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The combination of promethazine hydrochloride and codeine phosphate is contraindicated in pediatric patients under 6 decades of age. Concomitant administration of promethazine products and solutions with other respiratory depressants has an Affiliation with respiratory melancholy, and from time to time Demise, in pediatric clients. The association does circuitously relate to individualized pounds-dependent dosing, which could or else allow safe administration.
Codeine: In clients acquiring MAO inhibitors, an First tiny take a look at dose is a good idea to permit observation of any extreme narcotic effects or MAOI interaction.
Antiemetics usually are not recommended for procedure of uncomplicated vomiting in pediatric clients, and their use must be limited to extended vomiting of recognized etiology. The extrapyramidal symptoms which often can manifest secondary to Promethazine HCl Oral Remedy administration could be perplexed with the CNS signs of undiagnosed Main ailment, e.g., encephalopathy or Reye's syndrome. Using Promethazine HCl Oral Solution ought to be averted in pediatric people whose indicators and indications may possibly advise Reye's syndrome or other hepatic conditions.
Codeine resembles morphine the two structurally and pharmacologically, but its actions in the doses of codeine applied therapeutically are milder, with fewer sedation, respiratory despair and gastrointestinal, urinary, and pupillary results. Codeine generates an increase in biliary tract stress, but a lot less than morphine or meperidine. Codeine is considerably less constipating than morphine.
A pharmacist can advocate an ideal measuring product and can provide Recommendations for measuring the proper dose.
Unresponsive Cough The dosage of Promethazine HCl and Codeine Phosphate Oral Remedy should not be greater if cough fails to respond; an unresponsive cough needs to be reevaluated in 5 days or quicker for doable underlying pathology, including overseas physique or reduced respiratory website tract illness [see Dosage and Administration (2.three)].
Promethazine HCl and Codeine Phosphate Oral Solution ought to be applied with warning in people with extreme impairment of renal operate, and patients really should be monitored intently for respiratory despair, sedation, and hypotension.
Although antihistamines have been found to make fetal mortality in rodents, the pharmacological outcomes of histamine while in the rodent don't parallel All those in gentleman. There aren't any sufficient and effectively-managed scientific tests of promethazine in pregnant Women of all ages.
Anaphylactic reactions, as adjunctive therapy to epinephrine and various regular measures, once the acute manifestations have been controlled.
Because of the dangers of habit, abuse, and misuse with opioids, even at advised doses [see Warnings and Safeguards (five.one)], reserve Promethazine HCl and Codeine Phosphate Oral Option for use in Grownup people for whom the advantages of cough suppression are predicted to outweigh the pitfalls, and in whom an sufficient assessment on the etiology in the cough has been manufactured.
A pharmacist can advocate an appropriate measuring product and can offer instructions for measuring the correct dose.
Use other supportive measures (which includes oxygen and vasopressors) in the management of circulatory shock and pulmonary edema as indicated. Cardiac arrest or arrhythmias would require Superior daily life-guidance procedures. Gastric emptying could be valuable in getting rid of unabsorbed drug.
Sedation in both little ones and Grownups, in addition to reduction of apprehension and manufacture of gentle slumber from which the patient might be effortlessly aroused.