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Kim Springer
Mixing Phenergan and Demerol
Has anyone heard of any problems with mixing Phenergan and Demerol or either diluting Demerol to decrease irritation. I know Mepergan is not available anymore and was not sure of why they stopped making it.
When giving multiple drugs
When giving multiple drugs by the IV route, I would always strongly recommend placing only one drug in a syringe. This is especially true with promethazine (Phenergan). This is a nasty drug with horrible outcomes if not given properly. The nurse must ensure that there is no infiltration from the site. This drug requires the same level of attention as any antineoplastic drug. This includes administration through a free-flowing gravity infusion and never through a saline or heparin locked catheter without fluids infusing. Always require a brisk blood return that is checked before, during, and after the slow injection of promethazine. Be aware that contact between blood and promethazine will cause the blood to darken. Therefore if the catheter is in an artery, the blood will appear dark as venous blood. This has resulted in limb amputations for many patients. Demerol is a vein irritant, but Phenergan is the biggest risk. So I would only use separate syringes for each drug. Lynn

Lynn Hadaway, M.Ed., NPD-BC, CRNI

Lynn Hadaway Associates, Inc.

PO Box 10

Milner, GA 30257


Office Phone 770-358-7861

Tony West
Most moderate and certainly

Most moderate and certainly all larger cities have compounding pharmacies. Usually private, not your chain super drug stores. They can easily make Demerol & Phenergan po. This may not be an option while inpatient but once they have gone home if the need is still there it can usually be met. 

Given the vast array of other good IV substitutes for Phenergan perhaps asking to change the drug would be a way to avoid the dangers of IV Phenergan.  

Tony West, RN, CRNI
Healix, Inc.
Cell: 214-674-4848

Tony West, RN, CRNI

Healix, Inc.

Cell: 214-674-4848

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