Promethazine Uses & Alternatives: What Are Your Options?

Scott McDougall
Scott McDougallMPharmDirector & Registered Manager

Promethazine, often sold in treatments such as Phenergan, is a popular antihistamine medication with a broad range of effects. When used correctly, it’s a safe and effective choice for resolving issues like nausea and insomnia, but it’s not a suitable treatment option for everyone especially when taken in conjunction with certain other medications.

Due to this, we have listed viable alternatives for treating the issues that promethazine medications have so often been supplied for. If you've been advised not to use Phenergan or you’d simply rather find a non-drowsy solution, this article should give you the information you need.

In this piece, we’ll briefly run through the uses of promethazine, expand upon the potential risks, set out some strong options for proceeding without it, and explore why it’s so essential to get a comprehensive consultation before making a decision. Let’s get started.

What can promethazine treat?

Though it primarily serves to block histamine, a substance produced during allergic reactions, promethazine has also been observed to be effective at treating other issues. It’s a potent antiemetic drug, for instance (meaning it can reduce nausea and vomiting). Here are the core issues it’s most commonly used to treat:

Allergy symptoms

Allergic reactions typically yield various symptoms, some of which are also cold symptoms. Allergic rhinitis can lead you to develop a runny nose, start crying, suffer skin inflammation and itching, and deal with a stubborn cough. Taking promethazine can greatly reduce these issues, leading to much greater comfort.

Motion sickness

When people need to travel but suffer extensively from motion sickness (often encompassing nausea and vomiting), they can be prescribed a treatment like Phenergan. It’s typically taken in a larger dose a day ahead of a long trip or in a smaller dose an hour or two before a short trip.

Chemotherapy-induced nausea

Cancer sufferers who have to go through chemotherapy often experience nausea and vomiting, and promethazine products are prescribed to reduce it. They can be taken as tablets or prescribed as intravenous fluids when tablets aren’t viable (perhaps due to dry mouth, or even a need for IV rehydration).

Insomnia or sleep deprivation

Because promethazine has a strong sedative effect, it’s commonly used to treat insomnia or address sleep deprivation (particularly in those who are struggling to sleep because they’re preparing for or recovering from surgery).

Risks for those with mental health issues

As noted, promethazine can have more serious side effects if paired with certain other treatments, and this is largely due to its ability to induce drowsiness. Because it works as a sedative and can be prescribed to treat sleep issues, people may try it as a treatment for mental health issues such as anxiety, fear, or panic. Promethazine treatments are not licensed for use in treating such issues, and it is unlikely your healthcare provider will provide promethazine to address them.

If you’re suffering from anxiety, then, you mustn’t make the mistake of seeking promethazine on vaguely-related grounds (or, even worse, attempting to acquire it elsewhere). There are many other ways to treat mental health issues that help to resolve the conditions themselves. On that note, let’s get to the alternatives.

What can you use instead of promethazine?

Your alternatives to promethazine will of course depend on what issue you’re trying to resolve. Your first step should always be getting a full diagnosis from your GP or pharmacist, after which the nature of your problem should inform your search for a treatment.

  • If you want to treat allergy symptoms, there’s a huge range of treatments to choose from. There are nasal sprays, tablets, syrups and eye drops that can counteract symptoms of allergies and hay fever (you can view our treatments here). There are also other antihistamines that have minimal sedative properties, some of which are available to be sold as over-the-counter medications.
  • If you want to reduce or prevent nausea, it’s best to focus on the cause of nausea. Medication isn’t always the answer. For instance, it’s often possible to limit or prevent motion sickness by using a blindfold and/or making an effort to sleep through the journey. Alternatively, your diet may be causing you to feel sick, in which case you can change your eating habits accordingly. And if there’s a bigger underlying reason for nausea and vomiting, such as a significant stomach condition or a head injury, you should seek treatment for that issue: if it can’t be resolved quickly and the nausea lingers, your doctor will be able to prescribe you with a suitable alternative antiemetic for getting you through it.
  • If you want to get more or better sleep, you should first see what you can do to improve your sleep naturally. Anything from breathing problems to general anxiety can make it hard to get to sleep: you can find further information on your specific issue throughout the web, but it’s generally a good idea to work on your diet, get more exercise, practice mindfulness, and improve your sleep schedule.

Why it’s key to consult healthcare professionals

If you’re thinking about using promethazine, there are two big reasons why you should consult trustworthy healthcare professionals before seeking treatment.

Firstly, not all prescription services are equally discerning. If promethazine isn’t really the right choice for you, it can get in the way of more appropriate treatments, whether you’re dealing with nausea, allergies, sleep issues, anxiety, or something else entirely. Don’t take the risk of getting anything less than a proper diagnosis and treatment.

Secondly, you may be concerned about side effects, whether you’re intending to use it by itself or alongside another form of medication (which carries the biggest risk). The strong sedative effect makes promethazine something you mustn’t take lightly. The better you understand it before you think about using it, the safer you’ll be.

Need more assistance from a reliable healthcare provider? We’re happy to help. Get in touch to arrange a consultation and we’ll figure out the right treatment for you.

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