BMA Concise Guide to Medicine & Drugs

Promazine

Brand name None

Used in the following combined preparations None

QUICK REFERENCE

Drug group Anti-anxiety drug and antipsychotic drug

Overdose danger rating Medium

Dependence rating Low

Prescription needed Yes

Available as generic Yes

GENERAL INFORMATION

Promazine, introduced in the late 1950s, is a member of a group of drugs called phenothiazines, which act on the brain to regulate abnormal behaviour.

The main use of promazine is to calm agitated and restless behaviour. It is also given as a sedative for the short-term treatment of severe anxiety, especially that which occurs in the elderly and during terminal illness.

Promazine is less likely to cause the unpleasant side effects, particularly abnormal movements and shaking of the arms and legs (parkinsonism), that are experienced with other phenothiazine drugs. The most common adverse effect of promazine is sedation.

INFORMATION FOR USERS

Your drug prescription is tailored for you. Do not alter dosage without checking with your doctor.

How taken/used Tablets, liquid.

Frequency and timing of doses 4 x daily.

Adult dosage range 100–800mg daily (tablets).

Onset of effect 30 minutes–1 hour.

Duration of action 4–6 hours.

Diet advice None.

Storage Keep in original container at room temperature out of the reach of children. Protect from light.

Missed dose Take as soon as you remember. If your next dose is due within 2 hours, take a single dose now and skip the next.

Stopping the drug Do not stop the drug without consulting your doctor; symptoms may recur.

Exceeding the dose An occasional unintentional extra dose is unlikely to be a cause for concern. Large overdoses may cause drowsiness, dizziness, unsteadiness, seizures, and coma. Notify your doctor.

POSSIBLE ADVERSE EFFECTS

The more common adverse effects, such as drowsiness, lethargy, dry mouth, constipation, and blurred vision, may be helped by a reduction in dosage; discuss with your doctor if you have blurred vision or if any of these other symptoms are severe. Less commonly, promazine may cause parkinsonism (tremor and muscle rigidity of the face and limbs) or jaundice. Consult your doctor if these occur and also stop taking the drug if you have jaundice. Rarely, promazine may affect the body’s temperature-regulating ability, especially in the elderly.

INTERACTIONS

Sedatives All drugs that have a sedative effect are likely to increase the sedative properties of promazine.

Drugs for parkinsonism Promazine may reduce the effectiveness of these drugs.

Sotalol increases the risk of heart rhythm abnormalities when used with promazine.

Lithium increases the risk of side effects when used with promazine.

SPECIAL PRECAUTIONS

Be sure to tell your doctor if:

· You have heart problems.

· You have long-term liver or kidney problems.

· You have had epileptic seizures.

· You have prostate problems.

· You have glaucoma.

· You have Parkinson’s disease.

· You have myasthenia gravis.

· You are taking other medicines.

Pregnancy Safety in pregnancy not established. Discuss with your doctor.

Breast-feeding Safety in breast-feeding not established. Discuss with your doctor.

Infants and children Not recommended.

Over 60 Increased likelihood of adverse effects. Reduced dose may therefore be necessary.

Driving and hazardous work Avoid such activities until you have learned how promazine affects you because the drug can cause drowsiness and reduced alertness.

Alcohol Avoid. Alcohol may increase the sedative effect of this drug.

PROLONGED USE

Use of this drug for more than a few months may be associated with jaundice and abnormal movements. Sometimes a reduction in dose may be recommended.

Monitoring Periodic blood tests for liver function should be performed.