Antihistamines (sedating), anti- emetics.

Promethazine

Promethazine teoclate 25mg

Tablet

Avomine is a long acting anti-emetic, indicated for: - prevention and treatment of nausea and vomiting, including motion sickness and post operative vomiting; - vertigo due to Meniere's syndrome, labyrinitis and other causes .

For the prevention on long journeys: one 25mg tablet each evening at bedtime, starting the day before setting out. The duration of action is such that a second dose in 24 hours is not often necessary.

For the prevention of motion sickness on short journeys: one 25mg tablet one or two hours before travelling or as soon after as possible.

Treatment of motion sickness: One 25mg tablet as soon as possible and repeated the same evening followed by a third tablet the following evening.

Nausea and vomiting due to other causes

One 25mg tablet at night is often sufficient, but two or three tablets are sometimes necessary. Alternatively, more frequent administration such as 25mg two or three times a day may be required for some patients. It is often not necessary to give more than four of the 25mg Avomine Tablets in 24 hours

In the above indications children over 10 years of age may be given the lower adult doses described above. Children between 5 and 10 years may be given half the adult dose.

No specific dosage recommendations.

Administration: Oral.

Avomine should not be used in patients who are in a coma or suffering from CNS depression of any cause. It must not be given to neonates, premature infants or patients hypersensitive to phenothiazines. Avomine should be avoided in patients who have been taking monoamine oxidase inhibitors within the previous 14 days.

Avomine may thicken or dry lung secretions and impair expectoration, it should therefore be used with caution in patients with asthma, bronchitis or bronchiectesis. 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. Promethazine may mask the warnings 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 suppression of vomiting.

Avomine may enhance the action of any anticholinergic agent, tricyclic antidepressant, sedative or hypnotic. Alcohol should be avoided during treatment.

Avomine may interfere with immunologic urine pregnancy tests to produce false-positive and false-negative results.

Avomine should be discontinued at least 72 hours before any skin tests using allergen extracts as it may inhibit the cutaneous histamine response thus producing false-negative results.

Side effects may be seen in a few patients: drowsiness, dizziness, restlessness, headaches, nightmare, tiredness and disorientation. Anticholinergic side effects such as blurred vision, dry mouth and urinary retention occur occasionally. Newborn and premature 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 may occur.

Other side effects include anorexia, gastric irritation, palpitations, hypotension, arrhythmias, extrapyramidal effects, 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.

Manx

(P)

30 March 2009