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pDrugs having anticholinergic properties should be used with caution in patients with narrow-angle glaucomaprostatic hypertrophystenosing peptic ulcerpyloroduodenal obstructionand bladder-neck obstruction./ppA potentially fatal symptom complex sometimes referred to as Neuroleptic Malignant SyndromeNMShas been reported in association with promethazine HClpromethazine hydrochloridealone or in combination with antipsychotic drugsClinical manifestations of NMS are hyperpyrexiamuscle rigidityaltered mental status and evidence of autonomic instabilityirregular pulse or blood pressuretachycardiadiaphoresis and cardiac dysrhythmiasThe diagnostic evaluation of patients with this syndrome is complicatedIn arriving at a diagnosisit is important to identify cases where the clinical presentation includes both serious medical illnesse.gpneumoniasystemic infectionetcand untreated or inadequately treated extrapyramidal signs and symptomsEPSOther important considerations in the differential diagnosis include central anticholinergic toxicityheat strokedrug fever and primary central nervous systemCNSpathology./ppOtherAngioneurotic edemaNeuroleptic malignant syndromepotentially fatalhas also been reportedSee WARNINGS-Neuroleptic Malignant Syndrome/ppMeasure liquid medicine with the dosing syringe providedor with a special dose-measuring spoon or medicine cupIf you do not have a dose-measuring deviceask your pharmacist for one./ppThe safety of promethazine for long-term treatment of allergic rhinitis has not been established./p
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