Close
New

Medscape is available in 5 Language Editions – Choose your Edition here.

 

promethazine/dextromethorphan (Rx)Brand and Other Names:Promethazine DM

 
 
 

Dosing & Uses

AdultPediatric

Dosage Forms & Strengths

promethazine/dextromethorphan

oral syrup

  • (6.25mg/15mg)/5mL
more...

Cough

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

6.25 mg/15 mg (5 mL) PO q4-6hr PRN

Maximum: 30 mL/24 hr

Other Information

Administer with special measuring device for accurate dose

Dosage Forms & Strengths

promethazine/dextromethorphan

oral syrup

  • (6.25mg/15mg)/5mL
more...

Cough

<2 years: Contraindicated

2 to <6 years: 1.25-2.5 mL PO q4-6hr, up to 12.5 mg/30 mg (10 mL) in 24 hr

6 to <12 years: 2.5-5 mL PO 4-6hr, up to 25 mg/60 mg (20 mL) in 24 hr

12 years and older: As in adults; 6.25 mg/15 mg (5 mL) PO q4-6hr PRN, not to exceed 30 mL/24 hr

Next

Adverse Effects

Frequency Not Defined

Promethazine

  • Anticholinergic effects: dry mouth, blurred vision
  • Tachy/bradycardia
  • Confusion, disorientation, EPS, sedation
  • Photosensitivity
  • Agranulocytosis, leukopenia
  • Obstructive jaundice

Dextromethorphan

  • Dizziness
  • Drowsiness
  • Sedation
  • Constipation
  • Nausea
  • Vomiting
  • Blurred vision
  • Nystagmus
Previous
Next

Warnings

Black Box Warnings

Do not use in patients younger than 2 years of age because of potential for fatal respiratory depression; Administer with caution to children older than 2 years of age

Contraindications

Promethazine

  • Hypersensitivity
  • Newborn/premature infants, <2 yo (risk of potentially fatal respiratory depression)
  • Subcutaneous or intra-arterially administration
  • BPH
  • Narrow angle glaucoma
  • Pyloroduodenal obstruction, stenosing peptic ulcer, bladder neck obstruction
  • Severe CNS depression
  • Coma, Severe respiratory depression

Dextromethorphan

  • Concurrent nonselective MAO inhibitors: serotonin syndrome

Cautions

Promethazine

  • CVD, asthma, hepatic impairment, peptic ulcer, respiratory impairment
  • Anaphylaxis in susceptible individuals
  • May impair ability to drive or perform hazardous tasks
  • Monitor closely in patients with
  • - Cardiovascular disease
  • - Hepatic impairment
  • - Reye syndrome
  • - History of sleep apnea
  • Depresses hypothalamic thermoregulatory mechanism; exposure to extreme temperatures may cause hypo- or hyperthermia
  • Antiemetic effect may obscure toxicity of chemotherapeutic drugs

Dextromethorphan

  • Phenylketonuria: contains aspartame
Previous
Next

Pregnancy & Lactation

Pregnancy category: C

Lactation: Not recommended

Pregnancy Categories

A:Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.

B:May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.

C:Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.

D:Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.

X:Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.

NA:Information not available.

more...
Previous
Next

Pharmacology

Promethazine

Onset: 20 min

Duration: 4-6 hr

Bioavailability: low

Protein Bound: 93%

Vd: 12.9-17.7 L/hr

Metabolism: hepatic P450 enzyme CYP2D6

Metabolites: promethazine sulfoxide and glucuronides (inactive)

Excretion: urine, feces

Dialyzable: no

Dextromethorphan

Onset: 15-30 min

Duration: 3-6 hr

Metabolism: hepatic P450 enzyme CYP2D6

Excretion: urine

Mechanism of Action

Promethazine: Antidopaminergic effect due to blocking mesolimbic dopamine receptors and alpha-adrenergic receptors in the brain; antihistaminic effect due to blocking H1-receptors

Dextromethorphan: Acts on cough center in medulla; derivative of levorphanol

Previous
Next

Images

Previous
Next

Formulary

FormularyPatient Discounts

To view formulary information first create a list of plans. Your list will be saved and can be edited at any time.

Adding plans allows you to:

  • View the formulary and any restrictions for each plan.
  • Manage and view all your plans together – even plans in different states.
  • Compare formulary status to other drugs in the same class.
  • Access your plan list on any device – mobile or desktop.

The above information is provided for general informational and educational purposes only. Individual plans may vary and formulary information changes. Contact the applicable plan provider for the most current information.

Tier Description
1 This drug is available at the lowest co-pay. Most commonly, these are generic drugs.
2 This drug is available at a middle level co-pay. Most commonly, these are "preferred" (on formulary) brand drugs.
3 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs.
4 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
5 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
6 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
NC NOT COVERED – Drugs that are not covered by the plan.
Code Definition
PA Prior Authorization
Drugs that require prior authorization. This restriction requires that specific clinical criteria be met prior to the approval of the prescription.
QL Quantity Limits
Drugs that have quantity limits associated with each prescription. This restriction typically limits the quantity of the drug that will be covered.
ST Step Therapy
Drugs that have step therapy associated with each prescription. This restriction typically requires that certain criteria be met prior to approval for the prescription.
OR Other Restrictions
Drugs that have restrictions other than prior authorization, quantity limits, and step therapy associated with each prescription.
Add or Remove Plans
Plans for
Select State:
Non-Medicare PlansMedicare Plans

Select a box to add or remove a plan.

Select a class to view formulary status for similar drugs

Additional Offers
Email to Patient

From:

To:

The recipient will receive more details and instructions to access this offer.

By clicking send, you acknowledge that you have permission to email the recipient with this information.

Email Forms to Patient

From:

To:

The recipient will receive more details and instructions to access this offer.

By clicking send, you acknowledge that you have permission to email the recipient with this information.

Previous
 
 
 
All material on this website is protected by copyright, Copyright © 1994-2016 by WebMD LLC. This website also contains material copyrighted by 3rd parties.