Promethazine Dosage for a 6-Year-Old Child
Promethazine is contraindicated in children under 2 years of age, and for children 6 years old, the recommended dose for nausea and vomiting is 0.5 mg per pound of body weight (approximately 0.5-1 mg/kg), adjusted to the child's age, weight, and condition severity. 1
Dosing Guidelines for 6-Year-Old Children
- For nausea and vomiting: 0.5 mg per pound of body weight, with doses repeated as necessary at 4-6 hour intervals 1
- For allergy symptoms: 12.5 mg taken before meals and at bedtime, or 12.5-25 mg twice daily 1
- For motion sickness: 12.5-25 mg twice daily 1
- For sedation: 12.5-25 mg at bedtime 1
Safety Considerations
Promethazine carries significant risks in pediatric patients, including:
If dystonic reactions occur, they can be managed with diphenhydramine (1-2 mg/kg or 25-50 mg/dose parenterally) 4
Administration Recommendations
- Oral administration is preferred for children 1
- The medication should be dosed based on the specific indication and adjusted according to the child's response 1
- Avoid combining with other sedative medications due to increased risk of respiratory depression 3
Important Warnings
- Promethazine should not be used for vomiting of unknown etiology in children and adolescents 1
- The anticholinergic effects may cause dry mouth, urinary retention, and cognitive impairment 2
- First-generation antihistamines like promethazine have more sedative effects than second-generation alternatives 2
- There has been an increase in promethazine misuse/abuse cases, requiring vigilance when prescribing 5
Alternative Considerations
- Second-generation antihistamines may be preferable for allergy symptoms due to less sedation 2
- For nausea and vomiting, consider other antiemetics with fewer sedative properties if appropriate for the clinical situation 6
Always monitor the child closely after administration for adverse effects, particularly excessive sedation or respiratory depression.