Promethazine Administration Guidelines

Risks and Contraindications

• Adverse reactions including burning, pain, thrombophlebitis, tissue necrosis, and gangrene can occur with inadvertent perivascular extravasation, unintentional intra-arterial injection, and intraneuronal or perineuronal infiltration 1

Pharmacokinetics and Administration Sites

• For anaphylaxis management, when epinephrine is administered intramuscularly, the anterolateral thigh (vastus lateralis) produces higher and more rapid peak plasma levels compared with injections administered intramuscularly or subcutaneously in the arm (deltoid) 2, 3, 4
• This pharmacokinetic principle may apply to other medications as well, suggesting potential absorption differences between deltoid and larger muscle groups 4