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Promethazine usage requires careful attention to ensure safety, particularly in specific populations and situations. Below are important considerations and warnings for the use of promethazine:

• Children Under 2 Years: Do not administer promethazine to children younger than 2 years due to the risk of severe, potentially fatal respiratory issues such as slow or shallow breathing.

• Children 2 Years and Older: When prescribing promethazine for children aged 2 and above, use the smallest effective dose. Avoid combining it with other medications that may affect breathing. Seek immediate medical attention if you notice any signs of slow or shallow breathing.

• Nausea Treatment in Children: In pediatric cases, use promethazine only for nausea resulting from persistent vomiting with a known cause. Avoid giving this medication to children with liver conditions, including potential Reye's syndrome.

• Tissue Damage Risk: Promethazine can lead to severe tissue damage, which may necessitate surgical intervention. If you experience burning, pain, redness, swelling, or numbness around the injection site, inform a healthcare professional immediately. If such symptoms occur, discontinue the injection and have the site evaluated.

• Preferred Administration Method: This drug should ideally be administered via intramuscular injection to minimize side effects. There is an increased risk of adverse effects if injected into a vein. Promethazine must never be injected under the skin.

Adhering to these guidelines can help mitigate risks and ensure the safe use of promethazine. Always consult with a healthcare provider for personalized medical advice.

You might experience some common side effects like drowsiness, dizziness, constipation, blurred vision, or dry mouth while using this medication. These effects are typically mild and temporary. To ease dry mouth, consider using sugarless hard candy, ice chips, sugarless gum, drinking water, or saliva substitutes.

However, if any side effects persist or worsen, it's important to seek advice from a healthcare professional. Although most people do not experience serious side effects, be vigilant for any signs of infection, such as a persistent sore throat, fever, or chills. Other serious side effects to watch for include loss of coordination, fainting, confusion, slow heartbeat, tremors, unusual movements, mood changes, trouble urinating, easy bleeding/bruising, severe abdominal pain, or yellowing of the skin or eyes.

Seek immediate medical attention if you experience very serious side effects like slow or shallow breathing, seizures, or symptoms of a rare condition known as neuroleptic malignant syndrome, which includes fever, muscle stiffness, severe tiredness, confusion, sweating, irregular heartbeat, or dark urine. Also, although rare, a serious allergic reaction can occur, presenting as a rash, itching, swelling, severe dizziness, or trouble breathing. If you notice any such symptoms, seek medical help promptly. Always consult a healthcare provider for any effects not listed here.