Daily Bolus of LR: Black Box Warning on Promethazine
Leave a commentAugust 25, 2011 by dailybolusoflr
Promethazine (Phenergan)
· In 2009, a black box warning was issued by the FDA due to serious tissue injury that was caused by the drug when given in its injectable form
· Issues arose from high concentration, fast administration (these increase risk of extravasation) and use in peripheral lines that were mistakenly arterial or non-functioning and led to extravasation
· Patients experienced tissue damage, including gangrene and need for amputation
· The recommended route of administration for promethazine is deep tissue IM injection
· It is contraindictated to be given as a subcutaneous or known intra-arterial injection
· If a patient complains of pain or burning while this medication is being given, the infusion should be immediately stopped and the vein should be checked for integrity
· The drug comes in two concentrations: 25mg/mL and 50mg/mL
· The 50mg/mL concentration is NOT for peripheral vein use
· The maximum rate of infusion is 25mg/minute
http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm182498.htm