Patient/caregiver was educated on how to take promethazine as follows:

1. Take this medication as ordered by your physician. Do not change the dose on this medication without consulting your doctor.
2. Take the medication dose at the same time, every day, to avoid forgetting the intake of medication. If promethazine is being taken on a daily basis, taking it at bedtime can help avoid the risk of daytime drowsiness.
3. If promethazine is prescribed for motion sickness, to be used on an as needed basis, take the medication an hour before starting the journey. If promethazine is prescribed for calming down the pre-surgical anxiety, take the medication the night before the procedure or before the procedure, as ordered.
4. This medication can induce some nausea and vomiting, when taken on empty stomach. Taking the medication with a glass of water and some food or snack can help avoid these unpleasant gastrointestinal symptoms.
5. Promethazine can induce some dizziness and make one drowsy. Starting the medication at a low dose and gradually increasing the dose, to help optimum control of your symptoms, can contribute to reducing the risk for drowsiness and dizziness due to the medication. If the dizziness becomes bothersome, report it to your physician and other health care personnel, for any change in plan of care to be considered. Stay away from activities, such as, driving and operating heavy machinery, until they are used to the side effects caused by promethazine.
6. Do not take promethazine with alcohol or opioid pain medications, such as, hydrocodone and codeine, as these products can add to the confusion caused by promethazine. Also, avoid taking promethazine along with antidepressants and antianxiety medications, as they can seriously potentiate the drowsiness caused by promethazine. A number of OTC cough and cold medications, other antihistamines, and antianxiety medications have some similar ingredients as promethazine and so, must be avoided taking along with this medication, as they can potentiate the confusion caused by promethazine.
7. Take the tablet as a whole. If you encounter difficulty swallowing the whole tablet, you may cut the tablet and swallow it in pieces with a glass of water. You may also crush the tablet and sprinkle the powder on a spoonful of soft jelly or applesauce and swallow the jelly or sauce along with the medication.
8. When taking promethazine as an oral syrup, use a measuring spoon/cup to measure the correct dose being taken, in order to avoid risk for over/under dosing.
9. Maintain strict compliance with intake of the medication as ordered, with regards to dosage and frequency, to derive the benefit of the medication.
10. If promethazine is prescribed as part of a combination therapy, for management of anxiety before and after any medical/surgical procedures, observing compliance with alternative anxiety management measures can contribute towards better control of symptoms.
11. If promethazine is prescribed for controlling symptoms of seasonal allergies, observing compliance with other measures to reduce exposure to pollen, such as, wearing a mask, avoiding outside environment during the times of high pollen count, and using humidifiers in the room to increase the environmental moisture, can contribute significantly towards better control of symptoms.
12. Do not discontinue taking the medication without your physician’s consult, as you failed to see the desired result immediately after taking the medication.
13. Your physician could change the dose of promethazine, based on the relief obtained or side-effects developed. So, maintain compliance with follow-up physician appointments, to update on the relief from symptoms. Be accommodative to the plan of frequent dose changes, until you show an optimum response.
14. Promethazine interacts with a lot of other medications, thus influencing their function. If you are being newly started on promethazine, discuss with your physician regarding all your current medications and their safety with promethazine. Also, notify your physician regarding any current promethazine intake, if you are being started on any new medications and discuss their safety with promethazine.
15. Notify your doctor of any unresolved and worsening symptoms of seasonal allergies, motion sickness, nausea and vomiting or continuing unpleasant side-effects, so that, your dosage on the medication could be revised.
16. Promethazine carries the risk of aggravating blood sugars and can result in poor blood sugar control in diabetics. Maintain a log of everyday blood sugar readings, to allow for an easy follow-up on the pattern of blood sugars lately. Closely follow for any signs of poor blood sugar control, such as, dry mouth, frequent urination, increased thirst and hunger, dry skin, and blurred vision. Report these findings to your physician and other health care personnel, for any change in plan of care to be considered.
17. Promethazine carries the risk of inducing/aggravating tremors and dyskinesias, such as, uncontrolled tongue movements, lip smacking, and eye blinking. Dyskinesias could be due to side-effects of various medications intake or secondary to movement disorders, such as, parkinson’s disease. Irrespective to the cause of dyskinesias, individuals with history can be at increased risk to present with aggravation of the condition and so, promethazine must be avoided or carefully administered in such individuals, with periodical physician follow-up. Report any such findings to your physician and other health care personnel, for any change in plan of care to be considered.
18. Promethazine also can induce a life-threatening reaction called Neuroleptic malignant syndrome. Individuals taking promethazine can present with high fever, episodes of confusion, muscle rigidity, elevated blood pressure and rapid heart rate. Severe cases can present with muscle breakdown, elevated potassium levels in the blood due to muscle destruction, life-threatening cardiac arrhythmias due to the elevated blood potassium, and seizures.
19. Promethazine intake can increase the risk for skin rash and photosensitivity, in individuals exposed to sunlight. Individuals taking promethazine, especially those with history of photosensitivity, should avoid natural and bright lights or use sunscreens when getting out in the sun, to prevent any photosensitive responses from developing.
20. Continue taking promethazine as ordered, even if your symptoms are under control. Abrupt discontinuation on promethazine intake can result in precipitating the symptoms back again. Discontinuing the medication should only be on your physician’s recommendation.
21. If you miss a dose, try taking it at the earliest notice of noncompliance. If it is time for the next dose, skip the missed dose and take the dose scheduled. Do not take an extra dose to try making up for the missed dose. Notify your doctor and other health care personnel regarding your dose noncompliance.