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Promethazine for Insomnia

                                        
               Patient Information               
 
Promethazine is an antihistamine medicine that relieves the symptoms of allergies e.g. hay fever, hives
(urticaria) and rashes. It is also used to treat or stop you feeling sick due to motion sickness or vertigo. You 
can buy promethazine from community pharmacies, where it is often sold by the brand names Avomine®, 
Phenergan® or Sominex®.
 
Promethazine blocks a chemical in your body called acetylcholine and is an anticholinergic drug. In the last
few years studies have suggested that older adults who use anticholinergic medications for a long time, or at
higher doses, may have a higher risk of dementia. Research has not proven that anticholinergic drugs cause 
dementia, but it does suggest that older adults should limit the number of anticholinergic medications they 
take and use the lowest dose for the shortest length of time.  
(Click here for further information about anticholinergic medicines)
 
When you take an anticholinergic medication, it can act on many different parts of your body at the same
time causing side effects such as drowsiness, confusion, dry eyes, dry mouth, flushing and constipation.  
Because of these side effects, promethazine has a licence for the short-term treatment use only and national 
guidelines state that it 'less suitable for prescribing' to aid sleep and should not be prescribed as a hypnotic  or sleeping tablet.  Local guidelines also state that the use of a hypnotic should be avoided but if needed then 'use for 1-3 days only'.
 

In line with the above guidance, GP practices across Blackburn with Darwen and East Lancashire are currently reviewing patients prescribed promethazine tablets for insomnia and will be stopping prescribing for this indication.

Some patients, who have been taking promethazine on a regular basis, may benefit from stopping gradually and it is therefore recommended that you wean down your dose of promethazine by taking your tablet on alternate days for 4 weeks and then to stop it completely.

The NHS does not support repeat prescribing of sleeping tablets. Your GP practice will therefore now remove your promethazine tablets from your prescription.

There are other ways to improve your sleep. Please click on the link for more information.  

https://www.nhs.uk/every-mind-matters/mental-health-issues/sleep/
 
 
References
https://www.nhs.uk/medicines/promethazine/
https://bnf.nice.org.uk/treatment-summaries/hypnotics-and-anxiolytics/
https://www.elmmb.nhs.uk/elmmb-formulary/joint-medicines-formulary/4/4-1/
https://www.elmmb.nhs.uk/specialist-formulary/black-traffic-light-drugs-not-recommended-for-use/