What is Promethazine? Promethazine is a phenothiazine with antihistamine and antiemetic properties .Despite it being from an ‘antipsychotic’ class of drugs, it is used extensively for the purpose of controlling the symptoms of various allergic reactions and also prevent motion sickness. Its ability to relieve a person of their vomiting and nausea sensation is also well appreciated.

Promethazine is also used in combination with other drugs like Codeine and dextromethorphan to provide relief for other conditions like cough. You are advised to refrain from taking any additional cold or cough medication while taking Promethazine as it might result in a drug interaction leading to severe side effects or subdued drug action of the medication. It is recommended that you always consult a doctor before taking any medication while using Promethazine.

Several medications are contradicted to Promethazine thus you must check the ingredients of the other medication that you are currently using if you are prescribed with Promethazine. Medications which are of CNS depressant nature must be avoided as Promethazine itself is a CNS depressant therefore using a drug of similar nature could be fatal especially when the dosage of the drug in question is high. Patients who are already suffering from breathing problems are advised against the drug for the same reason. Being a CNS depressant the drug can slow down the patient’s respiratory rate.

The exact details regarding the effects of Promethazine codeine syrup on the growing fetus and the pregnant women taking it is not known completely . Codeine is generally not prescribed for pregnant women as it affects the growth of the fetus and can cause breathing problems therefore the syrup is not recommendable for pregnant women. It is advised that you take the drug only under the guidance of a doctor as the drug can have dangerous side effects if not used properly. Apart from being addictive it can also cause respiratory depression which can be fatal at times.

Promethazine codeine syrup may not be suitable for everyone and patients with respiratory problems must not take the drug at any point in life. Chad Lamont Butler, more popularly known as Pimp C died due to a Promethazine codeine syrup overdose. Butler was already suffering from ‘Sleep Apnea’ and when this condition coupled with respiratory depression caused due to the overdose resulted in his death. It may be noted here that several people have been using this drug for recreational purpose without understanding the level of danger involved .Since Codeine is an opiate the usage of  Promethazine codeine syrup in high doses results in a feeling of ‘well being’ and that is why people get addicted to the drug. It is important to understand that getting addicted to this drug in reality is no way encouraging your ‘well being’.

• Hospira
• KVK Tech, Inc.
• Paddock Laboratories, Inc.
• Sandoz
• Taro Pharmaceutical Industries
• Vintage Pharmaceutical, Inc.
• Watson Laboratories, Inc.
• Wockhardt USA
• Zydus Pharmaceuticals.

There are many more such companies and there is no need to worry about the quality of the available generic Promethazine Hydrochloride medication as even the generic versions need to be approved by the FDA to be sold in the market. The drug is generally graded by the FDA to indicate the standard of the drug. One difference that you might find in the generic version of Promethazine hydrochloride is the presence of additional inactive substances in addition to those present in the original however these are not harmful.

Promethazine hydrochloride are contradicted for patients aged below two and in younger patients the dosage is much lower when compared to adults. The dosage varies depending upon the condition for which the drug is being used. Usually Promethazine hydrochloride is used for treating allergic, nausea, vomiting and motion sickness symptoms. Promethazine hydrochloride is available in various strengths and forms. The various strengths in which they are available are:

• Promethazine 12.5 mg  (tablets and rectal suppositories)
• Promethazine 25 mg  (tablets and rectal suppositories)
• Promethazine 50 mg  (tablets and rectal suppositories)
• Promethazine 6.25 mg per 5 mL syrup
• Promethazine 25 mg per mL injection
• Promethazine 50 mg per mL injection.

Promethazine hydrochloride is available in the form of tablets,rectal suppositories,syrup and injection.

An important fact that you must be aware of if you are planning to use the medication is that the medication can manipulate the results of certain types of tests therefore we might end up with the wrong results. To avoid unnecessary confusion it is always advised that you inform your doctor before hand about the medication. Usually you will be asked to withdraw from taking the medications for atleast a week if you are to either take the pregnancy test or the glucose tolerance test.

If you are using the drug for the first time it is better to take the guidance of a doctor as you might not be able to judge the dosage that you require to treat yourself of the current condition. When the dosage level exceeds beyond the acceptable levels the person is likely to face an adverse reaction which is characterized by symptoms like :

• Mild depression of the central nervous system and cardiovascular system
• hypotension
• respiratory depression
• unconsciousness
• hyperreflexia
• hypertonia
• ataxia
• athetosis, and extensor-plantar reflexes (Babinski reflex)

Death have also been reported and cases of convulsion are not unheard but they are certainly rare in comparison. Symptoms of paradoxical-type reaction like hyperexcitability and nightmares have also been reported in children receiving dosages between 75 mg to 125 mg orally once a day.

If the person taking Promethazine Codeine have been taking the drug in higher doses then they are likely to experience withdrawal symptoms when they stop taking the medication. Depending on the level of dosage the withdrawal symptoms can be mild to severe. Withdrawal symptoms can be hard to manage without the help of a doctor and can last from few to days to weeks. Given below are few symptoms that one can expect while going through the withdrawal period:

• Pain
• Restless legs
• Nausea
• Diarrhea
• Vomiting
• Anxiousness
• Insomnia
• Muscle aches
These are however not the complete list of symptoms.

An average adult can usually take one teaspoon of Promethazine codeine every 4 to 6 hrs but the maximum dose that a person can have in a day is restricted to two tablespoon of the syrup. Promethazine and Codeine are present in the ratio of 10 mg to 6.25 mg in every teaspoonful of Promethazine codeine.
Proper storage of Promethazine codeine is important for further use in the subsequent days after opening it. Make sure the drug is stored in a place that is not exposed to the sunlight. The drug is to be stored in room temperature and in air tight containers in case they are in the tablet form.

Though dextromethorphan is an excellent cough suppressant it cannot treat coughs caused by smoking and asthma.’ Dm’ in Promethazine dm stands for dextromethorphan. The combination of these two medications are also available in the names like Promethazine with dextromethorphan,Phenergen Dm and Promethazine with Dm.

Since the drug is used only when you have cold or cough it is unlikely that your medication period is going to stretch beyond few days .You must be careful while taking the medication in syrup form as there is a chance for taking a higher dose unknowingly. You must be aware of the fact that Promethazine dm can be addictive. It is for this reason that you are advised to take the medication only in the strengths prescribed by your doctor. You must inform your doctor at once if you feel you are becoming increasing dependent on the effects of the drug. Be aware of the influence the drug has on you and alert your doctor at once if the movements of your eyes, lips, tongue, face, arms, or legs are not under your control. These symptoms indicate severe side effects.

It is important for the person who have had a Promethazine dm overdose be provided with medical help at once as an overdose can lead to the death of the person as well. A person who has had an overdose of Promethazine dm would feel restless or nervous, severe drowsiness, dizziness, dry mouth, large pupils, flushing, nausea, vomiting, shallow breathing, and fainting.

When the combination of Promethazine and Dextromethorphan known as Promethazine dm syrup is taken the person is relieved of his or her upper respiratory infection symptoms. Keep in mind that the medication is not effective for treating asthma conditions. They are effective in treating the various symptoms of conditions like cold, flu, allergy or hay fever such as cough, runny nose, sneezing and itchy watery eyes. Promethazine dm syrup can be identified by its characteristic slightly pineapple smell and yellowish colour. It is important that the liquid be clear while using. If any suspended particles or discoloration is observed refrain from using the medication.

In a teaspoon of Promethazine dm syrup you will find dextromorphan hydrobromide, 6.25 milligrams of promethazine hydrochloride and 7 percent alcohol. Promethazine dm syrup also contains some inactive substances and the list is complete with the following : ascorbic acid, citric acid, D&C yellow #10, FD&C yellow #6, menthol, methylparaben, orange pineapple flavor, propylene glycol, propylparaben, purified water, saccharin sodium, sodium benzoate, sodium citrate and sucrose.

Motion sickness is another condition where the drug has proved to be effective. For an average adult patient the recommended dosage is 25mg, taken twice a day. The first dose must be taken one and half hours prior to the start of the journey and is then followed up by another dose after an interval of 8 to 12 hrs. In the following days of the journey the patient is advised to take the first dose after he or she wakes up; the second dose is to be taken before the evening meal. When the user of the drug is a child, the prescribed dosage can be anywhere between 12.5 to 25mg taken twice a day in the form of tablets, syrup and rectal suppositories.
Promethazine’s sedation properties have also been acknowledged. Though the use of the drug can put a person to sleep, the person can easily be awakened if required unlike in the case of other sedation medications. When children are the benefiters, the dosage is restricted in the range of 12.5 to 25 mg but an adult would mostly require the dosage in the range of 25 to 50mg.

Promethazine also has pre and post operative uses. The drug is used to calm the person and help in falling asleep. While a young patient would be needing a dosage in the range of 12.5 to 25mg , an adult patient would require 50 mg dose.

There are several brands offering Promethazine and codeine in combination but even though it is a prescription only drug, people unaware of the dangers involved misuse it. When taken in high amounts the person gets high and due to the intake of the drug in combination the risks involved is increased even more. Since both Promethazine and codeine are CNS depressants a person can even die when the dosage becomes high. The CNS depressants properties of the drug slows down the breathing of the person to the extent of killing them.
The recreational usage of the medication came into being after the hip hop community in Southern United states and is known by various names like purple drank, including sizzurp, lean, syrup, drank, barre, purple jelly, and Texas tea. Not only is the usage is illegal it is also dangerous. Using this medication with other medications of CNS depressants types would turn fatal as it would lead to a drug overdose.
It is natural for your body to adapt to the drug’s effect therefore when a particular dosage no longer have an effect we have the tendency to increase the dosage. This is not advisable as the body’s tolerance level to the drug increases as the medication period increases and if you are not taking the guidance of a doctor you are likely to take the drug in excess ,which is harmful.

The drug is sold in many brand names like Phenergan, Promethegan, Romergan, Fargan, Farganesse, Prothiazine, Avomine, Atosil, Receptozine, Lergigan. The drug is available over the counter in many countries like United Kingdom, Australia, Canada, Switzerland but its availability is restricted in United states of America. United Sates have made the drug available only to those patients who are able to produce authentic prescription slips.

Promethazine is used for many conditions and although it was first developed as an antipsychotic medication its use has expanded to many more areas. It is no longer being used as an antipsychotic medication and its current antipsychotic strength has been evaluated to be 1/10 of that of chlorpromazine.

It is quite common for pregnant women to experience morning sickness and Promethazine is being recommended when the sickness is rated from moderate to severe. Hyperemesis gravidarum is the severe form of morning sickness where the patient faces excessive nausea and or vomiting . Due to which the pregnant women is unable to take in the required amount of food and fluid. In United kingdom it is usual for the doctors to give more preference to promethazine when compared to other such drugs as the drug has been used by many pregnant women. After promethazine , metoclopramide and prochlorperazine are commonly used for the treatment of the morning sickness.

It is advisable to take the drug only if prescribed to by a doctor.