Avomine

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When promethazine is the right antiemetic

Promethazine is the go-to drug for motion sickness — sea, air, car, and amusement-park motion. It is also effective for vestibular vertigo (acute labyrinthitis, vestibular neuritis, Meniere’s acute attacks), and as a sedating adjunct in allergic reactions or anxiety-related nausea. It is not first-line for chemotherapy-induced nausea (use ondansetron/granisetron instead) and not first-line for nausea-vomiting of pregnancy in most modern guidelines (NVP first-line is doxylamine+B6 — Doxinate, Pregnidoxin NU). Some jurisdictions still use promethazine for hyperemesis gravidarum after first-line failure.

Γιατί να παραγγείλετε από τη MedsBase

Avomine is supplied from a πιστοποιημένο από τη WHO-GMP κατασκευαστή. Every order ships discreetly worldwide and is covered by our Πολιτική Εγγύησης Επαναποστολής — if it does not arrive within 20 business days, we reship at no cost. Promethazine has been the global standard for motion sickness for decades and remains a useful sedating antiemetic when histaminergic/cholinergic vestibular nausea is the dominant problem.

Μηχανισμός δράσης

Promethazine is a phenothiazine-derived antihistamine. It blocks H1 histamine receptors (the antihistamine effect that reduces motion-induced vestibular signalling and gives sedation), muscarinic acetylcholine receptors (the anticholinergic effect that further suppresses vestibular and gut motility-driven emesis), and D2 dopamine receptors (a mild antiemetic effect at the chemoreceptor trigger zone). The unique value of promethazine in motion sickness is the combined H1 + anticholinergic blockade — the vestibular system depends on both pathways. The same combined blockade also explains its strong sedative and dry-mouth profile.

Ενδείξεις

• Motion sickness: sea, air, car, train; especially when other agents (cinnarizine, hyoscine patch) have failed or are unavailable.
• Vestibular vertigo: acute labyrinthitis, vestibular neuritis, Meniere’s acute attacks.
• Allergic reactions (urticaria, hay fever) where sedation is helpful or non-sedating antihistamines have failed.
• Pre-medication for anaesthesia (sedation + antiemetic + drying of secretions).
• Insomnia short-term occasional use.
• Hyperemesis gravidarum (jurisdiction-dependent, after first-line doxylamine+B6 failure).

Δόση

Παρενέργειες

• Πολύ συχνές: sedation, dry mouth, blurred vision, urinary hesitancy, constipation
• Συχνές: dizziness, hypotension on standing, palpitation, mild confusion (especially older adults)
• Λιγότερο συχνές: photosensitivity, rash, paradoxical excitation in children, extrapyramidal reactions (low frequency vs other phenothiazines)
• Σπάνιες αλλά σοβαρές: agranulocytosis, neuroleptic malignant syndrome (very rare), severe respiratory depression in young children, seizures in overdose

Αλληλεπιδράσεις φαρμάκων

• CNS depressants (alcohol, opioids, benzodiazepines, gabapentinoids, sleep medication): additive sedation and respiratory depression — avoid combination.
• Anticholinergics (TCAs, oxybutynin, atropine, hyoscine patch, antipsychotics): additive dry mouth, urinary retention, cognitive impairment — especially in older adults.
• MAO inhibitors: may prolong and intensify sedation — avoid combination.
• Adrenaline (epinephrine): promethazine may reverse the pressor effect (use noradrenaline if vasopressor needed during anaphylaxis on promethazine).
• Pregnancy test interference: may cause false positive/negative immunological pregnancy tests.

Συχνές Ερωτήσεις

How long before travel should I take Avomine?

For best motion-sickness protection, take 25 mg the night before travel and a second 25 mg dose 1–2 hours before departure. Once the journey is underway and you are already nauseated, prevention is much harder — take the dose proactively.

Will Avomine make me sleepy?

Yes — pronounced drowsiness is the dominant side effect. Do not drive, fly an aircraft, scuba dive, or operate machinery for 24 hours after a dose. Many users find this useful for long-haul flights but it is dangerous before active tasks.

Can Avomine be used in pregnancy?

Promethazine has been used historically for hyperemesis gravidarum but is no longer first-line in most modern guidelines. First-line for nausea-vomiting of pregnancy (NVP) is doxylamine + B6 (Doxinate, Pregnidoxin NU); ondansetron, metoclopramide, and promethazine are reserved for refractory cases under specialist supervision.

Can children take Avomine?

Children under 2 years must NOT take promethazine — risk of fatal respiratory depression. For ages 2–5 use only if essential under medical supervision. Standard motion-sickness dosing starts from age 5 with 12.5 mg the night before and morning of travel.

What is the difference between Avomine and ondansetron?

Avomine is a sedating H1 antihistamine + anticholinergic — ideal for motion sickness and vestibular vertigo where the histaminergic and cholinergic pathways are dominant. Ondansetron is a 5-HT3 antagonist — ideal for chemo, radiation, surgery, severe gastroenteritis where the serotonin pathway is dominant. They are not interchangeable.

Is Avomine addictive?

No, promethazine is not a controlled substance and does not cause physical dependence. However, the strong sedation makes it occasionally misused for sleep or to potentiate opioids — the latter is dangerous because of respiratory depression.

Can I drink alcohol with Avomine?

No — combination causes profound sedation and respiratory depression. Avoid alcohol, sleeping pills, and opioids while on promethazine.

What if I forget a dose?

Promethazine is usually used for prevention — take the next dose at the next planned time. If you miss the pre-travel dose, taking it once travel-induced nausea has already started is less effective; an ODT 5-HT3 (Ondem MD) or a cinnarizine alternative may give better breakthrough control.

How does Avomine differ from cinnarizine and meclozine?

All three are anti-vertigo/motion-sickness antihistamines. Cinnarizine has additional calcium-channel blocking action (useful in Meniere’s) and is less sedating. Meclozine is intermediate — less sedating than promethazine, longer-acting than cinnarizine. Promethazine is the most strongly sedating and is preferred when sedation is a benefit (long flights, severe vertigo).

How is Avomine stored?

Store tablets at room temperature (below 25°C), protected from light and moisture. Keep out of reach of children — accidental paediatric ingestion can cause severe respiratory depression.

Other Nausea Treatments

• Stemetil MD (prochlorperazine — vestibular nausea ODT)
• Dompewal (domperidone — gastric-emptying nausea)
• Ondem (ondansetron — chemo/PONV)
• Doxinate (doxylamine + B6 — pregnancy nausea)
• Metopar (paracetamol + metoclopramide — migraine nausea)
• Browse all Nausea Treatments

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