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  • Walla158
    started a topic Phenergan

    Phenergan

    I was prescribed Phenergan for first trimester nausea. I just wanted to check to make sure this is okay to be taking. Thanks for your help.

  • Sandra
    replied
    Walla158,

    Phenergan (promethazine) is rated a P3-unknown-risk to fetus cannot be ruled out. "In summary, promethazine when used for nausea and vomiting during early pregnancy does not appear to increase the risk of congenital anomalies but may have adverse effects to the mother and baby when given during labor and delivery. Promethazine should only be used during pregnancy if the benefit to the mother outweighs the risk to the fetus. Promethazine is an antihistamine that is used as an antiemetic. Several studies have reported that promethazine does not appear to increase the risk of congenital anomalies.[1-4] Promethazine does have the potential to decrease platelet aggregation; therefore, placing the mother and fetus at risk for bleeding when given during labor.[2] Promethazine may also cause respiratory depression in the neonate when given during labor.[5] Tan et al found that metoclopramide had less adverse effects such as drowsiness and dizziness than promethazine.[6] In summary, promethazine when used for nausea and vomiting during early pregnancy does not appear to increase the risk of congenital anomalies but may have adverse effects to the mother and baby when given during labor and delivery. Promethazine should only be used during pregnancy if the benefit to the mother outweighs the risk to the fetus. Metoclopramide may be a better choice due to less side effects compared to promethazine. Promethazine should not be given in patients with pheochromocytoma due to an unsafe drop in blood pressure." (Medications and Mothers' Milk database, Dr Thomas Hale PhD).

    1.##Bartfai Z, Kocsis J, Puho EH, Czeizel AE. A population-based case-control teratologic study of promethazine use during pregnancy. Reprod Toxicol. Feb 2008;25(2):276-285.
    2.##Briggs G, Freeman, R., and Yaffe, S. Drugs in Pregancy and Lactation. Vol Seventh Ed. Philadelphia PA: Lippincott, Williams, and Wilkins; 2005.
    3.##Diav-Citrin O, Shechtman S, Aharonovich A, et al. Pregnancy outcome after gestational exposure to loratadine or antihistamines: a prospective controlled cohort study. J Allergy Clin Immunol. Jun 2003;111(6):1239-1243.
    4.##Petik D, Acs N, Banhidy F, Czeizel AE. A study of the potential teratogenic effect of large doses of promethazine used for a suicide attempt by 32 pregnant women. Toxicol Ind Health. Feb-Mar 2008;24(1-2):87-96.
    5.##Kahn A, Hasaerts D, Blum D. Phenothiazine-induced sleep apneas in normal infants. Pediatrics. May 1985;75(5):844-847.
    6.##Tan PC, Khine PP, Vallikkannu N, Omar SZ. Promethazine compared with metoclopramide for hyperemesis gravidarum: a randomized controlled trial. Obstet Gynecol. May 2010;115(5):975-981.

    Sandra Lovato R.N.
    InfantRisk Center

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