Excessive anti-cholinergic effects (described below) can occur when promethazine is used with other antihistamines, for example, diphenhydramine (Benadryl); some phenothiazines, for example, thioridazine (Mellaril); some tricyclic antidepressants, for example, amitriptyline (Elavil); clozapine (Clozaril), cyclobenzaprine (Flexeril), and disopyramide (Norpace).
Phenergan (promethazine) is now contraindicated in children younger than 2 years because of possible fatal respiratory depression and should be used cautiously in other pediatric patients, according to a new black box warning recently requested by the Food and Drug Administration. The agency requested that the black box warning be added to Phenergan's label after a review of the drug's pediatric adverse events.
SIDE EFFECTS: Constipation, drowsiness, vision changes or dry mouth may occur. If any of these effects persist or worsen, notify your doctor. Unlikely to occur but report promptly: restlessness, muscle stiffness, weakness, difficulty speaking, loss of balance, mask- like facial expression, trembling or shaking, dizziness, lip smacking or other uncontrollable movements, difficulty urinating, skin rash/discoloration. Very unlikely to occur but report promptly: persistent sore throat or fever, unusual bleeding or bruising, stomach pain, yellowing of eyes or skin, dark urine, hot dry skin, vomiting. This drug may infrequently cause a very serious (rarely fatal) nervous system disorder (neuroleptic malignant syndrome).
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