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Phenergan vs. Scopolamine

Head-to-head comparisons of medication uses, side effects, warnings, and more.

Key takeaways

Promethazine (Phenergan) and Scopolamine (Transderm Scop) are both prescription medications used to prevent nausea and vomiting, but they have some key differences. Promethazine is an antihistamine and anticholinergic that also blocks dopamine, making it useful for treating allergies, motion sickness, and pre-surgery relaxation. It comes in various forms, including tablets, syrup, suppositories, and injections. Scopolamine, on the other hand, is strictly an anticholinergic and is used mainly for preventing nausea and vomiting from motion sickness and surgery. It is available only as a patch that you place behind your ear. Promethazine can cause serious breathing problems in children under 2 years old and has a higher risk of side effects in older adults, while Scopolamine is not recommended for children under 18. Both medications can cause drowsiness and dizziness, but Scopolamine also has a risk of withdrawal symptoms if used for more than three days. Promethazine starts working within 20 minutes, whereas Scopolamine takes at least 4 hours to become effective.

Promethazine

 

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Scopolamine

(Transderm Scop)

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Summary for Phenergan

Prescription only

Promethazine is a prescription medication with many uses, such as treatment or prevention of nausea, motion sickness, and allergy symptoms. Promethazine works by blocking several chemicals, including histamine, dopamine, and acetylcholine. It comes as tablets, an oral solution, rectal suppositories, and an injection. The dose of promethazine and how often you take it depends on your age and what medical condition you're taking it to treat. But it shouldn't be given to children younger than 2 years of age since it can cause serious breathing problems. Common side effects include sleepiness and dizziness.

Indications for Phenergan

  • Runny nose, watery eyes, and other symptoms of allergies
  • Runny or stuffy nose that isn't caused by allergies
  • Rash, swelling, anaphylaxis, and other symptoms of an allergic reaction
  • Dermographism
  • Treatment or prevention of nausea and vomiting before and after surgery
  • Treatment or prevention of motion sickness
  • Treatment of pain along with other pain medications after surgery
  • Help to relax your body and produce a light sleep, particularly before a procedure

Pros and Cons for Phenergan

Pros

  • Available as a lower-cost generic
  • Available in different formulations, such as a tablet, syrup, and injection
  • Starts working within 20 minutes

Cons

  • Can't be taken by children under 2 years old because risk of serious breathing problem
  • Higher risk of side effects in older adults
  • Can cause sleepiness

Common Side Effects for Phenergan

  • Feeling drowsy or tired
  • Dizziness
  • Confusion
  • Dry mouth
  • Nervousness
  • Blurry vision

The following side effects are those additionally reported with promethazine injection at the injection site:

  • Burning
  • Pain
  • Rash
  • Swelling

Warnings for Phenergan

  • Potentially life-threatening slow breathing (respiratory depression)
  • Serious tissue injury (Injection only)
  • Excessive sleepiness
  • Worsening of certain health problems
  • Seizures
  • Higher risk of infection (from low white blood cell count)
  • Risk of serious nerve problems (neuroleptic malignant syndrome)
  • Uncontrollable body movements

Summary for Scopolamine

Prescription only

Scopolamine (Transderm Scop) is a prescription anticholinergic medication. It's used to prevent nausea and vomiting from motion sickness, as well as from anesthesia or pain medications used in surgery. Scopolamine (Transderm Scop) comes as a patch that you place behind your ear. You need to apply it at least 4 hours before any activities that might cause motion sickness, or the night before your surgery. Common side effects scopolamine (Transderm Scop) include dry mouth, sleepiness, and dizziness.

Indications for Scopolamine

Pros and Cons for Scopolamine

Pros

  • Works well for preventing nausea and vomiting
  • Effects lasts for up to 3 days
  • Applied to skin, so a good choice for people who've trouble taking pills
  • Available as a lower-cost generic

Cons

  • Not for use in children younger than 18 years old
  • Takes about 4 hours to start working, so need to remember to take it ahead of time
  • Doesn't treat nausea and vomiting that's already happening
  • Can cause drowsiness, blurry vision, and confusion

Common Side Effects for Scopolamine

  • Dry mouth (29%)
  • Dizziness (12%)
  • Sleepiness (8%)
  • Agitation (6%)
  • Changes in vision (5%)

Warnings for Scopolamine

  • Angle-closure glaucoma
  • Brain and mental health problems
  • Risk of seizures in pregnant people with preeclampsia
  • Blockage in the stomach, intestines, or bladder
  • Withdrawal
  • Blurry vision
  • Skin burn from magnetic resonance imaging (MRI)

Prices with our coupons for Phenergan vs. Scopolamine

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Promethazine30 tablets / 25mg
$9.17$15.00
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Scopolamine10 patches / 1mg/3 days
$45.50$189.15
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