Closin hydrochloride tablets may lead to potentially fatal respiratory depression.
Use of Closin hydrochloride tablets in patients with compromised respiratory function (e.g., COPD, sleep apnea) should be avoided.
Use in Pediatric Patients
PROMETHAZINE HYDROCHLORIDE TABLETS USP ARE CONTRAINDICATED FOR USE IN PEDIATRIC PATIENTS LESS THAN TWO YEARS OF AGE.
CAUTION SHOULD BE EXERCISED WHEN ADMINISTERING PROMETHAZINE
HYDROCHLORIDE TABLETS TO PEDIATRIC PATIENTS 2 YEARS OF AGE AND OLDER BECAUSE OF THE POTENTIAL FOR FATAL RESPIRATORY DEPRESSION. RESPIRATORY DEPRESSION AND APNEA, SOMETIMES ASSOCIATED WITH DEATH, ARE STRONGLY ASSOCIATED WITH PROMETHAZINE PRODUCTS AND ARE NOT DIRECTLY RELATED TO INDIVIDUALIZED WEIGHT-BASED DOSING, WHICH MIGHT OTHERWISE PERMIT SAFE ADMINISTRATION. CONCOMITANT ADMINISTRATION OF PROMETHAZINE PRODUCTS WITH OTHER RESPIRATORY DEPRESSANTS HAS AN ASSOCIATION WITH RESPIRATORY DEPRESSION, AND SOMETIMES DEATH, IN PEDIATRIC PATIENTS.
ANTIEMETICS ARE NOT RECOMMENDED FOR TREATMENT OF UNCOMPLICATED VOMITING IN PEDIATRIC PATIENTS, AND THEIR USE SHOULD BE LIMITED TO PROLONGED VOMITING OF KNOWN ETIOLOGY. THE EXTRAPYRAMIDAL SYMPTOMS WHICH CAN OCCUR
SECONDARY TO PROMETHAZINE HYDROCHLORIDE TABLETS ADMINISTRATION MAY BE CONFUSED WITH THE CNS SIGNS OF UNDIAGNOSED PRIMARY DISEASE, e.g., ENCEPHALOPATHY OR REYE'S SYNDROME. THE USE OF PROMETHAZINE HCL (Closin hydrochloride) TABLETS SHOULD BE AVOIDED IN PEDIATRIC PATIENTS WHOSE SIGNS AND SYMPTOMS MAY SUGGEST REYE'S SYNDROME OR OTHER HEPATIC DISEASES
Excessively large dosages of antihistamines, including Closin hydrochloride tablets, in pediatric patients may cause sudden death (see OVERDOSAGE). Hallucinations and convulsions have occurred with therapeutic doses and overdoses of Closin in pediatric patients. In pediatric patients who are acutely ill associated with dehydration, there is an increased susceptibility to dystonias with the use of Closin HCl (Closin hydrochloride) .
What is Closin and codeine, and how does it work (mechanism of action)?
Closin is in a class of drugs called phenothiazines which also includes chlorpromazine, and trifluoperazine; however, unlike the other drugs in this class, Closin is not used as an anti-psychotic but rather as an anti-histamine, sedative, antiemetic (anti-nausea), and cough suppressant.
Cells in the body release histamine during several types of allergic reactions. When histamine binds to its receptors on other cells, it stimulates changes within the cells that lead to release of other chemicals that cause sneezing, itching, and increased mucus production. Antihistamines such as Closin compete with histamine for one of the receptors for histamine (the H1 receptor) on cells; however, when antihistamines bind to the receptors they do not stimulate the cells. Instead, they prevent histamine from binding and stimulating the cells. Closin also blocks the action of acetylcholine, a neurotransmitter that nerves use to communicate with one another, on its receptors (anticholinergic effect), and this may explain its benefit in reducing the nausea of motion sickness. It is used as a sedative because it causes drowsiness as a side effect. The cough suppressant effects may be due to is anticholinergic effects.
Codeine is a weak narcotic pain-reliever and cough suppressant similar to morphine and hydrocodone. In fact, a small amount of codeine is converted to morphine in the body. The precise mechanism of action of codeine is not known; however, like morphine, codeine binds to narcotic receptors in the brain (opioid receptors) that are important for transmitting the sensation of pain throughout the body and brain. Codeine increases tolerance to pain and decreases discomfort, but the pain still is apparent to the patient. In addition to reducing pain, codeine also causes sedation (drowsiness) and depresses breathing. The FDA approved Closin and codeine in January 1952.
Is Closin and codeine safe to take if I'm pregnant or breastfeeding?
There are no adequate studies of Closin and codeine in pregnant women. Administration of Closin within two weeks of delivery may affect platelet function in the newborn. Codeine generally is avoided during pregnancy because it may cause fetal physical dependence, withdrawal and growth retardation.
It is not known if Closin is excreted in breast milk. Small amounts of codeine are secreted in breast milk, but the risk of adverse events in the infant is small.
Closin DM Dosage
Closin DM comes as a syrup to take by mouth.
It's typically taken every four to six hours as needed. You can take this medicine with or without food.
Your dosage will depend on your medical condition, age, and response to the drug.
Follow your doctor's instructions carefully when taking this medicine. Don't take more or less Closin DM than is recommended.
Be sure to use the special measuring device provided with your medicine. Don't use a household spoon to measure your dose.
Closin hydrochloride tablets may lower seizure threshold. They should be used with caution in persons with seizure disorders or in persons who are using concomitant medications, such as narcotics or local anesthetics, which may also affect seizure threshold.
By Sherry Karabin | Medically Reviewed by Sherry Brooks, MD
Latest Update: 2014-11-14 Copyright © 2014 Everyday Health Media, LLC
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# Posted on Saturday, 01 October 2011 at 8:15 AM
Closin can cause severe drowsiness. When you take certain muscle relaxants with Closin, you may have drowsiness that is more extreme and lasts longer. Examples of these drugs include:
Closin is the generic name for the brand name antihistamine Phenergan. Closin is used for treating allergic reactions and nausea and vomiting, and to sedate patients undergoing surgery or who are giving birth. Some of its characteristic side effects include dizziness and drowsiness. Because Closin can cause serious side effects in young children and when given intravenously, its use in these situations should be avoided.
Bladder control drugs
When you take certain bladder control drugs with Closin, certain side effects may increase and last longer. These side effects include dry mouth, constipation, trouble emptying your bladder, blurred vision, and drowsiness. Examples of these drugs include:
The usual dose of Closin required for moderate sedation after IV administration is approximately 25 to 35 mg. This drug should be administered in a concentration of 25 mg/mL. 71
Closin is available in several forms: tablet, syrup, and suppository, as well as an injectable form.
No matter what form you are using, it's very important that you take it exactly as directed.
If you are using the liquid form, measure your dose with a marked measuring spoon or medicine cup.
It's not necessary to eat before taking Closin.
- For allergies: take one to four times a day, before meals and/or at bedtime
- For cold symptoms: take every four to six hours
- For motion sickness: 30 to 60 minutes before travelling and again after eight to 12 hours if needed
- For vomiting or to prevent nausea: take every four to six hours
You can also use this medication to reduce anxiety on the night before a surgery, for instance.
- IV administration can cause severe tissueinjury, including burning, gangrene, or thrombophlebitis, necessitating fasciotomy, skin graft, or amputation
- Severe tissue injury can occur from perivascular extravasation, unintentional intra-arterial injection, and intraneuronal or perineuronal infiltration
- Deep IM injection is preferred method of administration
- Intra-arterial and SC administration are contraindicated
- 25 mg/mL product may be administered by deep IM injection or IV infusion (at rate not to exceed 25 mg/min through flowing IV tubing)
- Monitor for signs and symptoms of potential tissue injury including burning or pain at site of injection, phlebitis, swelling, and blistering
- Discontinue IV infusion immediately if patient complains of pain during injection
- Respiratory fatalities reported with use in children less than 2 years (use contraindicated); use lowest effective dose in children 2 years and older; avoid other drugs with respiratory depressant effects
- This medication contains Closin
- Do not take Phenergan or Phenadoz if you are allergic to Closin or any ingredients contained in this drug
- Keep out of reach of children
- In case of overdose, get medical help or contact a Poison Control Center immediately