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Promethazine hydrochloride (promethazine hydrochloride injection) is indicated for the following conditions:
1. Amelioration of allergic reactions to blood or plasma.
2. In anaphylaxis as an adjunct to epinephrine and other standard measures after the acute symptoms have been controlled.
3. For other uncomplicated allergic conditions of the immediate type when oral therapy is impossible or contraindicated.
4. For sedation and relief of apprehension and to produce light sleep from which the patient can be easily aroused.
5. Active treatment of motion sickness.
6. Prevention and control of nausea and vomiting associated with certain types of anesthesia and surgery.
7. As an adjunct to analgesics for the control of postoperative pain.
8. Preoperative, postoperative, and obstetric (during labor) sedation.
Intravenously in special surgical situations, such as repeated bronchoscopy, ophthalmic surgery, and poor-risk patients, with reduced amounts of meperidine or other narcotic analgesic as an adjunct to anesthesia and analgesia.
Drowsiness is the most prominent CNS effect of the drug. Extrapyramidal reactions may occur with high doses; this is almost always responsive to a reduction in dosage. Other reported reactions include dizziness, lassitude, tinnitus, incoordination, fatigue, blurred vision, euphoria, diplopia, nervousness, insomnia, tremors, convulsive seizures, oculogyric crises, excitation, catatonic-like states, hysteria, and hallucinations.
Tachycardia, bradycardia, faintness, dizziness, and increases and decreases in blood pressure have been reported following the use of promethazine hydrochloride (promethazine hydrochloride injection). Venous thrombosis at the injection site has been reported. INTRA-ARTERIAL INJECTION MAY RESULT IN GANGRENE OF THE AFFECTED EXTREMITY.
Nausea and vomiting have been reported, usually in association with surgical procedures and combination drug therapy.
Drugs having anticholingeric properties should be used with caution in patients with narrow-angle glaucoma, prostatic hypertrophy, stenosing peptic ulcer, pyloroduodenal obstruction, and bladder-neck obstruction.
Promethazine hydrochloride (promethazine hydrochloride injection) should be used cautiously in persons with cardiovascular disease or impairment of liver function.
Promethazine hydrochloride (promethazine hydrochloride injection) is contraindicated in comatose states and in patients who have demonstrated an idiosyncrasy or hypersensitivity to promethazine or other phenothiazines.
Under no circumstances should promethazine hydrochloride (promethazine hydrochloride injection) be given by intra-arterial injection due to the likelihood of severe arteriospasm and the possibility of resultant gangrene.
Promethazine hydrochloride (promethazine hydrochloride injection) should not be given by the subcutaneous route; evidence of chemical irritation has been noted, and necrotic lesions have resulted on rare occasions following subcutaneous injection. The preferred parenteral route of administration is by deep intramuscular injection.