Safety and Monitoring of Promethazine‑Dextromethorphan in Patients with Bicuspid Aortic Valve

Epidemiology of Bicuspid Aortic Valve‑Related Aortopathy

• Approximately half of individuals with a bicuspid aortic valve exhibit dilation of the ascending aorta, reflecting a common aortopathy associated with this valve morphology. 1

Contraindications and Cautionary Guidance

• There is no specific contraindication for promethazine‑dextromethorphan solely based on bicuspid aortic valve anatomy; however, the presence of related cardiovascular conditions (e.g., aortopathy, valve dysfunction, prior arrhythmias) warrants heightened clinical vigilance when the drug is prescribed. 2

Monitoring Recommendations for Promethazine‑Dextromethorphan Use

• In patients with a bicuspid aortic valve who do not have significant valve dysfunction, standard cardiovascular monitoring (e.g., blood pressure and heart‑rate checks) should be performed as with any other patient receiving promethazine‑dextromethorphan. 1