Promethazine (including Phenergan)
1. About promethazine
Promethazine is an antihistamine medicine that relieves the symptoms of allergies.
It's known as a drowsy (sedating) antihistamine. It's more likely to make you feel sleepy than other antihistamines.
It's used for:
- short-term sleep problems (insomnia) – including when a cough or cold, or itching, is keeping you awake at night
- allergies, including hay fever and hives (urticaria)
- feeling and being sick (vomiting) – due to morning sickness, travel sickness or vertigo
- cough and cold symptoms, such as coughing and a runny nose
You can buy promethazine from pharmacies, where it's often sold as Avomine, Phenergan or Sominex. Promethazine is also available on prescription.
You can also buy promethazine mixed with other medicines, such as paracetamol, dextromethorphan, pholcodine or pseudoephedrine, to treat coughs and colds or pain.
Popular brand names include Day & Night Nurse and Night Nurse.
It comes as tablets, capsules and a liquid that you swallow.
2. Key facts
- Avoid drinking alcohol while taking promethazine. Alcohol increases the risks of side effects.
- To help you sleep, you'll usually take promethazine 20 minutes before you go to bed. It normally takes about 30 minutes to work.
- For preventing travel sickness, you can usually take promethazine the night before a long journey or 1 to 2 hours before a short journey.
- Common side effects include feeling sleepy, headaches, nightmares and feeling dizzy, restless or confused.
- Promethazine is known by the brand names Avomine, Phenergan and Sominex.
- When promethazine is mixed with other medicines, it's also known by the brand names Day & Night Nurse, Fedril and Night Nurse.
3. Who can and cannot take promethazine
Promethazine can be taken by most adults and children aged 2 years and above.
Promethazine is not suitable for some people. Tell your doctor or pharmacist if you:
- have had an allergic reaction to promethazine or any other medicines in the past
- have an eye problem called primary angle closure glaucoma
- have problems peeing or emptying your bladder
- have epilepsy or any other health problem that causes fits
- have an intolerance to, or cannot absorb, some sugars, such as lactose or sorbitol
- are due to have an allergy test. Promethazine can affect your results, so you may need to stop taking it a few days before your test. Ask the clinic where you are due to have your allergy test.
- are unable to have any alcohol. Some liquid promethazine products contain a very small amount of alcohol, so check the ingredients and the packaging carefully.
- are trying to get pregnant. Promethazine can affect home pregnancy tests. If you think you're pregnant, speak to your doctor so they can arrange a blood test instead.
4. How and when to take it
If you or your child have been prescribed promethazine, follow your doctor's instructions about how and when to take it.
Only take promethazine when you need it – for example, if you're unable to sleep because you're worrying about something or your cold symptoms are keeping you awake.
If you have bought promethazine or any medicine containing promethazine from a pharmacy or supermarket, follow the instructions that come with it, or ask a pharmacist for advice.
Dosage and strength
Promethazine comes in 10mg, 20mg and 25mg tablets and a liquid that you swallow.
If you're taking liquid promethazine, follow the instructions that come with the medicine for how much to take.
If you're taking promethazine tablets, your dose depends on why you're taking it:
- short-term insomnia – you'll usually take 20 to 50mg at night
- hay fever – you'll usually take 10mg twice a day to 20mg 3 times a day
- hives – you'll usually take 10mg twice a day to 20mg 3 times a day
- preventing travel sickness – 25mg taken 1 to 2 hours before a short journey or 25mg the night before a long journey
- treating travel sickness – take 25mg as soon as possible and 25mg the same evening, followed by 25mg the following evening (if you need it)
- morning sickness and vertigo – the dose can vary from 25mg a day to 25mg 4 times a day
Promethazine comes mixed with other ingredients for cough and cold symptoms – the usual dose depends on the type of medicine you're taking.
Check the instructions on the packaging carefully, or ask your pharmacist or doctor if you're unsure.
Doses are lower for children. Your doctor will use your child's age to work out the right dose.
How to take it
You can take promethazine tablets, capsules and liquid with or without food.
Always take your promethazine tablets or capsules with a drink of water. Swallow them whole. Do not chew them.
Liquid medicines containing promethazine come with a plastic syringe or spoon to help you measure out the right dose.
If you do not have a syringe or spoon, ask your pharmacist for one. Do not use a kitchen teaspoon as you will not get the right amount.
What if I forget my medicine?
For travel sickness, take it as soon as you remember.
For anything else, skip the missed dose and take your next dose at the usual time.
Never take 2 doses at the same time. Never take an extra dose to make up for a forgotten one.
If you forget doses often, it may help to set an alarm to remind you. You could also ask your pharmacist for advice on other ways to help you remember to take your medicine.
What if I take too much?
Too much promethazine can be dangerous.
If you take too much, you may:
- feel very sleepy
- have a very fast, uneven or pounding heartbeat (palpitations)
- have breathing problems
In serious cases, you can become unconscious or have fits and may need emergency treatment in hospital.
If your child takes too much promethazine, they may also:
- move unsteadily or stumble
- have uncontrolled movements, especially in their hands or feet
- see or hear things that are not there (hallucinations)
- have an uneven heartbeat
Urgent advice: Call your doctor straight away if:
- you take too much promethazine
If you need to go to A&E do not drive yourself – get someone else to drive you or call for an ambulance.
Take the promethazine packet or leaflet inside it, plus any remaining medicine, with you.
5. Side effects
Common side effects
Like all medicines, promethazine can cause side effects, although not everyone gets them.
Talk to your pharmacist or doctor if these side effects bother you or do not go away:
- feeling tired during the daytime
- feeling dizzy or unsteady on your feet, or having difficulty concentrating
Promethazine can sometimes make your skin more sensitive to sunlight. Keep out of direct or strong sunlight and follow sun safety advice.
If you're over 65, you're more likely to experience side effects such as:
- feeling confused
- dry mouth
- blurred vision
- difficulty peeing
Children are more likely to experience side effects such as feeling restless or excited.
Serious side effects
Call your doctor straight away if you have:
- yellowing of the skin or whites of the eyes - these can be signs of liver problems
- bruising or bleeding that's more than normal
- muscle stiffness or shaking, or unusual face or tongue movements
Serious allergic reaction
In rare cases, it's possible to have a serious allergic reaction (anaphylaxis) to promethazine.
Immediate action required: Call 999 or go to A&E if:
- you get a skin rash that may include itchy, red, swollen, blistered or peeling skin
- you're wheezing
- you get tightness in the chest or throat
- you have trouble breathing or talking
- your mouth, face, lips, tongue or throat start swelling
You could be having a serious allergic reaction and may need immediate treatment in hospital.
These are not all the side effects of promethazine. For a full list, see the leaflet inside your medicine packet.
6. How to cope with side effects
What to do about:
- feeling sleepy during the daytime – this usually wears off 12 hours after a dose. Do not drive or use tools or machinery if you're feeling this way.
- nightmares – speak to your pharmacist or doctor if these do not go away or are troubling you
- feeling dizzy or unsteady on your feet, or having difficulty concentrating – stop what you're doing and sit or lie down until you feel better. If the feeling does not go away or is troubling you, do not take any more medicine and speak to a pharmacist or your doctor.
- headaches – make sure you rest and drink plenty of fluids. Talk to your doctor if the headaches last longer than a week or are severe.
7. Pregnancy and breastfeeding
Your doctor may want to prescribe promethazine for morning sickness when other treatments have not worked.
Pregnant women have taken promethazine with no harmful effects to the mother or baby. But for safety it's best to take it for the shortest possible time.
For more information about how promethazine can affect you and your baby during pregnancy, read the leaflet about the best use of medicines in pregnancy (BUMPS).
Promethazine and breastfeeding
Promethazine passes into breast milk in small amounts. Talk to your doctor, as other medicines might be better while you're breastfeeding.
If you need a drowsy antihistamine to help you sleep, your doctor may recommend chlorphenamine.
But speak to your doctor before taking any antihistamine if your baby was premature, had a low birth weight, or has health problems.
8. Cautions with other medicines
Some medicines and promethazine interfere with each other and increase the chance of having side effects.
Tell your pharmacist or doctor if you're taking:
- a type of antidepressant called a monoamine oxidase inhibitor, such as phenelzine
- any medicine that makes you drowsy, gives you a dry mouth, or makes it difficult for you to pee. Taking promethazine might make these side effects worse.
If you're taking a cough or cold remedy or a painkiller containing promethazine, check carefully what the other ingredients are.
For example, promethazine often comes mixed with paracetamol. If you take 2 medicines that both contain paracetamol, there's a risk of overdose.
Ask your pharmacist for advice before you take this medicine together with any other painkillers or medicines.
Mixing promethazine with herbal remedies and supplements
There might be a problem taking some herbal remedies and supplements alongside promethazine, especially ones that cause side effects such as sleepiness, a dry mouth or making it difficult to pee.
Ask your pharmacist for advice.
9. Common questions
How does promethazine work?
How is it different from other cough and cold remedies?
How long does it take to work?
How long can I take it for?
Is promethazine addictive?
What's the difference between promethazine and other antihistamines?
Can I take more than one antihistamine at a time?
Will it help me sleep?
Can I take it with painkillers?
Can I drive or ride a bike with it?
Will it affect my fertility?
Will it affect my contraception?
Can I drink alcohol with it?
Is there any food or drink I need to avoid?
Is it dangerous to take with recreational drugs?
Can lifestyle changes help me sleep better?
Can lifestyle changes help with hayfever and other allergies?
Page last reviewed: 18/09/2018
Next review due: 18/09/2021