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Antihistamines such as promethazine compete with histamine for one of the receptors for histamine (the H1 receptor) on cells. However, when the antihistamines bind to the receptors they do not stimulate the cells. Instead, they prevent histamine from binding and stimulating the cells. Promethazine also blocks the action of acetylcholine (anticholinergic effect), and this may explain its benefit in reducing the nausea of motion sickness. It is used as a sedative because it causes drowsiness as a side effect. The FDA approved promethazine in 1951.

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Excessive sedation may occur when promethazine is combined with other medications that depress the central nervous system (brain) and cause sedation. Such drugs include ethanol, barbiturates, anti-anxiety medications, sedatives, other phenothiazines, and narcotic pain medications.

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PREPARATIONS: Tablets: 12.5, 25, and 50 mg; Suppositories: 12.5, 25, and 50 mg; Syrup: 6.25 mg/5 ml; Injection: 25 and 50 mg/ml.

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