Summary of medicine characteristics - PHENERGAN 25 MG TABLETS
1 NAME OF THE MEDICINAL PRODUCT
Phenergan 25 mg Tablets.
2 QUALITATIVE AND QUANTITATIVE COMPOSITION
Each tablet contains 25mg of the active substance Promethazine hydrochloride.
Also contains 173.52mg of lactose monohydrate.
For full list of excipients, see section 6.1
3 PHARMACEUTICAL FORM
Tablet
Pale blue film coated tablets marked PN 25 on one side.
4 CLINICAL PARTICULARS
4.1 Therapeutic indications
As symptomatic treatment for allergic conditions of the upper respiratory tract and skin including allergic rhinitis, urticaria and anaphylactic reactions to drugs and foreign proteins.
As an antiemetic.
For short term use:
Treatment of insomnia in adults.
As a paediatric sedative.
4.2 Posology and method of administration
Route of administration: Oral.
Not for use in children under the age of 2 years (see section 4.3).
As an antihistamine in allergy:
| Children 2–5 years | The use of Phenergan Elixir is recommended for this age group. |
| Children 5–10 years | 25 mg as a single dose*. Maximum daily dose 25 mg. |
| Children over 10 years and adults (including elderly) | 25 mg as a single dose*. Increasing to a maximum of 25 mg bd as required. |
*Single doses are best taken at night.
As an antiemetic:
| Children 2–5 years | The use of Phenergan Elixir is recommended for this age group. |
| Children 5–10 years | The use of Phenergan Elixir or Phenergan 10 mg Tablets is recommended. |
| Children over 10 years and adults (including elderly) | 25 mg to be taken the night before the journey. To be repeated after 6–8 hours as required. |
As a paediatric sedative for short term use and for short term treatment of insomnia in adults:
| Children 2–5 years | The use of Phenergan Elixir is recommended for this age group. |
| Children 5–10 years | 25 mg as a single night time dose. |
| Children over 10 years and adults (including elderly) | 25 or 50 mg as a single night time dose. |
4.3 Contraindications
Phenergan should not be used in patients in coma or suffering from CNS depression of any cause.
Phenergan should not be given to patients with a known hypersensitivity to promethazine or to any of the excipients.
Promethazine is contraindicated for use in children less than two years of age because of the potential for fatal respiratory depression..
Phenergan should be avoided in patients taking monoamine oxidase inhibitors up to 14 days previously.
4.4 Special warnings and precautions for use
Phenergan may thicken or dry lung secretions and impair expectoration.
It should therefore be used with caution in patients with asthma, bronchitis or bronchiectasis.
Use with care in patients with severe coronary artery disease, narrow angle glaucoma, epilepsy or hepatic and renal insufficiency.
Caution should be exercised in patients with bladder neck or pyloro-duodenal obstruction.
The use of promethazine should be avoided in children and adolescents with signs and symptoms suggestive of Reye’s Syndrome.
Promethazine may mask the warning signs of ototoxicity caused by ototoxic drugs e.g. salicylates. It may also delay the early diagnosis of intestinal obstruction or raised intracranial pressure through the suppression of vomiting.
Patients with rare hereditary problems of galactose intolerance, total lactase deficiency or glucose-galactose malabsorption should not take this medicine.
Phenergan should not be used for longer than 7 days without seeking medical advice.
4.5 Interaction with other medicinal products and other forms of interaction
Phenergan will enhance the action of any anticholinergic agent, tricyclic antidepressant, sedative or hypnotic. Alcohol should be avoided during treatment.
Phenergan may interfere with immunological urine pregnancy tests to produce falsepositive or false-negative results. Phenergan should be discontinued at least 72 hours before the start of skin tests as it may inhibit the cutaneous histamine response thus producing false negative results.
4.6 Fertility, pregnancy and lactation
Phenergan should not be used in pregnancy unless the physician considers it essential. The use of Phenergan is not recommended in the 2 weeks prior to delivery in view of the risk of irritability and excitement in the neonate.
Available evidence suggests that the amount excreted in milk is insignificant. However, there are risks of neonatal irritability and excitement.
4.7 Effects on ability to drive and use machines
Because the duration of action may be up to 12 hours, patients should be advised that if they feel drowsy they should not drive or operate heavy machinery.
4.8 Undesirable effects
The following CIOMS frequency rating is used: Very common (>1/10); common (>1/100 to <1/10); uncommon (>1/1000 to <1/100); rare (>1/10 00 to <1/1000); very rare (<1/10 000), not known (cannot be estimated from the available data).
Side effects may be seen in a few patients: drowsiness, dizziness, restlessness, headaches, nightmares, tiredness, and disorientation. Anticholinergic side effects such as blurred vision, dry mouth and urinary retention occur occasionally. Infants are susceptible to the anticholinergic effects of promethazine, while other children may display paradoxical hyperexcitability. The elderly are particularly susceptible to the anticholinergic effects and confusion due to promethazine. Other side-effects include urticaria, rash, pruritus, anorexia, gastric irritation, palpitations, hypotension, arrhythmias, extrapyramidal effects, restless legs syndrome, muscle spasms and tic-like movements of the head and face. Anaphylaxis, jaundice and blood dyscrasias including haemolytic anaemia rarely occur. Photosensitive skin reactions have been reported. Strong sunlight should be avoided during treatment.
Reporting of suspected adverse reactions
Reporting suspected adverse reactions after authorisation of the medicinal product is important. It allows continued monitoring of the benefit/risk balance of the medicinal product. Healthcare professionals are asked to report any suspected adverse reactions via Yellow Card Scheme at: www.mhra.gov.uk/yellowcard or search for MHRA Yellow Card in the Google Play or Apple App Store.
4.9 Overdose
4.9 OverdoseSymptoms of severe overdosage are variable. They are characterised in children by various combinations of excitation, ataxia, incoordination, athetosis and hallucinations, while adults may become drowsy and lapse into coma. Convulsions may occur in both adults and children. Coma or excitement may precede their occurrence. Cardiorespiratory depression is uncommon. If the patient is seen soon enough after ingestion, it should be possible to induce vomiting with ipecacuanha despite the antiemetic effect of promethazine; alternatively, gastric lavage may be used. Treatment is otherwise supportive with attention to maintenance of adequate respiratory and circulatory status. Convulsions should be treated with diazepam or other suitable anticonvulsant.
5 PHARMACOLOGICAL PROPERTIES
5.1 Pharmacodynamic properties
Pharmacotherapeutic group: Antihistamines for systemic use; Phenothiazine derivatives, ATC code: R06AD02
Potent, long acting, antihistamine with additional anti-emetic central sedative and anti-cholinergic properties.
5.2 Pharmacokinetic properties
Promethazine is distributed widely in the body. It enters the brain and crosses the placenta. Promethazine is slowly excreted via urine and bile. Phenothiazines pass into the milk at low concentrations.
5.3 Preclinical safety data
5.3 Preclinical safety dataNo additional pre-clinical data of relevance to the prescriber.
6 PHARMACEUTICAL PARTICULARS
6.1 List of excipients
Lactose monohydrate
Maize starch
Povidone K30
Magnesium stearate
Polyethylene glycol 200
Hypromellose (Pharmacoat 606)
Colouring agent: Opaspray M-1–4210A
Titanium dioxide (E171)
Hypromellose (E464)
Indigo carmine aluminium lake FD&C Blue no 2 (E132)
6.2 Incompatibilities
Not applicable
6.3 Shelf life
3 years.
6.4 Special precautions for storage
Store below 30oC. Store in the original carton in order to protect from light.
6.5 Nature and contents of container
Opaque white 250^m uPVC coated with 40gsm PVdC. 20^m hard temper aluminium foil (coated with vinyl heat seal lacquer) backing in cartons of 56 tablets.
Not all pack sizes may be marketed.
6.6 Special precautions for disposal
6.6 Special precautions for disposalNo special requirements
Aventis Pharma Limited, trading as Sanofi 410 Thames Valley Park Drive,
Reading,
Berkshire,
RG6 1PT,
United Kingdom.
8 MARKETING AUTHORISATION NUMBER(S)
PL 04425/0281
9 DATE OF FIRST AUTHORISATION/RENEWAL OF THEAUTHORISATION
Date of first authorisation: 23 January 2003
Date of latest renewal: 17 July 2006
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