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- Pharmacology For Dextromethorphan + Promethazine
Dextromethorphan + Promethazine Pharmacology
Dextromethorphan + Promethazine
About Dextromethorphan + PromethazineN/AMechanism of Action of Dextromethorphan + PromethazineN/APharmacokinets of Dextromethorphan + PromethazineN/AOnset of Action for Dextromethorphan + PromethazineN/ADuration of Action for Dextromethorphan + PromethazineN/AHalf Life of Dextromethorphan + PromethazineN/ASide Effects of Dextromethorphan + PromethazineN/AContra-indications of Dextromethorphan + PromethazineN/ASpecial Precautions while taking Dextromethorphan + PromethazineN/APregnancy Related InformationN/AOld Age Related InformationN/ABreast Feeding Related InformationN/AChildren Related InformationN/AIndications for Dextromethorphan + PromethazineN/AInteractions for Dextromethorphan + PromethazineN/ATypical Dosage for Dextromethorphan + PromethazineN/ASchedule of Dextromethorphan + PromethazineN/AStorage Requirements for Dextromethorphan + PromethazineN/AEffects of Missed Dosage of Dextromethorphan + PromethazineN/AEffects of Overdose of Dextromethorphan + PromethazineN/ADextromethorphan
About DextromethorphanA synthetic morphine (((dextrorotatory methyl ether of Levorphanol))) derivative,A synthetic narcotic antitussive.Mechanism of Action of DextromethorphanDextromethorphan hydrobromide is a selective antitussive which raises threshold of cough centre and suppresses the cough reflex by direct action on the cough centre in the medulla. It does not depress mucociliary function of the airway mucosa and is also devoid of constipating and addicting actions. (((Its antitussive action is not exerted through opioid receptors)))Pharmacokinets of DextromethorphanAbsorption: Well absorbed orally, Metabolism: Extensively metabolized by liver, Excretion: Excreted primarily through urine as metabolites; about 7 to 10% is excreted through faeces.Onset of Action for DextromethorphanBelow ? an hourDuration of Action for Dextromethorphan3 to 6 hoursHalf Life of Dextromethorphan11 hoursSide Effects of Dextromethorphan1. Dizziness
2. Nausea
3. Vomiting
4. Stomach pain
5. Drowsiness
6. Ataxia.Contra-indications of DextromethorphanPatients currently taking MAO inhibitors or within two weeks of discontinuing MAO inhibitors.Special Precautions while taking Dextromethorphan1. Atopic children
2. Sedated or deliberate patients
3. Those patients confined to the supine position
4. Patients sensitive to aspirin
Pregnancy Related InformationContraindicatedOld Age Related InformationN/ABreast Feeding Related InformationN/AChildren Related InformationMay be used
Children below 2 years: Syrup, tablets, or lozenges are contraindicated
Indications for DextromethorphanChronic nonproductive cough.Interactions for DextromethorphanN/ATypical Dosage for DextromethorphanOral:
Chronic nonproductive cough:
Adults and children above 12 years: 10 to 20mg every 4 hours; or 30mg three to four times daily.
Maximum dose: 120mg daily.
Children (((age 6 to 12))): 5 to 10mg every four hours
Maximum dose: 60mg daily
Children (((age 2 to 6))): 2.5 to 5mg every four hours.
Maximum dose: 30mg daily.
Schedule of DextromethorphanN/AStorage Requirements for DextromethorphanStore at room temperature in a well closed light resistant container. Protect from excess heat and moisture. Keep out of reach of children.Effects of Missed Dosage of DextromethorphanTake the missed dose as soon as noticed and if it is the time for next dose then skip the missed dose. Continue the regular schedule. Do not double the dose.Effects of Overdose of DextromethorphanRemove drug from the body by administration of activated charcoal and provide symptomatic treatment and supportive measures.Promethazine
About PromethazineA first-generation H1 antagonist, a phenothiazine derivative, Antihistamine,antiemetic,sedative.Mechanism of Action of PromethazineAntiallergic actions: Promethazine mainly acts on H1 receptor. It competes with Histamine for H1 receptor. It does not affect the release of Histamine. It blocks the Histamine actions on smooth muscles (GIT, uterus, blood vessel & bronchi) and reduces Histamine induced excess salivary secretion. It has anticholinergic actions. Promethazine produces sedation by inhibiting the stimuli to the brain stem reticular system.
Antiemetic and Antivertigo actions: The central antimuscarinic actions of antihistamines are responsible for their antivertigo and antiemetic effects. They suppress end organ receptors or inhibit central cholinergic action. It also acts on Chemoreceptor trigger zone.
Migraine: Promethazine is used in migraine due to its sedative as well as antiemetic actions.
Anaesthetic adjuncts: Promethazine is used as anaesthetic adjunct due to its sedative, antiemetic and anticholinergic properties.
Pharmacokinets of PromethazineAbsorption: It is well absorbed after oral administration. Distribution: It is distributed widely in the body. Metabolism: It is metabolised in the liver .Excretion: It is excreted mainly through urine. Small amount of drug is excreted through faeces and breast milk.Onset of Action for Promethazine15 - 60 minutesDuration of Action for Promethazine12 hoursHalf Life of Promethazine10 - 15 hoursSide Effects of Promethazine1. Tardive dyskinesia
2. Extrapyramidal reactions
3. Drowsiness
4. Sedation
5. Dizzines
6. Hypotension
7. Dry mouth
8. Constipation
9 .Blurred vision
10. Agranulocytosis
11. Photosensitivity
12. Insomnia
13. Weight gain
14. Cholestatic jaundiceContra-indications of Promethazine1.Hypersensitivity to Promethazine
2.Comatose
3.Blood dyscrasias
4.Patient taking antidepressants
5.Liver damageSpecial Precautions while taking Promethazine1. Renal impairment
2. Hepatic impairment
3. Cardiovascular disease
4. Pheochromocytoma
5. Hypocalcaemia
6. Epilepsy
7. Cholestatic jaundice
8. Patient exposed to extreme heat or cold or phosphorus insecticides
9. Ceribrovascular disorder
10. Patient on ECT
11. Reaction to Insulin
12. Prostatic hyperplasia
13. Glaucoma
14. Peptic ulcer
15. Slowly withdraw the drug with caution
Pregnancy Related InformationContraindicatedOld Age Related InformationUse with cautionBreast Feeding Related InformationContraindicatedChildren Related InformationUse with caution
CHILDREN (below 2 years): Contraindicated
NEONATES: Contraindicated
Indications for Promethazine1. Motion sickness
2. Nausea
3. Sedation
4. Allergy
5. Migraine
6. Vertigo
7. Anticough ingredient
8. Anaesthetic adjuncts
Interactions for PromethazineAlcohol: CNS depression, extrapyramidal reactions.
Aluminium salts: Decrease efficacy.
Antacids should be given 1 hour before or 2 hours after promethazine.
Anticholinergics: Decrease efficacy and increase the anticholinergic side-effects of promethazine.
Barbiturates: Decrease efficacy.
Barbiturate anaesthetics: Increase frequency and severity of neuromuscular excitation and hypotension.
Bromocriptine: Efficacy decreased by promethazine.
Charcoal: Prevents absorption of promethazine.
Lithium: Disorientation, unconsciousness and extrapyramidal symptoms.
Meperidine: Excessive sedation and hypotension.
TCAs: Serum concentration increased by promethazine.
Propranolol: Increased plasma levels of both drugs.
MAOIs: Additive orthostatic hypotensive effect.
Lab tests: Pregnancy tests: False positive results.
Plasma bound iodine (PBI): Increase in PBI occurs.Typical Dosage for PromethazineAdult:
Motion sickness: 50 mg / day in 2 divided dose
Allergy: 25 mg at bed time
Nausea: 12.5 - 25 mg / day
Sedation: 25 - 50 mg at bed time
Children:
Motion sickness: 12.5 - 25 mg / day
Allergy: 6.25 - 12. 5 mg 3 times a day
Sedation: 12.5 - 25 mg at bed time
Schedule of PromethazineGStorage Requirements for PromethazineThe drug should be kept at 15 - 25 degree C in a tightly closed container. Protect from heat and light. Keep out of the reach of childrenEffects of Missed Dosage of PromethazineTake the missed dose as soon s noticed and if it is the time to take the next dose then skip the missed dose.Effects of Overdose of PromethazineGive supportive measures and treatment. Gastric lavage has to be done. Hypotension can be treated with IV fluids, seizure with Diazepam or Barbiturates, arrhythmia with Phenytoin and excretion of drug can be increased by acidification of urine.Home Delivery for Dextromethorphan + Promethazine in Your City
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However, we do publish a comprehensive directory of Pharmacies, Chemists and Druggists in cities all over India. You can use this directory to find the medicine stores in your city (or area) that provide home delivery services for dextromethorphan + promethazine and other medicines and health products. Home delivery services for dextromethorphan + promethazine may be free or they may cost you depending on the pharmacy and the minimum order requirements. It would be best to get this clarified while placing the order.
Please be aware that you should take dextromethorphan + promethazine only if a doctor has recommended or prescribed it. Some or all pharmacies who provide a home delivery service for medicines might insist on a prescription for dextromethorphan + promethazine before they complete the sale. You can get this information while placing the order for dextromethorphan + promethazine with the pharmacy.
Dextromethorphan + Promethazine is a generic medicine name and there are several brands available for it. Some of the brands for dextromethorphan + promethazine might be better known than dextromethorphan + promethazine itself. If the pharmacy that's willing to deliver medicines to your home doesn't have dextromethorphan + promethazine in stock, you can ask for one of the branded alternatives for dextromethorphan + promethazine.