Tiredness which lasts for a long time. This may be due to a blood problem called anaemia
• Over-active behaviour in children

Tell your doctor or pharmacist if any of the following side effects get serious or lasts longer than a few days. Also tell them if you notice any side effects not listed in this leaflet.

• Dry mouth, blurred vision or you cannot pass water (urine)
• Feeling drowsy or sleepy, tiredness, disorientation, having nightmares, headaches, feeling restless
• Loss of appetite (anorexia), indigestion
• Feeling dizzy, lightheaded, faint (hypotension)
• Feeling confused, especially in elderly people
• Being more sensitive to the sun than usual. If this happens keep out of direct sunlight and do not use sun lamps
• Unpleasant sensation or an overwhelming urge to move the legs (also called Restless Legs Syndrome).

Reporting of Side Effects

If you get any side effects, talk to your doctor, pharmacist or nurse. This includes any possible side effects not listed in this leaflet. You can also report side effects directly via the Yellow Card Scheme at:. gov.uk/yellowcard or search for MHRA Yellow Card in the Google Play or Apple App Store.

By reporting side effects you can help provide more information on the safety of this medicine.

5. how to store phenergan tablets

• Keep this medicine out of the sight and reach of children
• Do not take Phenergan Tablets after the expiry date which is stated on the carton and blister pack after EXP. The expiry date refers to the last day of that month
• Store below 30°C -----
• Store in the original carton in order to protect from light

Do not throw away any medicines via wastewater or household waste. Ask your pharmacist how to throw away medicines you no longer use. These measures will help protect the environment.

6. contents of the pack and other information

What Phenergan Tablets contain.

• Each tablet contains 25mg of the active substance, promethazine hydrochloride
• The other ingredients are lactose, maize starch, povidone, magnesium stearate, polyethylene glycol, Opaspray (contains titanium dioxide-E171, hypromellose-E464 and indigo carmine aluminium lake blue-E132) and hypromellose

What Phenergan Tablets look like and contents of the pack

A pale blue film coated tablet marked PN 25 on one side. The tablets are available in blister packs of 56.

Marketing Authorisation Holder and Manufacturer

Marketing Authorisation Holder

410 Thames Valley Park Drive Reading

Tel: 0800 035 2525

Manufacturer

FAMAR HEALTH CARE SERVICES MADRID

S.A.U. Avda. Leganes, 62, Alcorcon 28923 _____

Madrid, Spain

This leaflet does not contain all the information about your medicine. If you have any questions or are not sure about anything, ask your doctor or pharmacist.

This leaflet was last revised in 09/2020 ©Sanofi, 2020

11503497–06