By Julie Botsford, PharmD, Medication Safety Officer; Butch Bowlby, RPh, MS, Director of Pharmacy; Cathi Cornelius, PharmD, BCPS, Utilization Pharmacy Specialist
Injectable Promethazine has been approved for removal from the Munson Healthcare (MHC) system formulary by the MHC Pharmacy and Therapeutics Committee. This action is the result of many years of discussion and work related to the Institute of Safe Medication Practices (ISMP) Hospital Best Practices which urges the removal of this formulation from hospitals and clinics nation-wide. The rationale is based on repeated serious patient harm across the country that has occurred from inadvertent arterial injection or intravenous extravasation.
MHC has had several reported adverse events related to injectable promethazine over the years, including extravasation. During routine audits, it has been found that instances of small hand/wrist veins have been used despite use of warnings.
A comprehensive reference document has been created to assist providers with safe and effective alternatives for nausea and vomiting treatment (Acute Nausea/Vomiting Medications, 3/2022).
References: ISMP Targeted Medication Safety Best Practices for Hospitals 2022-2023.