Promethazine Hydrochloride side effects: what 18,469 FDA adverse event reports show
Drug class
Not stated in label
Who reports
18,469 reports · 72% serious · 1,793 with death outcome · 75% female
Used for
Promethazine hydrochloride tablets, USP are useful for: Perennial and seasonal allergic rhinitis. Vasomotor rhinitis. Allergic conjunctivitis due to inhalant allergens and foods. Mild, uncomplicated allergic skin manifestations of urticaria and angioedema. Amelioration of allergic reactions to blood or plasma. Dermographism.
What it is
DESCRIPTION Each 12.5 mg promethazine hydrochloride tablet for oral administration contains 12.5 mg promethazine hydrochloride. Each 25 mg promethazine hydrochloride tablet for oral administration contains 25 mg promethazine hydrochloride.
Boxed warning
None in the current label
Causality screen of the 40 strongest signals
What the badges mean
- Likely indication confounding The term appears in the label's indications: reports probably describe the disease being treated (or its progression), not a drug effect. Classic confounding by indication.
- Reporting / coding artifact An administrative, monitoring or exposure term (product issue, off-label use, 'test normal', overdose...). Not a biological reaction; a high PRR here reflects how reports are coded.
- Lab value / disease marker A laboratory result, investigation or disease-activity marker (antibody positive, CRP abnormal, swollen joint count) not described in the label. These usually mirror the monitored disease or testing protocol rather than a drug effect; not screened further.
- Not in label — unassessed Not found in the label text, not an artifact pattern. This is a genuine candidate for a formal causality assessment (Bradford Hill / WHO-UMC); it has NOT had one here.
Strongest disproportionality signals
Flagged terms (PRR ≥ 2, χ² ≥ 4, n ≥ 10), ranked by PRR; infinite PRRs (no comparator reports) excluded. The EBGM column is a second, shrinkage-based estimate (MGPS) with its 5th percentile EB05 and the BCPNN IC025; a pair flagged by PRR alone is marked PRR-only and should be read as fragile. The strata column recomputes the PRR on serious reports only (and, for the 300 most-reported drugs, adjusted for age band), and flags pairs whose reports are unusually skewed by sex or come mostly from consumers. Each row also shows the PRR against the other drugs of the same FDA class, which removes most confounding by the condition being treated, and a calibrated p-value: on validation, known non-causes average an ROR of about 2, so significance is judged against that empirical null (✓ = p < 0.05 after calibration). 1,141 further terms are in the interactive explorer. Reaction links open the term's cross-drug page.
| Reaction | Reports | PRR 95% CI · ROR · χ²/p | EBGM EB05 · IC025 | Label screen | Serious-only & strata | Trial cross-check |
|---|---|---|---|---|---|---|
| Human rhinovirus test positive | 56 | 200.9 151.2–266.9ROR 201.5 · calibrated p 8e-10 ✓ | 161.2 EB05 128.8 · IC025 +5.6 3/3 methods agree | Lab value / disease marker | serious n=56 · ♀ 100% (drug 75%) | no trial arm names this drug |
| Viral test positive | 38 | 131.3 93.8–183.6ROR 131.5 · calibrated p 3e-8 ✓ | 111.1 EB05 84.5 · IC025 +5.0 3/3 methods agree | Lab value / disease marker | serious n=38 · ♀ 100% (drug 75%) · 100% clinician | no trial arm names this drug |
| Pneumonia haemophilus | 50 | 129.8 96.9–173.9ROR 130.2 · calibrated p 3e-8 ✓ | 111.6 EB05 87.9 · IC025 +5.3 3/3 methods agree | Not in label — unassessed | serious n=50 · ♀ 100% (drug 75%) | no trial arm names this drug |
| Respiratory syncytial virus test positive | 57 | 99.8 76.2–130.8ROR 100.1 · calibrated p 2e-7 ✓ | 89.1 EB05 71.3 · IC025 +5.2 3/3 methods agree | Lab value / disease marker | serious n=57 · ♀ 100% (drug 75%) | no trial arm names this drug |
| Autoscopy | 26 | 57.8 39.0–85.8ROR 57.9 · calibrated p 1e-5 ✓ | 53.0 EB05 38.0 · IC025 +4.1 3/3 methods agree | Not in label — unassessed | serious n=26 · ♀ 0% (drug 75%) | no trial arm names this drug |
| Biliary dyskinesia | 56 | 38.3 29.3–49.9ROR 38.4 · calibrated p 9e-5 ✓ | 36.6 EB05 29.3 · IC025 +4.4 3/3 methods agree | Not in label — unassessed | serious n=57 · ♀ 100% (drug 75%) | no trial arm names this drug |
| Cholecystitis chronic | 170 | 29.1 25.0–33.9ROR 29.4 · calibrated p 3e-4 ✓ | 28.4 EB05 25.0 · IC025 +4.5 3/3 methods agree | Not in label — unassessed | serious PRR 22.7 · ♀ 100% (drug 75%) | no trial arm names this drug |
| Mast cell activation syndrome | 33 | 29.0 20.5–40.9ROR 29.0 · calibrated p 5e-4 ✓ | 27.9 EB05 20.8 · IC025 +3.7 3/3 methods agree | Not in label — unassessed | serious n=33 · ♀ 100% (drug 75%) · 100% clinician | no trial arm names this drug |
| Gallbladder injury | 47 | 28.2 21.1–37.6ROR 28.2 · calibrated p 5e-4 ✓ | 27.2 EB05 21.3 · IC025 +3.9 3/3 methods agree | Not in label — unassessed | serious n=47 · ♀ 100% (drug 75%) | no trial arm names this drug |
| Chronic kidney disease-mineral and bone disorder | 26 | 28.1 19.0–41.4ROR 28.1 · calibrated p 6e-4 ✓ | 26.9 EB05 19.3 · IC025 +3.5 3/3 methods agree | Not in label — unassessed | serious n=26 | no trial arm names this drug |
| Tongue biting | 50 | 28.1 21.2–37.1ROR 28.1 · calibrated p 5e-4 ✓ | 27.2 EB05 21.4 · IC025 +4.0 3/3 methods agree | Not in label — unassessed | serious n=49 · ♀ 100% (drug 75%) | no trial arm names this drug |
| Infusion site discharge | 36 | 24.4 17.5–33.9ROR 24.4 · calibrated p 0.001 ✓ | 23.6 EB05 17.8 · IC025 +3.6 3/3 methods agree | Not in label — unassessed | serious n=28 · ♀ 100% (drug 75%) · 78% consumer | no trial arm names this drug |
| Tongue injury | 19 | 23.4 14.9–36.9ROR 23.5 · calibrated p 0.002 ✓ | 22.5 EB05 15.1 · IC025 +3.1 3/3 methods agree | Not in label — unassessed | serious n=17 | no trial arm names this drug |
| Hyperparathyroidism secondary | 45 | 20.5 15.3–27.5ROR 20.6 · calibrated p 0.002 ✓ | 20.0 EB05 15.6 · IC025 +3.6 3/3 methods agree | Not in label — unassessed | serious n=45 | no trial arm names this drug |
| Nephrogenic anaemia | 79 | 19.5 15.6–24.3ROR 19.6 · calibrated p 0.002 ✓ | 19.1 EB05 15.8 · IC025 +3.7 3/3 methods agree | Not in label — unassessed | serious n=79 | no trial arm names this drug |
| Pancreatitis chronic | 34 | 16.6 11.9–23.3ROR 16.7 · calibrated p 0.006 ✓ | 16.2 EB05 12.0 · IC025 +3.2 3/3 methods agree | Not in label — unassessed | serious n=34 | no trial arm names this drug |
| Wrong patient received product | 41 | 16.5 12.1–22.4ROR 16.5 · calibrated p 0.006 ✓ | 16.1 EB05 12.3 · IC025 +3.3 3/3 methods agree | Reporting / coding artifact | serious n=41 · ♀ 0% (drug 75%) · 100% clinician | no trial arm names this drug |
| Jugular vein thrombosis | 25 | 16.3 11.0–24.2ROR 16.3 · calibrated p 0.007 ✓ | 15.7 EB05 11.0 · IC025 +3.0 3/3 methods agree | Not in label — unassessed | serious n=25 · ♀ 100% (drug 75%) | no trial arm names this drug |
| Patent ductus arteriosus | 53 | 15.3 11.6–20.0ROR 15.3 · calibrated p 0.007 ✓ | 14.9 EB05 11.8 · IC025 +3.3 3/3 methods agree | Not in label — unassessed | serious n=53 · ♀ 53% (drug 75%) · 100% clinician | no trial arm names this drug |
| Thrombophlebitis superficial | 38 | 14.2 10.3–19.5ROR 14.2 · calibrated p 0.010 ✓ | 13.7 EB05 10.3 · IC025 +3.0 3/3 methods agree | Not in label — unassessed | serious n=38 · ♀ 100% (drug 75%) | no trial arm names this drug |
| Wound infection staphylococcal | 20 | 13.2 8.5–20.5ROR 13.2 · calibrated p 0.016 ✓ | 12.3 EB05 7.9 · IC025 +2.6 3/3 methods agree | Not in label — unassessed | serious n=19 | no trial arm names this drug |
| Fear of disease | 20 | 12.8 8.2–19.8ROR 12.8 · calibrated p 0.018 ✓ | 11.8 EB05 7.6 · IC025 +2.5 3/3 methods agree | Not in label — unassessed | serious n=19 · ♀ 100% (drug 75%) | no trial arm names this drug |
| Infusion site haemorrhage | 34 | 12.0 8.6–16.9ROR 12.0 · calibrated p 0.020 ✓ | 11.5 EB05 8.3 · IC025 +2.8 3/3 methods agree | Not in label — unassessed | serious n=25 · 71% consumer | no trial arm names this drug |
| Mouth haemorrhage | 74 | 11.6 9.2–14.5ROR 11.6 · calibrated p 0.021 ✓ | 11.2 EB05 9.2 · IC025 +3.0 3/3 methods agree | Not in label — unassessed | serious n=74 · ♀ 100% (drug 75%) | no trial arm names this drug |
| Jaundice neonatal | 19 | 11.5 7.3–18.0ROR 11.5 · calibrated p 0.026 ✓ | 10.4 EB05 6.6 · IC025 +2.4 3/3 methods agree | Not in label — unassessed | serious n=19 | no trial arm names this drug |
| Acute sinusitis | 17 | 11.3 7.0–18.2ROR 11.3 · calibrated p 0.028 ✓ | 10.1 EB05 6.2 · IC025 +2.3 3/3 methods agree | Not in label — unassessed | serious n=17 | no trial arm names this drug |
| Atelectasis | 94 | 11.1 9.1–13.6ROR 11.2 · calibrated p 0.023 ✓ | 10.8 EB05 9.1 · IC025 +3.0 3/3 methods agree | Not in label — unassessed | serious PRR 8.7 | no trial arm names this drug |
| Impaired gastric emptying | 122 | 11.0 9.2–13.1ROR 11.0 · calibrated p 0.024 ✓ | 10.7 EB05 9.2 · IC025 +3.1 3/3 methods agree | Not in label — unassessed | serious PRR 9.6 | no trial arm names this drug |
| Staphylococcus test positive | 20 | 10.8 6.9–16.7ROR 10.8 · calibrated p 0.032 ✓ | 9.7 EB05 6.3 · IC025 +2.4 3/3 methods agree | Lab value / disease marker | serious n=19 | no trial arm names this drug |
| Infusion site bruising | 20 | 10.8 6.9–16.7ROR 10.8 · calibrated p 0.032 ✓ | 9.7 EB05 6.3 · IC025 +2.4 3/3 methods agree | Not in label — unassessed | serious n=18 | no trial arm names this drug |
| Cholecystitis acute | 53 | 10.7 8.2–14.1ROR 10.8 · calibrated p 0.028 ✓ | 10.3 EB05 8.1 · IC025 +2.8 3/3 methods agree | Not in label — unassessed | serious n=53 · ♀ 100% (drug 75%) | no trial arm names this drug |
| Atrial septal defect | 77 | 10.5 8.4–13.1ROR 10.5 · calibrated p 0.029 ✓ | 10.2 EB05 8.3 · IC025 +2.9 3/3 methods agree | Not in label — unassessed | serious PRR 8.3 | no trial arm names this drug |
| Haemorrhagic diathesis | 32 | 10.2 7.2–14.5ROR 10.3 · calibrated p 0.034 ✓ | 9.5 EB05 6.9 · IC025 +2.6 3/3 methods agree | Not in label — unassessed | serious n=32 · ♀ 100% (drug 75%) | no trial arm names this drug |
| Rebound acid hypersecretion | 27 | 10.1 6.9–14.7ROR 10.1 · calibrated p 0.037 ✓ | 9.2 EB05 6.4 · IC025 +2.5 3/3 methods agree | Not in label — unassessed | serious n=27 | no trial arm names this drug |
| Hereditary angioedema | 92 | 10.0 8.2–12.3ROR 10.1 · calibrated p 0.033 ✓ | 9.7 EB05 8.1 · IC025 +2.9 3/3 methods agree | Likely indication confounding shares a disease stem with the indications wording | serious PRR 8.6 | no trial arm names this drug |
| Orthopnoea | 27 | 9.7 6.6–14.1ROR 9.7 · calibrated p 0.043 ✓ | 8.8 EB05 6.2 · IC025 +2.4 3/3 methods agree | Not in label — unassessed | serious n=28 | no trial arm names this drug |
| Device related sepsis | 17 | 9.6 5.9–15.4ROR 9.6 · calibrated p 0.048 ✓ | 8.3 EB05 5.2 · IC025 +2.1 3/3 methods agree | Reporting / coding artifact | serious n=17 | no trial arm names this drug |
| Appetite disorder | 54 | 9.5 7.3–12.4ROR 9.5 · calibrated p 0.042 ✓ | 9.0 EB05 7.1 · IC025 +2.7 3/3 methods agree | Not in label — unassessed | serious n=51 | no trial arm names this drug |
| Alcohol poisoning | 22 | 9.5 6.2–14.4ROR 9.5 · calibrated p 0.047 ✓ | 8.5 EB05 5.7 · IC025 +2.3 3/3 methods agree | Not in label — unassessed | serious n=22 | no trial arm names this drug |
| Supraventricular extrasystoles | 28 | 9.5 6.5–13.7ROR 9.5 · calibrated p 0.045 ✓ | 8.7 EB05 6.1 · IC025 +2.4 3/3 methods agree | Not in label — unassessed | serious n=27 | no trial arm names this drug |
Trial evidence (ClinicalTrials.gov)
Most frequently reported reactions
By raw co-report count, regardless of disproportionality. Common terms here are often the illness itself or generic outcomes.
| Reaction | Reports | PRR 95% CI · ROR · χ²/p | EBGM EB05 · IC025 | Label screen | Serious-only & strata | Trial cross-check |
|---|---|---|---|---|---|---|
| Nausea | 2,586 | 3.7 3.6–3.9ROR 4.2 · calibrated p 0.347 | 3.7 EB05 3.6 · IC025 +1.8 3/3 methods agree | Likely indication confounding term in indications; also in warnings | serious PRR 3.9 | no trial arm names this drug |
| Vomiting | 1,771 | 4.3 4.1–4.5ROR 4.7 · calibrated p 0.276 | 4.3 EB05 4.1 · IC025 +2.0 3/3 methods agree | Likely indication confounding term in indications; also in warnings | serious PRR 3.9 | no trial arm names this drug |
| Pain | 1,472 | 2.7 2.6–2.9ROR 2.9 · calibrated p 0.671 | 2.7 EB05 2.6 · IC025 +1.4 3/3 methods agree | Likely indication confounding term in indications | serious PRR 2.8 | no trial arm names this drug |
| Fatigue (tiredness) | 1,443 | 2.1 2.0–2.2ROR 2.2 · calibrated p 0.949 | 2.1 EB05 2.0 · IC025 +1.0 3/3 methods agree | Labeled adverse reaction exact term | serious PRR 2.3 | no trial arm names this drug |
| Diarrhoea (diarrhea) | 1,297 | 2.3 2.2–2.4ROR 2.4 · calibrated p 0.862 | 2.3 EB05 2.2 · IC025 +1.1 3/3 methods agree | Not in label — unassessed | serious PRR 2.3 | no trial arm names this drug |
| Headache | 1,216 | 2.2 2.1–2.3ROR 2.3 · calibrated p 0.907 | 2.2 EB05 2.1 · IC025 +1.0 3/3 methods agree | Not in label — unassessed | serious PRR 2.5 | no trial arm names this drug |
| Dyspnoea (shortness of breath) | 1,104 | 2.2 2.1–2.3ROR 2.3 · calibrated p 0.905 | 2.2 EB05 2.1 · IC025 +1.0 3/3 methods agree | Not in label — unassessed | serious PRR 2.1 | no trial arm names this drug |
| Drug ineffective (drug did not work) | 880 | 0.8 0.7–0.8ROR 0.7 · calibrated p 0.155 | 0.8 EB05 0.7 · IC025 -0.5 PRR-only: not supported by EBGM or IC | Reporting / coding artifact | serious PRR 1.0 | no trial arm names this drug |
| Anxiety | 874 | 3.5 3.3–3.7ROR 3.6 · calibrated p 0.459 | 3.5 EB05 3.3 · IC025 +1.7 3/3 methods agree | Not in label — unassessed | serious PRR 3.5 | no trial arm names this drug |
| Pneumonia (lung infection) | 813 | 2.9 2.7–3.1ROR 2.9 · calibrated p 0.645 | 2.9 EB05 2.7 · IC025 +1.4 3/3 methods agree | Labeled adverse reaction exact term | serious PRR 2.3 | no trial arm names this drug |
| Asthenia (weakness) | 811 | 2.5 2.3–2.6ROR 2.5 · calibrated p 0.806 | 2.4 EB05 2.3 · IC025 +1.2 3/3 methods agree | Not in label — unassessed | serious PRR 2.3 | no trial arm names this drug |
| Abdominal pain | 791 | 3.9 3.6–4.1ROR 4.0 · calibrated p 0.378 | 3.9 EB05 3.6 · IC025 +1.8 3/3 methods agree | Not in label — unassessed | serious PRR 3.5 | no trial arm names this drug |
| Pyrexia (fever) | 779 | 2.6 2.4–2.7ROR 2.6 · calibrated p 0.761 | 2.6 EB05 2.4 · IC025 +1.2 3/3 methods agree | Labeled adverse reaction exact term | serious PRR 2.2 | no trial arm names this drug |
| Dizziness | 773 | 1.8 1.6–1.9ROR 1.8 · calibrated p 0.828 | 1.8 EB05 1.7 · IC025 +0.7 | Labeled adverse reaction exact term | serious PRR 1.9 | no trial arm names this drug |
| Malaise (feeling unwell) | 743 | 1.9 1.8–2.1ROR 2.0 · calibrated p 0.921 | 1.9 EB05 1.8 · IC025 +0.8 | Not in label — unassessed | serious PRR 1.9 | no trial arm names this drug |
Unlabeled candidate signals
These flagged terms were not found in the FDA label text and do not match an artifact pattern. They are the pairs that would merit a structured assessment (temporality, dose-response, biological plausibility, consistency across databases, trial or cohort evidence). The screen has not done that; string-matching misses label wording, and a strong PRR can still be stimulated reporting, co-medication, or the disease itself.
- Pneumonia haemophilus — n=50, PRR 129.8
- Autoscopy — n=26, PRR 57.8
- Biliary dyskinesia — n=56, PRR 38.3
- Cholecystitis chronic — n=170, PRR 29.1
- Mast cell activation syndrome — n=33, PRR 29.0
- Gallbladder injury — n=47, PRR 28.2
- Chronic kidney disease-mineral and bone disorder — n=26, PRR 28.1
- Tongue biting — n=50, PRR 28.1
- Infusion site discharge — n=36, PRR 24.4
- Hyperparathyroidism secondary — n=45, PRR 20.5
✓ A hand-written Bradford Hill causality assessment exists for this drug: Oxycodone Hydrochloride ↔ Drug Dependence.
Want to assess one of these properly? The runbook describes the Bradford Hill / trial-evidence workflow used on the assessment page, and handoff_top1000_signals.csv lists the strongest unassessed pairs across all drugs.
Common questions
What are the most reported side effects of Promethazine?
In FDA FAERS, the most frequently co-reported reaction terms for Promethazine are nausea, vomiting, pain, fatigue, diarrhoea, headache. These are report counts, not rates: FAERS has no denominator, reporting is voluntary and uneven, and a term can be reported because of the illness being treated rather than the drug.
Does Promethazine have an FDA boxed warning?
No. The FDA label retrieved for Promethazine has no boxed warning; see the label's Warnings and Precautions for the recognised risks.
Do FAERS signals prove that Promethazine causes these side effects?
No. A disproportionality signal (PRR, ROR) means a reaction is reported more often with this drug than with others in the database. That can reflect a real effect, but also the disease being treated, stimulated reporting after news or litigation, co-medications, or how reports are coded. Causality needs temporality, dose-response, biological plausibility, consistency across data sources and, ideally, trial or cohort evidence. This page screens each term against the FDA label and ClinicalTrials.gov results; it does not establish causation.
Sources & methods
- FDA label via openFDA (set ID 4f681538-7ac4-484c-9e6d-b571d73b9e0b, effective 20221008; matched on
openfda.generic_name.exact:"PROMETHAZINE") - Bayesian shrinkage measures computed offline over all 1,317,300 cached pairs: BCPNN information component (IC, with Norén closed-form IC025) and MGPS empirical-Bayes geometric mean (EBGM, EB05) with a two-component gamma prior fitted by maximum marginal likelihood (α₁=0.57, β₁=0.02, α₂=1.42, β₂=0.70, w=0.17); unstratified
- FAERS pair statistics from the OpenPV build of 2026-09-14 (openFDA
count=aggregation, fieldpatient.drug.openfda.generic_name.exact, 1,181 reaction terms, min 3 co-reports); PRR/ROR with 95% CI, chi-square with Yates correction - Serious-only and stratified counts (serious:1, patient.patientsex, primarysource.qualification) from openFDA count queries; serious-only PRR uses the drug serious report total and the term global serious total (N_serious=11,882,979); strata shown only when n ≥ 20
- Seriousness and sex counts from openFDA
count=serious,patient.patientsex,seriousnessdeath - ClinicalTrials.gov API v2 (query
PROMETHAZINE, results-bearing studies sorted by enrollment)
Page generated 2026-10-14. Label and PubChem text are retrieved automatically and may lag the current label; always check the current prescribing information. OpenPV is a beta research tool of the Open Source Medicine Foundation.