Editing Promethazine (section)

==Side effects==
Some documented [[Adverse effect (medicine)|side effects]] include:

* [[Tardive dyskinesia]], pseudoparkinsonism, acute dystonia (effects due to dopamine D2 receptor antagonism)<ref name=Promethazinestats/>
* Confusion in the elderly<ref name=Promethazinestats/>
* Drowsiness, dizziness, fatigue, more rarely [[Vertigo (medical)|vertigo]]
* Known to have effects on [[serotonin]] and dopamine receptors.<ref name="pmid28767476">{{cite journal | vauthors = Schreiner NM, Windham S, Barker A | title = Atypical Neuroleptic Malignant Syndrome: Diagnosis and Proposal for an Expanded Treatment Algorithm: A Case Report | journal = A&A Case Reports | volume = 9 | issue = 12 | pages = 339–343 | date = December 2017 | pmid = 28767476 | doi = 10.1213/XAA.0000000000000610 | s2cid = 39699580 }}</ref>
* Dry mouth<ref name=Promethazinestats/>
* Nausea<ref>[https://bnf.nice.org.uk/drug/promethazine-hydrochloride.html National Institute for Health and Care Excellence]</ref>
* [[Hypoventilation|Respiratory depression]] in patients under the age of two and those with severely compromised pulmonary function<ref>{{Cite journal| vauthors = Hampton T |date=23 February 2005|title=Promethazine Warning|url=https://jamanetwork.com/journals/jama/article-abstract/200400|journal=JAMA|volume=293|issue=8|page=921|doi=10.1001/jama.293.8.921-c|url-access=subscription}}</ref>
* Blurred vision, xerostomia, dry nasal passages, dilated pupils, constipation, and urinary retention. (due to its anticholinergic effects)<ref name=Promethazinestats/>
* Chest discomfort/pressure (In children less than 2 years old)<ref name=Promethazinestats/>
* [[Akathisia]]<ref>{{Cite web |url=http://www.cordingleyneurology.com/restless.html |title=Cordingley Neurology |access-date=15 February 2008 |archive-date=21 December 2016 |archive-url=https://web.archive.org/web/20161221215517/http://cordingleyneurology.com/restless.html |url-status=usurped }}</ref>

Less frequent:

* Cardiovascular side effects to include arrhythmias and hypotension<ref name=Promethazinestats/>
* [[Neuroleptic malignant syndrome]]<ref name=Promethazinestats/>
* Liver damage and cholestatic jaundice<ref name=Promethazinestats/>
* Bone marrow suppression, potentially resulting in agranulocytosis, thrombocytopenia, and leukopenia<ref name=Promethazinestats/>
* Depression of the thermoregulatory mechanism resulting in hypothermia/hyperthermia<ref name=Promethazinestats/>

Rare side effects include:

* [[Seizures]]<ref name=Promethazinestats/>

Because of the potential for more severe side effects, this drug is on the list to avoid in the elderly.<ref>NCQA's HEDIS Measure: [http://www.ncqa.org/Portals/0/Newsroom/SOHC/Drugs_Avoided_Elderly.pdf Use of High Risk Medications in the Elderly] {{webarchive|url=https://web.archive.org/web/20100201113909/http://www.ncqa.org/Portals/0/Newsroom/SOHC/Drugs_Avoided_Elderly.pdf |date=1 February 2010 }}</ref>  In many countries (including the US and UK), promethazine is contraindicated in children less than two years of age, and strongly cautioned against in children between two and six, due to problems with respiratory depression and sleep apnea.<ref>{{cite journal |vauthors=Starke P, Weaver J, Chowdhury B | year = 2005 | title = Boxed warning added to promethazine labeling for pediatric use | journal = N. Engl. J. Med. | volume = 352 | issue = 5| page = 2653 | doi=10.1056/nejm200506233522522| pmid = 15972879 | doi-access = free }}</ref>

Promethazine is listed as one of the drugs with the highest anticholinergic activity in a study of anticholinergic burden, including long-term cognitive impairment.<ref>{{cite journal | vauthors = Salahudeen MS, Duffull SB, Nishtala PS | title = Anticholinergic burden quantified by anticholinergic risk scales and adverse outcomes in older people: a systematic review | journal = BMC Geriatrics | volume = 15 | issue = 31 | pages = 31 | date = March 2015 | pmid = 25879993 | pmc = 4377853 | doi = 10.1186/s12877-015-0029-9 | doi-access = free }}</ref>