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Promethazine hydrochloride and Phenylephrine hydrochloride syrup is used for the short-term relief of upper respiratory symptoms, including a blocked nose, that come with an allergy or the common cold.
Pharmacology
Phenylephrine is a potent agonist of the postsynaptic α-receptors. Its main action is to narrow the blood vessels in the lining of the nose, and this relieves the nasal congestion that comes with allergies or head colds. Promethazine blocks H1 receptors. Besides its antihistamine action, it has useful sedative and antiemetic effects in clinical practice.
Dosage Reference
Reference Information Only
Dosages shown are general references from official sources. Always consult your doctor or pharmacist for personalized dosing.
Adults:
Adults and children 12 years and over can take 1 teaspoonful (5 mL) every 4 to 6 hours. They should not go beyond 6 teaspoonsful (30 mL) in 24 hours.
For children 6 to under 12 years of age, the dose is ½ to 1 teaspoonful (2.5 to 5 mL) every 4 to 6 hours, again with a limit of 6 teaspoonsful (30 mL) in 24 hours.
Children 2 to under 6 years of age take ¼ to ½ teaspoonful (1.25 to 2.5 mL) every 4 to 6 hours.
Children under 2 years of age should not be given Promethazine and Phenylephrine, as they are not recommended for this age group.
Side Effects
Nervous system: Phenylephrine + Promethazine can cause sedation, sleepiness, occasional blurred vision, dryness of mouth and dizziness. Rarely, there is confusion, disorientation, and extrapyramidal symptoms such as oculogyric crisis, torticollis and tongue protrusion (usually in association with parenteral injection or excessive dosage). Cardiovascular: blood pressure may go up or down. Dermatologic: rash, and rarely photosensitivity. Hematologic: rarely, leukopenia and thrombocytopenia, and agranulocytosis (1 case). Gastrointestinal: nausea and vomiting. Nervous system: restlessness, anxiety, nervousness and dizziness. Cardiovascular: hypertension (see Warning). Other: precordial pain, respiratory distress, tremor and weakness.
Cautions & Contraindications
Warnings & Precautions
It isn't known whether the Phenylephrine + Promethazine combination can harm an unborn baby when given to a pregnant woman, or whether it can affect the ability to reproduce. Promethazine and Phenylephrine should be given to a pregnant woman only if clearly needed. Promethazine should be used cautiously in people with cardiovascular disease or impaired liver function. Phenylephrine also needs caution in patients with cardiovascular disease, particularly hypertension. Promethazine Promethazine may cause marked drowsiness. Patients who are up and about should be warned against driving or operating dangerous machinery until it is known that promethazine doesn't make them drowsy or dizzy. The sedative action of promethazine hydrochloride adds to the sedative effects of central nervous system depressants. So agents such as alcohol, narcotic analgesics, sedatives, hypnotics and tranquilizers should either be stopped or given in a reduced dose when promethazine hydrochloride is being used. If barbiturates are given together with promethazine hydrochloride, the barbiturate dose should be reduced by at least one-half. Analgesic depressants such as morphine or meperidine should be reduced by one-quarter to one-half. Promethazine may lower the seizure threshold. This should be taken into account in people with known seizure disorders, and when it is given with narcotics or local anesthetics, which may also affect the seizure threshold. Sedative drugs or CNS depressants should be avoided in patients with a history of sleep apnea. Antihistamines should be used with caution in patients with narrow-angle glaucoma, stenosing peptic ulcer, pyloroduodenal obstruction, and urinary bladder obstruction due to symptomatic prostatic hypertrophy and narrowing of the bladder neck. Cholestatic jaundice has been reported with the use of promethazine. Phenylephrine Phenylephrine is an adrenergic agent, so it should be given with caution to patients with thyroid diseases, diabetes mellitus or heart disease, and to those taking tricyclic antidepressants. Men with symptomatic benign prostatic hypertrophy can develop urinary retention when given oral or nasal decongestants. Phenylephrine can decrease cardiac output, so extreme caution is needed when giving it parenterally or orally to patients with arteriosclerosis, to elderly people, and/or to patients whose cerebral or coronary circulation is poor to begin with. Phenylephrine should also be used with caution in patients taking diet preparations such as amphetamines or phenylpropanolamine, because their combined adrenergic effects could cause a serious hypertensive response and possibly a stroke.
Contraindications
Promethazine must not be given to anyone who is known to be hypersensitive to it, or who has had an unusual (idiosyncratic) reaction to promethazine or to other phenothiazines. Antihistamines are also not to be used for lower respiratory tract symptoms, and that includes asthma. Phenylephrine must not be used in patients with hypertension or with peripheral vascular insufficiency, because ischemia can follow, with a risk of gangrene or thrombosis in vascular beds that are already compromised. It should also be avoided in patients known to be hypersensitive to the drug, and in those who are taking a monoamine oxidase inhibitor (MAOI).
Pregnancy & Breastfeeding
Phenylephrine and Promethazine falls under Pregnancy Category C. No adequate, well-controlled studies of promethazine have been done in pregnant women. So the medicine should be used during pregnancy only if the likely benefit justifies the possible risk to the fetus.
⚠️ Talk to your doctor before taking any medicine during pregnancy or while breastfeeding.
Overdose
An overdose of Promethazine and Phenylephrine can cause effects that range from mild depression of the central nervous system and cardiovascular system to much more serious problems. These include profound hypotension, respiratory depression, unconsciousness and sudden death. Hypertension, headache, convulsions, cerebral hemorrhage and vomiting can also occur.
Vital signs, meaning respiration, pulse, blood pressure, temperature and EKG, need to be monitored only in cases of extreme overdosage or individual sensitivity. Activated charcoal may be given orally or by lavage, or sodium or magnesium sulfate can be given orally as a cathartic.
⚠️ In an emergency call 999 or go to the nearest hospital emergency department.
Storage
Store Phenylephrine + Promethazine at no more than 30°C. Keep it away from light, and keep it out of the reach of children.
Drug Interactions
Common questions about Phenergan Plus 5 mg+6.25 mg
What is Phenergan Plus 5 mg+6.25 mg Syrup?
Phenergan Plus 5 mg+6.25 mg Syrup is a medicine that contains Phenylephrine + Promethazine. It is made by Synovia Pharma PLC. It belongs to the Sedating Anti-histamine group of medicines.
What is Phenergan Plus used for?
Promethazine hydrochloride and Phenylephrine hydrochloride syrup is used for the short-term relief of upper respiratory symptoms, including a blocked nose, that come with an allergy or the common cold.
What are the side effects of Phenergan Plus?
Nervous system: Phenylephrine + Promethazine can cause sedation, sleepiness, occasional blurred vision, dryness of mouth and dizziness. Rarely, there is confusion, disorientation, and extrapyramidal symptoms such as oculogyric crisis, torticollis and tongue protrusion (usually in association with parenteral injection or excessive dosage).
Can I take Phenergan Plus during pregnancy or while breastfeeding?
Phenylephrine and Promethazine falls under Pregnancy Category C. No adequate, well-controlled studies of promethazine have been done in pregnant women. Talk to your doctor before taking any medicine during pregnancy or while breastfeeding.
What happens if I take too much Phenergan Plus?
An overdose of Promethazine and Phenylephrine can cause effects that range from mild depression of the central nervous system and cardiovascular system to much more serious problems. These include profound hypotension, respiratory depression, unconsciousness and sudden death. In an emergency call 999 or go to the nearest hospital emergency department.
How should I store Phenergan Plus?
Store Phenylephrine + Promethazine at no more than 30°C. Keep it away from light, and keep it out of the reach of children.
Can I take other medicines with Phenergan Plus?
Some medicines can interact with Phenylephrine + Promethazine, for example: Adrenaline, Atropine Sulphate, Propranolol Hydrochloride. Tell your doctor or pharmacist about every medicine you take.
Do I need a prescription for Phenergan Plus?
Phenergan Plus is a prescription (Rx) medicine. Take it as your doctor advises.