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Promethazine Withdrawal Effects and Timeline

Promethazine is an antihistamine used to treat a variety of conditions, such as allergies, motion sickness, and post-surgery pain relief.

This synthetic drug is also a powerful sedative, which is why it is often added to sleep aids and medications that cause drowsiness like cough syrup or cold medicine.

On its own, promethazine is not particularly addictive; in fact, a study from the Journal of Addiction Medicine found that only 354 instances of promethazine abuse were reported to the National Poison Data System between 2002 and 2012. The study goes on to report that, of these 354 cases, less than 20 percent required admission to a medical facility, further proving the minimal effects promethazine has on its own.

However, this drug is not always used on its own. Promethazine is often combined with powerfully addictive substances like codeine. Codeine is an opioid – an addictive drug from the same family as heroin – and it produces a feeling of euphoria when ingested. Combine this euphoric feeling with the powerful sedative effects of promethazine, and the result is a highly addictive substance that is easily procured.

Withdrawal Symptoms

Admittedy, withdrawing from promethazine and codeine is not an easy task. This is because codeine, like all opioids, attaches to and activates the opioid receptors in the brain. The drug also affects the brain’s limbic system, which controls mood and feelings of pleasure and relaxation. As the drug leaves the body, individuals are met with both physical pain and mental anguish. This detox period can last up to seven or eight days, and some symptoms can linger even longer.

Some of the most common withdrawal symptoms from promethazine and codeine include:

  • Restless legs
  • Insomnia
  • Pain
  • Nausea
  • Depression
  • Cravings
  • Vomiting
  • Headaches
  • Muscle aches

People going through withdrawal from promethazine may experience more intense pain than they are used to. This is particularly true of people suffering from chronic pain. A 2015 study in Drug and Alcohol Dependence found that “having a prescription for methadone for pain or being in methadone maintenance for the treatment of opioid dependence were both statistically associated with promethazine use.” When someone is going through withdrawal, be it from methadone, codeine, or another painkiller, the body also processes out the promethazine in their system. This can lead to heightened senses (after they have been dulled and sedated by the drug) and can make withdrawal uncomfortable.

How Long Does Withdrawal Take?

  • A typical withdrawal period lasts around seven days though, as mentioned, some symptoms can last longer. Addiction specialists typically break up this time into three phases. The first phase lasts 1-4 days, and during this time, physical withdrawal is at its peak. An individual may experience nausea, soreness, headaches, and other uncomfortable symptoms as codeine begins to leave the system. This is also a result of promethazine leaving the system. The U.S. National Library of Medicine reports that promethazine has a total elimination half-life of 12 hours, which means that its sedative effects will vanish within 24 hours of a person’s last dose.
  • The second stage of withdrawal occurs during days 5-7. At this time, the physical symptoms will begin to fade, and new symptoms will take their place. Instead of feeling sweaty, shaky, or nauseated, an individual may feel fatigued or dehydrated. This is a direct result of the previous four days, and these symptoms often dissipate with appropriate care. Psychological symptoms tend to set in during this stage too. People who have experienced withdrawal from promethazine and codeine have reported feeling depressed around day five. They have also reported feeling cravings for their drug of choice. This period of withdrawal is a pivotal time, as these feelings can lead someone to relapse if they don’t have a strong support network.

The final stage of withdrawal begins on day eight and lasts for some time after, sometimes for as long as 30 days. At this time, almost all physical symptoms will have passed, and the individual will be fully detoxed from codeine and promethazine. However, cravings, depression, and other psychological effects remain. During this time, a person in recovery should continue looking to their family, friends, and treatment professionals for support as their sobriety is still fragile.

Managing Promethazine Withdrawal

Whenever someone goes though withdrawal from any drug, it is best to have a medical professional available to help with any potentially adverse effects. In the case of promethazine, the physical withdrawal symptoms are not life-threatening though they are uncomfortable. Regardless, having an addiction specialist or doctor available for the person going through withdrawal is still useful. If the individual becomes dehydrated, or even if the psychological symptoms begin to feel like too much, professional intervention can make all the difference for the person.

Whether a person is experiencing withdrawal from promethazine, codeine, or cocaine, it is important to remember that this stage of recovery will pass. The discomfort only lasts for a few days, and loved ones are there to offer strength and support every step of the way. Once a person has completed the withdrawal process, they can begin therapy in a comprehensive treatment program.