Promethazine: Side Effects, Misuse, and Addiction

Promethazine is a prescription antihistamine with a known potential for abuse, especially when combined with substances like codeine or alcohol. Read on to learn more about promethazine side effects, the dangers of promethazine misuse, and how to get help if you or someone you know has developed a promethazine addiction.

What Is Promethazine?

Promethazine is a prescription medication developed in the mid-1940s, when a team of scientists from the French chemical manufacturing company Rhône-Poulenc combined phenothiazine and a diamine side chain of diphenhydramine to create a new drug. Their creation, promethazine, is a synthetic medication that belongs to a pharmaceutical family known as phenothiazines.

More recently, promethazine has gained a reputation as a potential drug of abuse, popularized in rap songs and on social media as an ingredient in what’s sometimes called “purple drank,” “sizzurp,” or “lane.”

What Is Promethazine Used For?

As a medication, promethazine has several uses, including the treatment of allergies, motion sickness, and more. It is also a strong sedative sometimes prescribed during labor, before and after surgery, and at other times.

Promethazine is a first-generation antihistamine only available by prescription. It effectively treats several conditions, such as:

  • Allergies.
  • Motion sickness.
  • Nausea/vomiting.
  • Hives.

Promethazine may also be used with other medicines to treat symptoms of the common cold, including sneezing, cough, and runny nose.

Promethazine Side Effects

Even though promethazine is a useful medicine, it is not without risks. Common side effects of promethazine include:

  • Drowsiness.
  • Blurred vision.
  • Sedation.
  • Confusion.
  • Dizziness.

Rare but serious side effects of promethazine include:

  • Respiratory depression.
  • Seizures.
  • Hallucinations.
  • Changes in heart rate.
  • Yellow skin and/or eyes.
  • Fever.
  • Rigid muscles.

Is Promethazine Abused?

Yes, although it is not a controlled substance, promethazine does have the potential to be abused. Research has drawn links between promethazine misuse and people with a history of opioid addiction or other substance use disorders.

Promethazine misuse may also be more common among adolescents, due to the spread of popular music and social media content glamorizing the use of promethazine in concoctions like purple drank.

While it is clear that promethazine abuse can be dangerous, there is not much research that offers a clear picture of its addictive potential.

Promethazine Mixed With Other Substances

The risk of misuse and addiction heightens when promethazine is combined with codeine and other addictive substances like alcohol. A formulation of promethazine mixed with codeine was previously available in the U.S. as a prescription cough and cold medicine.

Although the prescription version of promethazine with codeine has since been discontinued—due to rising misuse—the drug is still being found on the black market and purchased illicitly.

Codeine is a type of prescription opioid that can alleviate coughing and pain. However, all opioids are federally controlled substances with a known potential for misuse, addiction, and overdose.

Additionally, both codeine and promethazine can have sedative effects and cause respiratory depression (i.e., slowed or stopped breathing). Mixing promethazine with codeine or any other sedatives (e.g., alcohol or benzodiazepines like Xanax) is very dangerous.

Promethazine Abuse & Overdose

Promethazine abuse can lead to side effects that range from inconvenient and uncomfortable to incredibly dangerous and life-threatening. Overdosing on promethazine may cause symptoms such as:

  • Trouble breathing.
  • Decreased or stopped breathing.
  • Dizziness/fainting.
  • Increased heart rate.
  • Tense muscles.
  • Incoordination.
  • Dilated pupils.
  • Flushing.
  • Excessive agitation or excitement.
  • Lost of consciousness.

Promethazine Withdrawal Symptoms

People who frequently use codeine (with or without promethazine) may develop a dependence on opioids. If they stop using it or drastically decrease their use, they may experience withdrawal. Withdrawal can be very uncomfortable and last several days, with symptoms that may include:

  • Dilated pupils.
  • Sweating.
  • Runny nose.
  • Restlessness/irritability/anxiety.
  • Trouble sleeping.
  • Increased heart rate.
  • Increased breathing rate.
  • Chills.
  • Nausea/vomiting.
  • Stomach cramps.
  • Diarrhea.
  • Muscle aches.

Treatment for Promethazine Addiction

If you or a loved one is struggling with an addiction to cough syrup or cold medicine, it is important to get treatment as soon as possible. At our inpatient drug rehab in Orange County, we provide whole-person, addiction-focused healthcare to help you find meaningful recovery from substance use disorders. We offer different types of addiction treatment, including inpatient residential treatment and medical detox.

For more information about our facility and programs, such as how to start addiction treatment or what to expect in inpatient rehab, please contact our caring admissions navigators at . They can also answer your questions about using your insurance to pay for rehab or other rehab payment options.

Was this page helpful?
Thank you for your feedback.

American Addiction Centers (AAC) is committed to delivering original, truthful, accurate, unbiased, and medically current information. We strive to create content that is clear, concise, and easy to understand.

Read our full editorial policy

While we are unable to respond to your feedback directly, we'll use this information to improve our online help.

The Price of Not Getting Help
When contemplating the costs of addiction treatment for yourself, child, or loved one, consider the costs, or consequences, of “things as they are now.” What would happen if the substance abuse or addiction continued? Rehab doesn't have to be expensive. We accept a variety of insurances. Learn more below.