Special Warning : אזהרת שימוש

4.4 Special warnings and precautions for use
Prothiazine Expectorant may thicken or dry lung secretions and impair expectoration.
It should therefore be used with caution in patients with asthma, bronchitis or bronchiectasis.
Use with care in patients with severe coronary artery disease, narrow angle glaucoma, epilepsy or hepatic and renal insufficiency.
Caution should be exercised in patients with bladder neck or pyloro-duodenal obstruction.
The use of promethazine should be avoided in children and adolescents with signs and symptoms suggestive of Reye’s Syndrome.
Promethazine may mask the warning signs of ototoxicity caused by ototoxic drugs e.g.
salicylates. It may also delay the early diagnosis of intestinal obstruction or raised intracranial pressure through the suppression of vomiting.

Phenothiazine derivatives may potentiate QT interval prolongation which increases the risk of onset of serious ventricular arrhythmias of the torsade de pointes type, which is potentially fatal (sudden death). QT prolongation is exacerbated, in particular, in the presence of bradycardia, hypokalaemia, and acquired (i.e. drug induced) QT prolongation. If the clinical situation permits, medical and laboratory evaluations should be performed to rule out possible risk factors before initiating treatment with a phenothiazine derivative and as deemed necessary during treatment (see section 4.8).

Photosensitivity reactions
Due to the risk of photosensitivity, exposure to strong sunlight or ultraviolet light should be avoided during or shortly after treatment (see section 4.8).

Use with care in patients who suffer from chronic cough, have asthma or is suffering from an acute asthma attack.

Do not give with a cough suppressant or any other cough and cold medicine.

Ipecac is cardio active and so should be avoided by patients on anti-arrhythmic drugs.
It should be avoided by diabetics.
Prothiazine Expectorant should not be used for longer than 7 days without seeking medical advice.
Excipients with known effect
Prothiazine Expectorant syrup contain sucrose, sorbitol and glucose. Patients with rare hereditary problems of fructose intolerance, glucose-galactose malabsorption or sucrase- isomaltase insufficiency should not take this medicine.

Effects on Driving

4.7 Effects on ability to drive and use machines
Because the duration of action may be up to 12 hours, patients should be advised that if they feel drowsy they should not drive or operate heavy machinery.