Prohist is a phenothiazine and a low-potency neuroleptic with sedating action. During pregnancy Prohist is used for its antiemetic action. There are published results on several hundred pregnancies with Prohist (e.g. Bartfai 2008 , Diav-Citrin 2003 ). In an intriguing design for toxicity analysis, Petik (2008) looked at women who attempted suicide by Prohist overdose in the first trimester and found no increased risk for birth defects or preterm birth. There was also no difference in birth weight between exposed children and their siblings. Mean intelligence quotient was not reduced and the rate of behavioral problems was not increased in the exposed children.
Bladder control drugs
When you take certain bladder control drugs with Prohist, 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:
How Is Prohist Administered?
Prohist can be administered by mouth in solid (tablet) or liquid (solution or syrup) form, by injection (intravenously or intramuscularly), or into the rectum in the form of a suppository. When taking liquid Prohist, patients should use a measuring spoon or cup made specifically for measuring medications, and not a household spoon. The suppository can only be inserted through the rectum (lower part of the large intestine through the anus), and should not be swallowed.
Prior to removing the wrapper, if a suppository feels soft, the patient should first hold it under cold, running water for one minute. After removing the wrapper, the tip of the suppository should be dipped in water prior to insertion, using the finger. In adults, the suppository should be inserted into the rectum by one inch and by about one-half to one inch in children 2 and older.
Since Prohist administered intravenously can cause severe chemical irritation and damage to tissues, deep intramuscular injection is the preferred method of injection.
Subcutaneous injection is also not advised because it may result in chemical irritation and damage to tissues, including necrosis.
For children 2 years of age through adolescence, the recommended oral dose of Prohist is 1.1 mg/kg/dose PO. 40 The oral dosage of Prohist, as recommended in pediatric dentistry, is found in Table 35.4 .
Table 35.4 . Dose of Prohist
Prohist is a prescription drug. It comes as an oral tablet, an oral solution, an injectable solution, and a rectal suppository.
Prohist oral tablet is only available as a generic drug. Generic drugs usually cost less than brand-name versions.
What Is Prohist and How Does It Work?
Prohist is used to prevent and treat nausea and vomiting related to certain conditions (such as motion sickness, or before/after surgery). It is also used to treat allergy symptoms such as rash, itching, and runny nose. It may be used to help you feel sleepy/relaxed before and after surgery or to help certain narcotic pain relievers (such as meperidine) work better. The suppository form is used when medications cannot be taken by mouth.
Prohist is an antihistamine and works by blocking a certain natural substance (histamine) that your body makes during an allergic reaction. Its other effects (such as anti-nausea, calming, pain relief) may work by affecting other natural substances (such as acetylcholine) and by acting directly on certain parts of the brain.
Prohist is available under the following different brand names: Phenergan, and Phenadoz.
Dosage of Prohist:
Adult Dosage Forms and Strengths
Dosing Consideraations – Should be Given as Follows:
- Taken orally or rectally: 25 mg at bedtime or 12.5 mg before meals and at bedtime (dosage range, 6.25-12.5 mg once every 8 hours)
- Intravenously (IV)/intramuscularly (IM): 25 mg; may be repeated in 2 hours when necessary; switch to oral dosing as soon as possible
Nausea and Vomiting
- Taken orally or rectally: 12.5-25 mg once every 4-6 hours as needed
- Intravenously (IV)/intramuscularly (IM): 12.5-25 mg once every 4-6 hours as needed
- 25 mg taken orally or rectally 30-60 minutes before departure and once every 8-12 hours as needed; on succeeding travel days, 25 mg orally or rectally every morning and every evening
- 50 mg taken orally or rectally on night before procedure or 25-50 mg intravenously (IV)/intramuscularly (IM) combined with reduced doses of analgesics and atropine-like drugs
- 25-50 mg intravenously/intramuscularly/orally/rectally combined with reduced doses of analgesics and atropine-like drugs
- 25-50 mg intravenously (IV)/intramuscularly (IM) in early labor; may be increased to 25-75 mg once every 2-4 hours after labor established; not to exceed two doses or up to 100 mg/day during labor
Allergic Conditions (Off-label)
- Children under 2 years old: Contraindicated
- Children 2 years and older: 25 mg taken orally or rectally at bedtime or 12.5 mg once every 6 hours; alternatively, 6.25-12.5 mg orally/rectally once every 8 hours
- Children under 2 years old: Contraindicated
- Children 2 years and older: 0.25-1 mg/kg orally/rectally once every 4-6 hours as needed; not to exceed 25 mg
- Children under 2 years: Contraindicated
- Children 2 years and older: 12.5-25 mg orally/rectally administered 30-60 minutes before departure and once every 8-12 hours as needed or 0.5 mg/kg orally once every 12 hours as needed
- Succeeding days of travel: 12.5-25 mg twice daily (upon arising or before evening meals)
- Children under 2 years: Contraindicated
- Children 2 years and older: 12.5-25 mg orally/intramuscularly/rectally at bedtime
- Children under 2 years: Contraindicated
- Children 2 years and older: 1 mg/kg orally or rectally with reduced dose of analgesic and appropriate dose of atropine-like drug
- Children under 2 years: Contraindicated
- Children 2 years and older: 12.5-25 mg with reduced dose of analgesic and appropriate dose of atropine-like drug
How it works
Prohist belongs to a class of drugs called phenothiazines. A class of drugs is a group of medications that work in a similar way. These drugs are often used to treat similar conditions.
Prohist works by preventing the release of a substance called histamine from certain cells in your body. Histamine is normally released when you’re exposed to things you’re allergic to, such as pollen, dander, mold, or chemicals.
By preventing the release of histamine, this drug causes sleepiness and helps with pain control. This is because histamine helps regulate wakefulness and helps to keep you alert and your senses heightened.
This drug also works to reduce stimulation of the part of your brain that sends signals to make you vomit.
This drug can cause extreme drowsiness. It can also cause other side effects.
Before taking Prohist,
- tell your doctor and pharmacist if you are allergic to Prohist, other phenothiazines (certain medications used to treat mental illness, nausea, vomiting, severe hiccups, and other conditions) or any other medications. Also tell your doctor and pharmacist if you have ever had an unusual or unexpected reaction when you took Prohist, another phenothiazine, or any other medication. Ask your doctor or pharmacist if you do not know if a medication you are allergic to is a phenothiazine.
- tell your doctor and pharmacist what prescription and nonprescription medications, vitamins, nutritional supplements and herbal products you are taking or plan to take. Be sure to mention any of the following: antidepressants ('mood elevators') such as amitriptyline (Elavil), amoxapine (Asendin), clomipramine (Anafranil), desipramine (Norpramin), doxepin (Adapin, Sinequan), imipramine (Tofranil), nortriptyline (Aventyl, Pamelor), protriptyline (Vivactil), and trimipramine (Surmontil); antihistamines; azathioprine (Imuran);barbiturates such as phenobarbital (Luminal); cancer chemotherapy; epinephrine (Epipen); ipratropium (Atrovent)medications for anxiety, irritable bowel disease, mental illness, motion sickness, Parkinson's disease, seizures, ulcers, or urinary problems; monoamine oxidase (MAO) inhibitors such as isocarboxazid (Marplan), phenelzine (Nardil), tranylcypromine (Parnate), and selegiline (Eldepryl, Emsam, Zelapar); narcotics and other pain medication; sedatives; sleeping pills;and tranquilizers. Your doctor may need to change the doses of your medications or monitor you carefully for side effects.
- tell your doctor if you have or have ever had an enlarged prostate (a male reproductive gland); glaucoma (a condition in which increased pressure in the eye can lead to gradual loss of vision); seizures; ulcers; blockage in the passage between the stomach and intestine; blockage in the bladder; asthma or other lung disease; sleep apnea; cancer;any condition that affects the production of blood cells in your bone marrow; or heart or liver disease. If you will be giving Prohist to a child, also tell the child's doctor if the child has any of the following symptoms before he or she receives the medication: vomiting, listlessness, drowsiness, confusion, aggression, seizures, yellowing of the skin or eyes, weakness, or flu-like symptoms. Also tell the child's doctor if the child has not been drinking normally, has had excessive vomiting or diarrhea, or appears dehydrated.
- tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. If you become pregnant while taking Prohist, call your doctor.
- talk to your doctor about the risks and benefits of taking Prohist if you are 65 years of age or older. Older adults should not usually take Prohist because it is not as safe as other medications that can be used to treat the same conditions.
- if you are having surgery, including dental surgery, tell the doctor or dentist that you are taking Prohist.
- you should know that this medication may make you drowsy. Do not drive a car or operate machinery until you know how this medication affects you. If you are giving Prohist to a child, watch the child to be sure he or she does not get hurt while riding a bike or participating in other activities that could be dangerous.
- ask your doctor about the safe use of alcohol while you are taking this medication. Alcohol can make the side effects of Prohist worse.
- plan to avoid unnecessary or prolonged exposure to sunlight and to wear protective clothing, sunglasses, and sunscreen. Prohist may make your skin sensitive to sunlight.
CNS Depressants- Prohist hydrochloride tablets may increase, prolong, or intensify the sedative action of other central-nervous-system depressants, such as alcohol, sedatives/hypnotics (including barbiturates), narcotics, narcotic analgesics, general anesthetics, tricyclic anti-depressants, and tranquilizers; therefore, such agents should be avoided or administered in reduced dosage to patients receiving Prohist HCl. When given concomitantly with Prohist hydrochloride tablets, the dose of barbiturates should be reduced by at least one-half, and the dose of narcotics should be reduced by one-quarter to one-half. Dosage must be individualized. Excessive amounts of Prohist HCl (Prohist hydrochloride) relative to a narcotic may lead to restlessness and motor hyperactivity in the patient with pain; these symptoms usually disappear with adequate control of the pain.
Epinephrine- Because of the potential for Prohist to reverse epinephrine's vasopressor effect, epinephrine should NOT be used to treat hypotension associated with Prohist hydrochloride tablets overdose.
Anticholinergics- Concomitant use of other agents with anticholinergic properties should be undertaken with caution. Monoamine Oxidase Inhibitors (MAOI) - Drug interactions, including an increased incidence of extrapyramidal effects, have been reported when some MAOI and phenothiazines are used concomitantly. This possibility should be considered with Prohist hydrochloride tablets.
What causes vaginal odour after sex?
Can you lower cholesterol through diet alone?
Quiz: Am I pregnant?
Gallstones diet sheet
When it feels like something is stuck in your throat
This is what cold weather does to your heart
How to support someone through a panic attack
What to do if you're struggling with your mental health at Christmas
When should you worry about neck pain?
Quiz: When will I get my first period?
Quiz: Am I depressed?
The best way to treat a herpes outbreak
When to worry about spots on the penis
Quiz: Do I have diabetes?
What causes head pressure and brain fog?
Meningitis symptoms checklist
What causes extremely smelly farts?
Quiz: Do I have OCD?
Should you worry about pelvic pain in pregnancy?
Why you constantly need to pee
What causes a musty smell in the nose?
What causes a lump on the tongue?
Symptoms you need to stop hiding from your doctor
How to have a healthy Christmas party
How to drink sensibly over the festive season
What your constant yawning could mean
Gout diet sheet
The respiratory system
Oesophageal reflux diet sheet
It is used to prevent (or treat) feelings of sickness (nausea). It is commonly recommended for sickness associated with travel and for vertigo.
It is also used to relieve allergies such as hay fever and allergic skin rashes.
Prohist also makes you feel sleepy (has a sedative effect). It may be taken (for a few days only) to help promote sleep in adults with sleeping problems. It has been popular in the past as a means of 'settling' children, but Prohist should not be used in this way.
Prohist is available on prescription, or you can buy it without a prescription at pharmacies. It is not suitable for children under 2 years of age.
Prohist is a phenothiazine derivative first-generation H 1 receptor antagonist but is also an antagonist at muscarinic (M1) and dopamine (D2) receptors. Adverse effects associated with therapeutic use of Prohist include dystonic reactions, psychosis in the absence of other anticholinergic symptoms or signs, and neuroleptic malignant syndrome. The principal effects of Prohist overdose are central nervous system depression and anticholinergic effects, including delirium, agitation, and hallucinations. In an analysis of a series of cases of Prohist overdose in a prospective database of poisoning admissions to an Australian regional toxicology service, the main feature of Prohist toxicity was delirium, the probability of which was related to dose . Administration of activated charcoal reduced the probability of delirium.
The FDA has issued a black-box warning about the use of Prohist hydrochloride in children younger than 2 years because the drug could lead to severe or fatal breathing problems.
Never use Prohist if you are allergic to it or any similar drugs, including:
- Chlorpromazine (Thorazine)
- Fluphenazine (Prolixin)
- Mesoridazine (Serentil)
- Perphenazine (Trilafon)
- Prochlorperazine (Compazine)
- Thioridazine (Mellaril)
- Trifluperazine (Stelazine)
Let your doctor know right away if you have unusual or unexpected side effects to this medication.
Prohist may lead to impaired thinking or reaction time. Drinking alcohol could increase the side effects of this medication.
It's also possible that serious side effects might result. If you notice twitching, uncontrollable eye movements or uncontrollable movements of your lips, tongue, face, arms, or legs, call your doctor at once.
Let your doctor know if you have or have ever had any conditions that affect the production of blood cells in your bone marrow. It's also important to alert your healthcare provider of the following conditions:
- An enlarged prostate gland
- Blockage in the passageway between your stomach and intestines
- Blockage in your bladder
- Asthma or other lung diseases
- Sleep apnea
- Heart disease
- Liver disease
If you are planning to give Prohist to your child, it's important that you discuss your child's medical history with his/her doctor, listing problems that include vomiting, flu-like symptoms, weakness, listlessness, drowsiness, confusion, aggression, seizures, and yellowing of the skin or eyes.
Tell your pediatrician if your child isn't drinking normally, appears dehydrated, or has excessive diarrhea or vomiting.
If you are 65 or older, Prohist may not be the safest treatment option for your conditions. Talk to your doctor about other drugs that might be safer.
If you are planning to have any type of surgery, including dental, make sure the physician knows you are using Prohist hydrochloride in advance.
Purple Drank SIzzurp
The misuse of a liquid syrup combination of Prohist hydrochloride and codeine (an opioid pain reliever), indicated to treat common cold symptoms and cough, has become “increasingly popular among youth in several areas of the country,” according to the National Institute on Drug Abuse. The syrup may be mixed with alcohol or flavored sodas and consumed for its mind-altering or mood-boosting effects, and may be referred to as “purple drank” or “sizzurp”.
The prescription cough syrup has been known to sell on the streets for upwards of $1,000, with one brand (that the company stopped distributing in 2014) selling for as much as $3,000, Bloomberg said in 2017.
“It’s the caviar of drugs,” said Ronald Peters, a retired professor of behavioral sciences at the University of Texas Health Science Center in Houston.
It was reported that Prohist codeine syrup was prescribed about 4 million times in the U.S. in 2016, bringing in about $15 million in sales.
The U.S. Department of Health and Human Services reported that 11,000 emergency room visits occurred in the United States in 2011 (the most recent year for which data is available) as the result of codeine misuse. The boxed warning in the label of Prohist/codeine syrup now includes a warning regarding the risk for abuse, misuse, and addiction.