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Promethazine Hydrochloride 25 mg Tablet, 1,000-count — NDC 53746-0521-10 package photo

Promethazine Hydrochloride 25 mg Tablet, 1,000-count

by Amneal Pharmaceuticals of New York LLC · 1000 TABLET in 1 BOTTLE (53746-521-10)
NDC 53746-0521-10
🏷️ FDA NDC (as labeled) 53746-521-10 billing pads the product segment with a zero
This package
Contains1,000-count Cost per ea$0.0455 NADAC Per package$45.50 / 1000 tablets Pack sizes2 compare ↓
Also priced by: Medicaid pays $0.2563/unit · Part D plans $0.1075/unit — full pricing hub ↓
Also comes in: 100 tablets 53746-0521-01
Rx only Generic On market Non-controlled
🗂️ Data synced Jul 24, 2026 · sources: openFDA · FDA label (DailyMed) · FDA Orange & Purple Book · First Databank · CMS NADAC, ASP, Medicare & Medicaid · RxNorm
📋 All sources & update times →

🆔 Identity & classification

FDA NDC (as labeled) 53746-521-10
Product NDC 53746-521
11-digit billing NDC 53746052110
NCPDP billing unit EA — each (per item)
RxCUI 992438, 992447, 992475
UNII R61ZEH7I1I
UPC 0353746522016
Application # ANDA091179
SPL Set ID 0b5734b8-6a52-44ff-ac29-9a91a4335394
Established class (EPC) Phenothiazine
Chemical class Phenothiazines
DEA schedule Non-controlled
Marketing category ANDA
Marketing status On market
FDA listing status Listed (active directory)
Marketing start 2022-06-22
Route ORAL
Dosage form TABLET
Substance PROMETHAZINE HYDROCHLORIDE
GPI-14 41400020100310
GCN Seq No 003878
GCN 15043
HICL code 012014
Ingredient (HICL) Promethazine Hcl
HIC1 code Z
Therapeutic class — broad (HIC1) Body As A Whole
HIC2 code Z2
Therapeutic class — intermediate (HIC2) Antihistamines, Antiserotonins, Immunosuppressants
HIC3 code Z2P
Therapeutic class — specific (HIC3) Antihistamines - 1St Generation
AHFS code 04:04.12.00
AHFS class Phenothiazine Derivatives
FDB label name PROMETHAZINE 25 MG TABLET
FDB brand name Promethazine Hcl
Legend status F — Federal legend — prescription drug or device
TE code (Orange Book) AB · RLD · RS
Why two NDCs? The FDA registers this code as 53746-521-10 — a 5-3-2 layout, and that's what's printed on the package and shown on DailyMed. For insurance claims, every NDC is standardized to a uniform 11-digit 5-4-2 format by adding a zero to the product segment → 53746-0521-10. Same drug, same package — only the format differs.
Where does this data come from?
Identifiers from the FDA openFDA NDC Directory and Structured Product Labeling; RxCUI from RxNorm (NLM); GPI from Medi-Span; GCN / HIC / AHFS / legend from First Databank.

🏷️ RxNorm drug class

This medicine belongs to the Phenothiazine class.

Pharmacologic class Phenothiazine
Drug family (ATC) Antihistamines for topical use, Phenothiazine derivatives
Where does this data come from?
Therapeutic classes from RxNorm RxClass (U.S. National Library of Medicine) — Established Pharmacologic Class (FDA), ATC drug family (WHO) and mechanism of action, matched by this product’s RxCUI.

🏭 Manufacturer & labeler

LabelerAmneal Pharmaceuticals of New York LLC
Application holderAMNEAL PHARMACEUTICALS NY LLC
FDA applicationANDA091179 (ANDA)
Labeler code53746
First marketedJun 2022
Product typeHuman Prescription Drug
Portfolio228 products on file
The labeler markets the product; the application holder owns the FDA approval. They’re often the same company but can differ (e.g. a repackager or an authorized generic). A mailing address / phone appears here when the manufacturer includes it in the product’s FDA label (not all do).
Where does this data come from?
Labeler, application holder and registered establishment from the FDA openFDA NDC Directory and Drugs@FDA; address/contact from the product’s FDA label.

🩺 Clinical

Label name PROMETHAZINE 25 MG TABLET Ingredient Promethazine Hcl
📗 Our plain-language guide HelloPharmacist
  • Promethazine has several uses. It's most commonly used for allergy symptoms like hay fever, hives, and itchy or watery eyes. It's also used to prevent or treat nausea and vomiting...
  • Yes — drowsiness is the most common and expected side effect. You should avoid driving, operating machinery, or doing anything that requires sharp focus until you know how it affec...
  • Will promethazine make me really drowsy?
  • Promethazine is strictly off-limits for children under 2 years old — it can slow or stop breathing, and there have been fatalities reported in this age group. For children 2 and ol...
📖 Read our full Promethazine guide →
Where does this data come from?
Plain-language summary from MedlinePlus (U.S. National Library of Medicine); supplement & herbal interactions and nutrient depletion data from the Natural Medicines database; our full guide is HelloPharmacist editorial content.

💊 What it looks like

Color white / pink
ShapeRound
ImprintAN;522
Size9 mm
ScoringNot scored
One label can cover several strengths, so colors may be combined — always confirm a loose pill against the dispensed prescription label or a pharmacist.
Where does this data come from?
Physical description (imprint, shape, color, scoring, coating) from this product’s FDA Structured Product Labeling (SPL), mirrored from DailyMed / openFDA.

🧪 Inactive Ingredients / Excipients

Inactive ingredients, also called excipients, are components of the drug product other than the active ingredient. They may include fillers, dyes, coatings, preservatives, flavors, or other formulation ingredients.

Loading inactive ingredients from the official FDA label in the background. No external source is being called by this page request.
Where does this data come from?
Source: official FDA Structured Product Labeling (SPL) via DailyMed and the openFDA label index. Structured IACT rows and label-wide narrative are kept separate; availability and product-level specificity depend on the submitted label.

Inactive ingredient FAQ

Are inactive ingredients the same for every manufacturer?
No. Inactive ingredients can differ by manufacturer, dosage form, strength, and package / product version.
Why might an inactive ingredient be missing?
Some SPLs do not provide a complete structured inactive-ingredient list, and older or unusual labels may only include the information in narrative text.
Can inactive ingredients matter?
Yes. They can matter for allergies, intolerances, dyes, gluten / lactose concerns, preservatives, and formulation differences — but confirm with a pharmacist or the manufacturer when it’s clinically important.

💲 Pricing

A drug doesn't have one price. Each row is a different public payment system, and none is what you'd pay at the counter — that depends on your insurance. The ⓘ on each row explains what it measures.

Price systemPer eaPer package
Retail pharmacies payNADAC · weekly $0.046 $45.50 / 1000 tablets
Medicaid paysCMS SDUD · 12 mo $0.2563 $256.30 / 1000 tablets
Medicare drug plans payPart D · Q2 2026 $0.1075 $107.50 / 1000 tablets
Medicare Part B allowsASP · Q0169 No ASP payment limit on file for Q0169 this quarter.
NADAC price history (per ea) — tap or hover for the price & month
Nov 2022 Dec 2025 Apr 2026 Sep 2026 $0.054 $0.045
▼ Down 15% over the last 14 months.
Where does this data come from?
NADAC (National Average Drug Acquisition Cost) is the CMS weekly pharmacy-acquisition-cost survey — what pharmacies pay. ASP (Average Sales Price) is the CMS Medicare Part B drug-payment file, published quarterly. Medicaid pays is computed by us from CMS State Drug Utilization Data (total reimbursed ÷ units, trailing 12 months) — gross of rebates and inclusive of dispensing fees, so it reflects what Medicaid paid, not an acquisition cost. Medicare drug plans pay is the median negotiated point-of-sale unit cost across plans listing this NDC in the CMS quarterly Prescription Drug Plan pricing files, before rebates. The VA pays is the federal contract price (FSS, and the statutory Big 4 ceiling where listed) from the VA National Acquisition Center pharmaceutical price file. All are free public government data; each measures a different payer, so the figures are not directly comparable.

🧾 Billing & reimbursement

FDA NDC (as labeled)53746-521-10
11-digit billing NDC53746-0521-10
Format5-3-2 as registered → padded to 5-4-2 for billing (zero added to the product segment)
HCPCS J-codeQ0169
DescriptorPROMETHAZINE HYDROCHLORIDE, 12.5 MG, ORAL, FDA APPROVED PRESCRIPTION ANTI-EMETIC, FOR USE AS A COMPLETE THERAPEUTIC SUBSTITUTE FOR AN IV ANTI-EMETIC AT THE TIME OF CHEMOTHERAPY TREATMENT, NOT TO EXCEED A 48 HOUR DOSAGE REGIMEN
Billing units / pkg2 units
Crosswalk sourcePDAC NDC-HCPCS crosswalk (DME MAC / DMEPOS)
Where does this data come from?
The HCPCS J-code crosswalk comes from the CMS ASP NDC-HCPCS crosswalk and the DMEPDAC (DME MAC) NDC-HCPCS crosswalk — free public CMS data. Billing units are derived from the code’s descriptor and the package amount.

🔁 Therapeutic equivalents

ProductLabelerPackNADAC/unitTEStatusPrice vs. this
Promethazine Hydrochloride 25 mg 00591-5307-01 Actavis 100 tablets $0.045 — Availability likely —
Promethazine Hydrochloride 25 mg 00904-7304-61 Major 100 tablets $0.045 AB Availability likely —
Promethazine Hydrochloride 25 mg 10702-0003-01 KVK-Tech, 100 tablets $0.045 AB Availability likely —
Promethazine Hydrochloride 25 mgthis 53746-0521-10 Amneal 1000 tablets $0.045 AB Availability likely —
Promethazine Hydrochloride 25 mg 65162-0521-10 Amneal 100 tablets $0.045 AB Availability likely —
Promethazine Hydrochloride 25 mg 68001-0162-00 BluePoint 100 tablets $0.045 AB Availability likely —
Promethazine Hydrochloride 25 mg 68084-0155-01 American 100 tablets $0.045 AB Availability likely —
Promethazine Hydrochloride 25 mg 68382-0041-01 Zydus 100 tablets $0.045 AB Availability likely —
Promethazine Hydrochloride 25 mg 00615-8154-39 NCS 30 tablets — AB FDA listed —
Promethazine Hydrochloride 25 mg 43063-0405-01 PD-Rx 1 tablet — AB FDA listed —
Promethazine Hydrochloride 25 mg 43063-0874-01 PD-Rx 100 tablets — AB FDA listed —
Promethazine Hydrochloride 25 mg 50090-4452-00 A-S 5 tablets — AB FDA listed —
Promethazine Hydrochloride 25 mg 50090-4453-00 A-S 12 tablets — AB FDA listed —
Promethazine Hydrochloride 25 mg 50090-4608-00 A-S 90 tablets — AB FDA listed —
Promethazine Hydrochloride 25 mg 50090-4750-00 A-S 12 tablets — AB FDA listed —
Promethazine Hydrochloride 25 mg 50090-4811-00 A-S 5 tablets — AB FDA listed —
Promethazine Hydrochloride 25 mg 50090-4812-00 A-S 90 tablets — AB FDA listed —
Promethazine Hydrochloride 25 mg 50090-4813-00 A-S 12 tablets — AB FDA listed —
Promethazine Hydrochloride 25 mg 50090-4875-00 A-S 12 tablets — AB FDA listed —
Promethazine Hydrochloride 25 mg 51655-0085-20 Northwind 20 tablets — AB FDA listed —
Promethazine Hydrochloride 25 mg 51655-0140-52 Northwind 30 tablets — AB FDA listed —
Promethazine Hydrochloride 25 mg 51655-0462-27 Northwind 12 tablets — AB FDA listed —
Promethazine Hydrochloride 25 mg 51655-0758-20 Northwind 20 tablets — AB FDA listed —
Promethazine 25 mg 54348-0117-00 PharmPak, 1 tablet — AB FDA listed —
Promethazine Hydrochloride 25 mg 55154-3373-00 Cardinal 10 tablets — AB FDA listed —
Promethazine Hydrochloride 25 mg 63187-0829-10 Proficient 10 tablets — AB FDA listed —
Promethazine Hydrochloride 25 mg 65841-0041-01 Zydus 100 tablets — AB FDA listed —
Promethazine Hydrochloride 25 mg 68071-4424-01 NuCare 10 tablets — AB FDA listed —
Promethazine Hydrochloride 25 mg 68071-4544-02 NuCare 12 tablets — AB FDA listed —
Promethazine Hydrochloride 25 mg 68071-4686-01 NuCare 10 tablets — AB FDA listed —
Promethazine Hydrochloride 25 mg 68071-4737-03 NuCare 30 tablets — AB FDA listed —
Promethazine Hydrochloride 25 mg 68071-4809-02 NuCare 20 tablets — AB FDA listed —
Promethazine Hydrochloride 25 mg 68071-4865-04 NuCare 4 tablets — AB FDA listed —
Promethazine Hydrochloride 25 mg 68788-7886-01 Preferred 10 tablets — AB FDA listed —
Promethazine Hydrochloride 25 mg 70518-1306-01 REMEDYREPACK 6 tablets — AB Discontinued —
Promethazine Hydrochloride 25 mg 70518-4419-00 REMEDYREPACK 30 tablets — AB FDA listed —
Promethazine Hydrochloride 25 mg 71205-0126-10 Proficient 10 tablets — AB FDA listed —
Promethazine Hydrochloride 25 mg 71205-0658-10 Proficient 10 tablets — AB FDA listed —
Promethazine Hydrochloride 25 mg 71205-0805-15 Proficient 15 tablets — AB FDA listed —
Promethazine Hydrochloride 25 mg 71335-1139-00 Bryant 14 tablets — AB FDA listed —
Promethazine Hydrochloride 25 mg 71335-1359-00 Bryant 14 tablets — AB Discontinued —
Promethazine Hydrochloride 25 mg 72189-0176-10 DIRECT 10 tablets — AB FDA listed —
Promethazine Hydrochloride 25 mg 76420-0679-01 Asclemed 100 tablets — AB FDA listed —
Promethazine Hydrochloride 25 mg 80425-0265-01 Advanced 20 tablets — AB FDA listed —
Promethazine Hydrochloride 25 mg 85766-0109-00 Sportpharm 1000 tablets — AB FDA listed —
Promethazine Hydrochloride 25 mg 87063-0015-00 ASCLEMED 1000 tablets — AB FDA listed —
Promethazine Hydrochloride 25 mg 67046-1043-03 Coupler 30 tablets — AB FDA listed —
Promethazine Hydrochloride 25 mg 87441-0070-01 Unit 30 tablets — AB FDA listed —
Promethazine Hydrochloride 25 mg 82868-0115-20 Northwind 20 tablets — AB FDA listed —
Promethazine Hydrochloride 25 mg 67296-0198-04 Redpharm 10 tablets — AB FDA listed —
About this product: this is a generic version of the medicine. FDA equivalence ratings are shown when available, and other versions are listed above, least expensive first.
Where does this data come from?
Equivalents are other NDCs of the same ingredient, form and route from the openFDA NDC Directory, ranked least-expensive-first by NADAC. Therapeutic-equivalence (AB) ratings come from the FDA Orange Book; biologics use the FDA Purple Book for biosimilar & interchangeable status.

⏳ Availability & generic status

🏛️
2022
On the market since
Jun 2022
📍
2026
Currently FDA-listed
4 years listed
🔓
·
Generic on the market
this product is a generic
✅This is a generic drug

This product is an FDA-approved generic. Other versions of the same drug are listed under Therapeutic equivalents, least expensive first.

Where does this data come from?
Patents and exclusivity from the FDA Orange Book (small-molecule drugs), refreshed from public FDA data. Generic launch timing is an estimate, not a guarantee.

🗺️ Medicaid utilization & spend

📍 This exact package only: Medicaid data is reported per full 11-digit NDC — labeler, product and pack size — so every number here is for 53746-0521-10, not the drug overall. Other pack sizes report separately.
💊 Pharmacy benefit only: These are Medicaid outpatient pharmacy claims, billed by NDC. They exclude the medical benefit — clinic- or hospital-administered drugs billed under HCPCS J-codes — so drugs used mostly that way (e.g. Avastin, Lucentis, Keytruda) can look low or missing here. That’s expected, not an error.
📅 Q1 2025 – Q1 2026 · 5 quarters of data
ⓘ The newest quarter is usually incomplete when first published; states restate recent quarters in later CMS releases, so the latest figures typically revise upward. State coverage-policy changes can also shift quarter-to-quarter totals.
Prescriptions last 4 qtrs
28.5K
Units reimbursed last 4 qtrs
1.1M
Gross reimbursed last 4 qtrs
$286.3K
Avg / prescription
$10.04
Avg / unit
$0.2563
Latest quarter Q1 2026
6KRx
Medicaid pays / ea
$0.2563
gross reimbursed
vs
NADAC / ea
$0.0455
acquisition cost
=
Spread
+$0.2108
+463% vs cost
What Medicaid paid per ea (before rebates; includes the pharmacy’s dispensing fee) compared with NADAC — the average price pharmacies pay to buy the drug. A positive spread means Medicaid reimbursed more than the purchase price, before manufacturer rebates.
Fee-for-service vs managed care ⓘ
27% FFS 73% MCO
Fee-for-service · 7,784 Rx Managed care · 20,728 Rx
State Medicaid map
Alaska: 1,365 units · 186 per 100k residents AK Maine: 6,907 units · 495 per 100k residents ME Washington: 21,509 units · 275 per 100k residents WA Idaho: 19,066 units · 971 per 100k residents ID Montana: 5,265 units · 465 per 100k residents MT North Dakota: 2,613 units · 334 per 100k residents ND Minnesota: 5,312 units · 92.6 per 100k residents MN Wisconsin: 1,400 units · 23.7 per 100k residents WI Michigan: 17,358 units · 173 per 100k residents MI New York: no data reported NY Vermont: no data reported VT New Hampshire: 1,035 units · 73.8 per 100k residents NH Oregon: 23,184 units · 548 per 100k residents OR Nevada: no data reported NV Wyoming: 778 units · 133 per 100k residents WY South Dakota: no data reported SD Iowa: 2,897 units · 90.3 per 100k residents IA Illinois: 15,884 units · 127 per 100k residents IL Indiana: 29,357 units · 428 per 100k residents IN Ohio: 108,571 units · 921 per 100k residents OH Pennsylvania: 10,979 units · 84.7 per 100k residents PA New Jersey: no data reported NJ Massachusetts: no data reported MA California: 12,500 units · 32.1 per 100k residents CA Utah: 21,819 units · 639 per 100k residents UT Colorado: 5,860 units · 99.7 per 100k residents CO Nebraska: 895 units · 45.2 per 100k residents NE Missouri: 24,657 units · 398 per 100k residents MO Kentucky: 187,503 units · 4,143 per 100k residents KY West Virginia: 13,324 units · 753 per 100k residents WV Virginia: 28,983 units · 333 per 100k residents VA Maryland: 17,076 units · 276 per 100k residents MD Connecticut: no data reported CT Rhode Island: no data reported RI Arizona: 13,645 units · 184 per 100k residents AZ New Mexico: 10,513 units · 497 per 100k residents NM Kansas: 4,130 units · 140 per 100k residents KS Arkansas: 9,000 units · 293 per 100k residents AR Tennessee: 93,140 units · 1,307 per 100k residents TN North Carolina: 114,091 units · 1,053 per 100k residents NC South Carolina: 25,769 units · 480 per 100k residents SC Delaware: no data reported DE Oklahoma: 45,098 units · 1,113 per 100k residents OK Louisiana: 56,629 units · 1,238 per 100k residents LA Mississippi: 24,738 units · 841 per 100k residents MS Alabama: 24,215 units · 474 per 100k residents AL Georgia: 46,232 units · 419 per 100k residents GA D.C.: no data reported DC Hawaii: no data reported HI Texas: 41,712 units · 137 per 100k residents TX Florida: 21,810 units · 96.5 per 100k residents FL
Units reimbursed · per 100k residents
23.74,143
gray = no data reported ⓘ
Colors are per 100,000 residents, so big states don’t automatically dominate. Tap or hover a state for its actual totals.
Tap or hover a state
…for its Medicaid breakdown
🏆 Top states by units · per 100k residents
1 Kentucky 4,143 /100k
2 Tennessee 1,307 /100k
3 Louisiana 1,238 /100k
4 Oklahoma 1,113 /100k
5 North Carolina 1,053 /100k
6 Idaho 971 /100k
7 Ohio 921 /100k
8 Mississippi 841 /100k
National units — by quarter
💵 About the dollar figures: “reimbursed” is what Medicaid paid pharmacies before confidential manufacturer rebates, so the program’s real net cost is lower than these numbers. Fee-for-service and managed-care claims are combined unless split above. Source: CMS State Drug Utilization Data; per-100k rates use 2023 Census population estimates.

💊 Medicaid utilization by pack size

Medicaid (SDUD) totals over the four most recent reported quarters for every package size of this drug — handy when a specific package (e.g. a starter/titration pack) carries little or no Medicaid volume on its own.
100 tablets53746-0521-01 95,894 Rx · $697,348
1000 tablets this page53746-0521-10 28,512 Rx · $286,268
Drug total (last 4 qtrs): 124,406 Rx · 4,592,855 units · $983,616 gross reimbursed
Tap a pack size to open its page. Source: CMS State Drug Utilization Data, last 4 quarters.

🔬 Reported adverse events (FAERS)

Read carefully: FAERS reports are voluntary and unverified. Counts are not incidence, do not establish causation, are subject to reporting bias, and cannot be used to compare one drug to another. Shown for signal context only. Reports for Promethazine Hydrochloride — the ingredient across all brands.

Top reported reactions

Dependence3,586
Nausea2,646
Vomiting1,802
Pain1,693
Fatigue1,496
Diarrhoea1,341
Headache1,288

Reporter sex

0 reports
Male · 28%
Female · 72%
Unknown · 0%

Serious outcomes

Death1,989
Life-threatening854
Disabling600
Reports over time (by year) — tap or hover for the count & year
2019 2021 2023 2026 4,383 0
Most recent year is provisional (FAERS lags ~3 months).
Where does this data come from?
Adverse-event reports from the FDA Adverse Event Reporting System (FAERS) via openFDA. FAERS reports are voluntary and unverified — counts are not incidence and don’t establish causation.

📦 Packaging — all sizes for this product

Package NDCDescription Per unit Per pack Marketing startStatus
53746-0521-01 100 TABLET in 1 BOTTLE (53746-521-01) $0.0455 / ea $4.55 2022-06-22 Active
53746-0521-10 You're viewing this 1000 TABLET in 1 BOTTLE (53746-521-10) $0.0455 / ea $45.48 2022-06-22 Active

You're viewing the largest of 2 pack sizes for this product.

This pack effectively ties for the lowest per-ea cost of the 2 priced pack sizes ($0.0455 NADAC).

This pack accounts for about 23% of this product's recent Medicaid fills; most go to the 100 tablets pack. See all packs ↓

Pack size FAQ

What quantity is in NDC 53746-0521-10?
NDC 53746-0521-10 is a 1,000-count package — 1000 tablet in 1 bottle.
What is the difference between NDC 53746-0521-10 and NDC 53746-0521-01?
Both are Promethazine Hydrochloride 25 mg Tablet — the drug itself is identical. NDC 53746-0521-10 is the 1,000-count package, while NDC 53746-0521-01 is the 100 tablets package.
What NDC number is used to bill for this package of Promethazine Hydrochloride 25 mg Tablet?
Bill NDC 53746-0521-10 — the 11-digit billing format is 53746052110. Pharmacy and medical claims use the 11-digit form; the FDA label may print a shorter form of the same code.

Prices are the latest CMS NADAC pharmacy acquisition cost per NDC; per-pack figures are per-unit × pack quantity, shown only when the pack is denominated in the same measure NADAC prices.

📄 Full prescribing information FDA SPL

The complete FDA label for this product — the official prescribing information, verbatim, section by section. Jump with a chip, search within the label, or expand everything.
🎯 Indications and Usage 129 words ▾

INDICATIONS AND USAGE Promethazine hydrochloride tablets are useful for: Perennial and seasonal allergic rhinitis. Vasomotor rhinitis. Allergic conjunctivitis due to inhalant allergens and foods.

Mild, uncomplicated allergic skin manifestations of urticaria and angioedema. Amelioration of allergic reactions to blood or plasma. Dermographism.

Anaphylactic reactions as adjunctive therapy to epinephrine and other standard measures after the acute manifestations have been controlled. Preoperative, postoperative and obstetric sedation. Prevention and control of nausea and vomiting associated with certain types of anesthesia and surgery.

Therapy adjunctive to meperidine or other analgesics for control of postoperative pain. Sedation in both children and adults as well as relief of apprehension and production of light sleep from which the patient can be easily aroused. Active and prophylactic treatment of motion sickness.

Antiemetic therapy in postoperative patients.

⏱️ Dosage and Administration ~2 min read ▾

DOSAGE AND ADMINISTRATION Promethazine hydrochloride tablets are contraindicated for children under 2 years of age (see WARNINGS: Black Box Warning and Use in Pediatric Patients ). Allergy The average oral dose is 25 mg taken before retiring; however, 12.5 mg may be taken before meals and on retiring, if necessary. Single 25 mg doses at bedtime or 6.25 mg to 12.5 mg taken three times daily will usually suffice.

After initiation of treatment, in children or adults, dosage should be adjusted to the smallest amount adequate to relieve symptoms. The administration of promethazine hydrochloride in 25 mg doses will control minor transfusion reactions of an allergic nature. Motion Sickness The average adult dose is 25 mg taken twice daily.

The initial dose should be taken one-half to one hour before anticipated travel and be repeated eight to twelve hours later if necessary. On succeeding days of travel, it is recommended that 25 mg be given on arising and again before the evening meal. For children, promethazine hydrochloride tablets, syrup, or rectal suppositories, 12.5 mg to 25 mg, twice daily, may be administered.

Nausea and Vomiting Antiemetics should not be used in vomiting of unknown etiology in children and adolescents (see WARNINGS: Use in Pediatric Patients ). The average effective dose of promethazine hydrochloride for the active therapy of nausea and vomiting in children or adults is 25 mg. When oral medication cannot be tolerated, the dose should be given parenterally or by rectal suppository.

12.5mg to 25 mg doses may be repeated, as necessary, at four- to six-hour intervals. For nausea and vomiting in children, the usual dose is 0.5 mg per pound of body weight, and the dose should be adjusted to the age and weight of the patient and the severity of the condition being treated. For prophylaxis of nausea and vomiting, as during surgery and the post-operative period, the average dose is 25 mg repeated at four- to six-hour intervals, as necessary.

Sedation This product relieves apprehension and induces a quiet sleep from which the patient can be easily aroused. Administration of 12.5 mg to 25 mg promethazine hydrochloride by the oral route or by rectal suppository at bedtime will provide sedation in children. Adults usually require 25 mg to 50 mg for nighttime, pre-surgical, or obstetrical sedation.

Pre- and Post-operative Use Promethazine hydrochloride in 12.5 mg to 25 mg doses for children and 50 mg doses for adults the night before surgery relieves apprehension and produces a quiet sleep. For pre-operative medication, children require doses of 0.5 mg per pound of body weight in combination with an appropriately reduced dose of narcotic or barbiturate and the appropriate dose of an atropine-like drug. Usual adult dosage is 50 mg promethazine hydrochloride with an appropriately reduced dose of narcotic or barbiturate and the required amount of a belladonna alkaloid.

Post-operative sedation and adjunctive use with analgesics may be obtained by the administration of 12.5 mg to 25 mg in children and 25 mg to 50 mg doses in adults. Promethazine hydrochloride tablets are contraindicated for children under 2 years of age.

⛔ Contraindications 58 words ▾

CONTRAINDICATIONS Promethazine hydrochloride tablets are contraindicated for use in pediatric patients less than two years of age. Promethazine is contraindicated in comatose state, and in individuals known to be hypersensitive or to have had an idiosyncratic reaction to promethazine or to other phenthiazines. Antihistamines are contraindicated for use in the treatment of lower respiratory tract symptoms including asthma.

⚠️ Warnings ~2 min read ▾

WARNINGS PROMETHAZINE HYDROCHLORIDE SHOULD NOT BE USED IN PEDIATRIC PATIENTS LESS THAN 2 YEARS OF AGE BECAUSE OF THE POTENTIAL FOR FATAL RESPIRATORY DEPRESSION. POST-MARKETING CASES OF RESPIRATORY DEPRESSION, INCLUDING FATALITIES, HAVE BEEN REPORTED WITH USE OF PROMETHAZINE HYDROCHLORIDE IN PEDIATRIC PATIENTS LESS THAN 2 YEARS OF AGE. A WIDE RANGE OF WEIGHT-BASED DOSES OF PROMETHAZINE HYDROCHLORIDE HAVE RESULTED IN RESPIRATORY DEPRESSION IN THESE PATIENTS.

CAUTION SHOULD BE EXERCISED WHEN ADMINISTERING PROMETHAZINE HYDROCHLORIDE TO PEDIATRIC PATIENTS 2 YEARS OF AGE AND OLDER. IT IS RECOMMENDED THAT THE LOWEST EFFECTIVE DOSE OF PROMETHAZINE HYDROCHLORIDE BE USED IN PEDIATRIC PATIENTS 2 YEARS OF AGE AND OLDER AND CONCOMITANT ADMINISTRATION OF OTHER DRUGS WITH RESPIRATORY DEPRESSANT EFFECTS BE AVOIDED. CNS Depression Promethazine hydrochloride tablets may impair the mental and/or physical abilities required for the performance of potentially hazardous tasks, such as driving a vehicle or operating machinery.

The impairment may be amplified by concomitant use of other central nervous system depressants such as alcohol, sedatives/hypnotics (including barbiturates), narcotics, narcotic analgesics, general anesthetics, tricyclic antidepressants, and tranquilizers; therefore such agents should either be eliminated or given in reduced dosage in the presence of promethazine hydrochloride (see PRECAUTIONS, Information for Patients and Drug Interactions ). Respiratory Depression Promethazine hydrochloride tablets may lead to potentially fatal respiratory depression.

Use of promethazine hydrochloride tablets in patients with compromised respiratory function (e.g., COPD, sleep apnea) should be avoided. Lower Seizure Threshold Promethazine hydrochloride tablets may lower seizure threshold. It should be used with caution in persons with seizure disorders or in persons who are using concomitant medications, such as narcotics or local anesthetics, which may also affect seizure threshold.

Bone-Marrow Depression Promethazine hydrochloride tablets, should be used with caution in patients with bone marrow depression. Leukopenia and agranulocytosis has been reported, usually when promethazine hydrochloride has been used in association with other known marrow-toxic agents. Neuroleptic Malignant Syndrome A potentially fatal symptom complex sometimes referred to as Neuroleptic Malignant Syndrome (NMS) has been reported in association with promethazine hydrochloride alone or in combination with antipsychotic drugs.

Clinical manifestations of NMS are hyperpyrexia, muscle rigidity, altered mental status and evidence of autonomic instability (irregular pulse or blood pressure, tachycardia, diaphoresis and cardiac dysrhythmias). The diagnostic evaluation of patients with this syndrome is complicated. In arriving at a diagnosis, it is important to identify cases where the clinical presentation includes both serious medical illness (e.g., pneumonia, systemic infection, etc.) and untreated or inadequately treated extrapyramidal signs and symptoms (EPS).

Other important consideration in the differential diagnosis include central anticholinergic toxicity, heat stroke, drug fever and primary central nervous system (CNS) pathology. The management of NMS should include 1) Immediate discontinuation of promethazine hydrochloride, antipsychotic drugs, if any, and other drugs not essential to concurrent therapy. 2) Intensive symptomatic treatment and medical monitoring.

3) Treatment of any concomitant serious medical problems for which specific treatments are available. There is no general agreement about specific pharmacological treatment regimens for uncomplicated NMS. Since reoccurrences of NMS have been reported with phenothiazines, the reintroduction of promethazine hydrochloride should be carefully considered.

Use in Pediatric Patients PROMETHAZINE HYDROCHLORIDE TABLETS ARE CONTRAINDICATED FOR USE IN PEDIATRIC PATIENTS LESS THAN TWO YEARS OF AGE. CAUTION SHOULD BE…

🤒 Adverse Reactions 169 words ▾

ADVERSE REACTIONS Central Nervous System Drowsiness is the most prominent CNS effect of this drug. Sedation, somnolence, blurred vision, dizziness; confusion, disorientation, and extrapyramidal symptoms such as oculogyric crisis, torticollis, and tongue protrusion; lassitude, tinnitus, incoordination, fatigue, euphoria, nervousness, diplopia, insomnia, tremors, convulsive seizures, excitation, catatonic like states, hysteria. Hallucinations have also been reported.

Cardiovascular Increased or decreased blood pressure, tachycardia, bradycardia, faintness. Dermatologic Dermatitis, photosensitivity, urticaria. Hematologic Leukopenia, thrombocytopenia, thrombocytopenic purpura, agranulocytosis.

Gastrointestinal Dry mouth, nausea, vomiting, jaundice. Respiratory Asthma, nasal stuffiness, respiratory depression (potentially fatal) and apnea (potentially fatal). (see WARNINGS, Respiratory Depression .) Other Angioneurotic edema.

Neuroleptic malignant syndrome (potentially fatal) has also been reported (see WARNINGS, Neuroleptic Malignant Syndrome ). Paradoxical Reactions: Hyperexcitability and abnormal movements have been reported in patients following a single administration of promethazine hydrochloride. Consideration should be given to the discontinuation of promethazine hydrochloride and to the use of other drugs if these reactions occur.

Respiratory depression, nightmares, delirium, and agitated behavior have also been reported in some of these patients.

🆘 Overdosage ~1 min read ▾

OVERDOSAGE Signs and symptoms of overdosage with promethazine hydrochloride range from mild depression of the central nervous system and cardiovascular system to profound hypotension, respiratory depression, unconsciousness, and sudden death. Other reported reactions include hyperreflexia, hypertonia, ataxia, athetosis, and extensor-plantar reflexes (Babinski reflex). Stimulation may be evident, especially in children and geriatric patients.

Convulsions may rarely occur. A paradoxical-type reaction has been reported in children receiving single doses of 75 mg to 125 mg orally, characterized by hyperexcitability and nightmares. Atropine-like signs and symptoms – dry mouth, fixed, dilated pupils, flushing, as well as gastrointestinal symptoms – may occur.

Treatment Treatment of overdosage is essentially symptomatic and supportive. Only in cases of extreme overdosage or individual sensitivity do vital signs including respiration, pulse, blood pressure, temperature, and EKG, need to be monitored. Activated charcoal orally or by lavage may be given, or sodium or magnesium sulfate orally as a cathartic.

Attention should be given to the reestablishment of adequate respiratory exchange through provision of a patent airway and institution of assisted or controlled ventilation. Diazepam may be used to control convulsions. Acidosis and electrolyte losses should be corrected.

Note that any depressant effects of promethazine hydrochloride are not reversed by naloxone. Avoid analeptics which may cause convulsions. The treatment of choice for resulting hypotension is administration of intravenous fluids, accompanied by repositioning if indicated.

In the event that vasopressors are considered for the management of severe hypotension which does not respond to intravenous fluids and repositioning, the administration of norepinephrine or phenylephrine should be considered. EPINEPHRINE SHOULD NOT BE USED, since its use in patients with partial adrenergic blockade may further lower the blood pressure. Extrapyramidal reactions may be treated with anticholinergic antiparkinsonian agents, diphenhydramine, or barbiturates.

Oxygen may also be administered. Limited experience with dialysis indicates that it is not helpful.

🧬 Clinical Pharmacology 127 words ▾

CLINICAL PHARMACOLOGY Promethazine is a phenothiazine derivative which differs structurally from the antipsychotic phenothiazines by the presence of a branched side chain and no ring substitution. It is thought that this configuration is responsible for its relative lack (1/10 that of chlorpromazine) of dopamine antagonist properties. Promethazine is an H 1 receptor blocking agent.

In addition to its antihistaminic action, it provides clinically useful sedative and antiemetic effects. Promethazine is well absorbed from the gastrointestinal tract. Clinical effects are apparent within 20 minutes after oral administration and generally last four to six hours, although they may persist as long as 12 hours.

Promethazine is metabolized by the liver to a variety of compounds; the sulfoxides of promethazine and N-demethylpromethazine are the predominant metabolites appearing in the urine.

📦 How Supplied / Storage and Handling 198 words ▾

HOW SUPPLIED Promethazine Hydrochloride Tablets, USP for oral administration are available as: Promethazine Hydrochloride Tablets USP, 12.5 mg are white to off-white, biconvex, round uncoated tablets, debossed with “AN” and bisect on one side and “745” on the other side are supplied as: Bottles of 100: NDC 53746-745-01 Promethazine Hydrochloride Tablets USP, 25 mg are white to off-white, flat-faced, beveled edge, round, uncoated tablets, debossed with “AN” above “521” with single line bisect separating them on one side and plain on the other side are supplied as: Bottles of 100: NDC 53746-521-01 Bottles of 1,000: NDC 53746-521-10 Promethazine Hydrochloride Tablets USP, 50 mg are pink color, biconvex, round tablets, debossed with “AN” above “522” on one side and plain on the other side are supplied as: Bottles of 100: NDC 53746-522-01 Store at 20° to 25°C (68° to 77°F) [see USP Controlled Room Temperature].

Dispense in a tight, light-resistant container as defined in the USP with a child-resistant closure. To report SUSPECTED ADVERSE REACTIONS, contact Amneal Pharmaceuticals at 1-877-835-5472 or FDA at 1-800-FDA-1088 or www.fda.gov/medwatch. Manufactured by: Amneal Pharmaceuticals Pvt.

Ltd. Oral Solid Dosage Unit Ahmedabad 382213, INDIA Distributed by: Amneal Pharmaceuticals LLC Bridgewater, NJ 08807 Rev. 09-2021-00

📋 Description 122 words ▾

DESCRIPTION Promethazine hydrochloride, a phenothiazine derivative, is designated chemically as (±)-10- [2-(Dimethylamino)propyl]phenothiazine monohydrochloride and has the following structural formula: Promethazine hydrochloride is a racemic compound; the molecular formula is C 17 H 20 N 2 S HCl and its molecular weight is 320.88 g/mol. Promethazine hydrochloride, USP occurs as a white to faint yellowish crystalline powder which slowly oxidizes and turns blue on prolonged exposure to air. It is freely soluble in water, in hot dehydrated alcohol, and in chloroform; practically insoluble in ether.

Each tablet for oral administration contains 12.5 mg, 25 mg or 50 mg promethazine hydrochloride, USP. The inactive ingredients include: lactose anhydrous, magnesium stearate, and microcrystalline cellulose. The 50 mg also contains D&C Red # 27 Lake.

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Source: FDA Structured Product Labeling, mirrored from DailyMed / openFDA. Prefer the government’s original formatting? View this label on DailyMed ↗
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