Re: "Problems With Promethazine IV" (November, page 12). I read with interest the article on the Institute for Safe Medicine Practices urging the FDA to re-examine the product labeling for promethazine. Back about 40 years ago when I was a junior resident, the same problems were noted with inadvertent intra-arterial or subcutaneous administration of hydroxyzine (Vistaril). The FDA removed its approval for IV use. We used it widely in small doses to treat or prevent nausea and vomiting and, like promethazine, it was quite effective.