Implementation

• When administering promethazine concurrently with opioid analgesics, supervise ambulation closely to prevent injury from increased sedation

• PO: Administer with food, water, or milk to minimize GI irritation. Tablets may be crushed and mixed with food or fluids for patients with difficulty swallowing

• IM: Administer deep into well-developed muscle. Subcut or inadvertent intra-arterial administration may cause severe tissue necrosis

• Direct IV:

Diluent: Dilute with 0.9% NaCl or D5W
Concentration: Doses should not exceed a concentration of 25 mg/mL. Administer through a large-bore vein through a running IV line into the most distal port. Slight yellow color does not alter potency. Do not use if precipitate is present

• Rate:
Administer each 25 mg slowly, over at least 10–15 min (maximum rate = 25 mg/min). Rapid administration may produce a transient fall in blood pressure

• Syringe Compatibility:

» butorphanol

» cimetidine

» dihydroergotamine

» droperidol

» fentanyl

» glycopyrrolate

» hydromorphone

» metoclopramide

» midazolam

» pentazocine

» ranitidine

» scopolamine

• Syringe Incompatibility:

» heparin

» ketorolac

» pentobarbital

» phenobarbital

» phenytoin

» thiopental

• Y-Site Compatibility:

» alfentanil

» amifostine

» amikacin

» amsacrine

» anidulafungin

» ascorbic acid

» atracurium

» atropine

» benztropine

» bivalirudin

» bumetanide

» buprenorphine

» butorphanol

» calcium chloride

» calcium gluconate

» carboplatin

» caspofungin

» cimetidine

» ciprofloxacin

» cisatracurium

» cisplatin

» cladribine

» codeine

» cyclophosphamide

» cyclosporine

» cytarabine

» dactinomycin

» daptomycin

» dexmedetomidine

» digoxin

» diltiazem

» diphenhydramine

» dobutamine

» docetaxel

» dopamine

» doxacurium

» doxorubicin

» enalaprilat

» ephedrine

» epinephrine

» epirubicin

» epoetin alfa

» eftifibatide

» erythromycin

» esmolol

» etoposide

» etoposide phosphate

» famotidine

» fenoldopam

» fentanyl

» filgrastim

» fluconazole

» fludarabine

» gemcitabine

» gentamycin

» glycopyrrolate

» granisetron

» hetastarch

» hydromorphone

» ifosfamide

» insulin

» isoproterenol

» labetalol

» levofloxacin

» lidocaine

» linezolid

» lorazepam

» magnesium sulfate

» mannitol

» mechlorethamine

» melphalan

» meperidine

» metaraminol

» methoxamine

» methyldopate

» metoclopramide

» metoprolol

» metronidazole

» midazolam

» milrinone

» mitoxantrone

» morphine

» nalbuphine

» naloxone

» nitroglycerin

» norepinephrine

» octreotide

» ondansetron

» oxaliplatin

» oxytocin

» paclitaxel

» palonosetron

» pancuronium

» pemetrexed

» pentamidine

» pentazocine

» phentolamine

» phenylephrine

» procainamide

» prochlorperazine

» propranolol

» protamine

» pyridoxime

» quinupristin/dalfopristin

» ranitidine

» remifentanil

» rituximab

» rocuronium

» sargramostim

» sodium acetate

» succinylcholine

» sufentanil

» tacrolimus

» teniposide

» theophylline

» thiamine

» thiotepa

» tigecycline

» tirofiban

» tobramycin

» tolazoline

» trastuzumab

» trimetaphan

» vancomycin

» vasopressin

» vecuronium

» verapamil

» vincristine

» vinorelbine

» voriconazole

• Y-Site Incompatibility:

» acyclovir

» aldesleukin

» allopurinol

» aminophylline

» amphotericin B cholesteryl

» amphotericin B colloidal

» amphotericin B liposome

» ampicillin

» ampicillin/sulbactam

» azathioprine

» cefazolin

» cefepime

» cefonocid

» cefoperazone

» cefotaxime

» cefotetan

» cefoxitin

» ceftazidime

» ceftizoxime

» ceftriaxone

» cefuroxime

» chloramphenicol

» clindamycin

» dantrolene

» dexamethasone

» diazepam

» diazoxide

» doxorubicin liposome

» ertapenem

» fluorouracil

» folic acid

» foscarnet

» furosemide

» ganciclovir

» inamrinone

» indomethacin

» ketorolac

» methylprednisolone

» nafcillin

» nitroprusside

» oxacillin

» pantoprazole

» penicillin G

» pentobarbital

» phenobarbital

» phenytoin

» piperacillin/tazobactam

» sodium bicarbonate

» streptokinase

» ticarcillin/clavulanate

» trimethoprim/sulfamethoxazole

» urokinase

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