Product Description

Promethazine Codeine Oral Solution

Promethazine Codeine Oral Solution (also known as Promethazine with Codeine) is a prescription combination medication containing promethazine hydrochloride (an antihistamine) and codeine phosphate (an opioid cough suppressant). It is indicated for the temporary relief of cough and upper respiratory symptoms associated with allergies or the common cold in adults 18 years and older.

Typical Composition

Each 5 mL usually contains:

• Codeine phosphate: 10 mg
• Promethazine hydrochloride: 6.25 mg
• Often includes 7% alcohol and a flavored syrup base

It is classified as a Schedule V controlled substance in the United States due to the opioid component.

Pharmacology

• Codeine: Suppresses the cough reflex in the brain and provides mild pain relief and sedation.
• Promethazine: Blocks histamine, reduces allergy symptoms, and adds significant sedative effects.

The combination produces cough relief along with drowsiness and relaxation.

Safety Profile & Risks

When used exactly as prescribed for short periods under medical supervision, it can be effective. However, it carries serious safety concerns:

Common Side Effects:

• Drowsiness and sedation
• Dizziness
• Dry mouth
• Constipation
• Nausea

Serious Risks:

• Respiratory depression (dangerously slowed breathing) — potentially life-threatening
• Addiction and physical dependence — Codeine is an opioid with notable abuse potential
• Overdose: Can cause extreme sedation, coma, respiratory failure, and death
• Increased risk in children, elderly, and people with breathing disorders
• Ultra-rapid metabolizers of codeine can experience dangerously high morphine levels

Major Warnings

The FDA has issued a Black Box Warning for this medication due to:

• Risk of severe breathing problems in children
• Potential for life-threatening respiratory depression when combined with alcohol, benzodiazepines, other opioids, or sedatives

Abuse Potential

This medication has a significant history of recreational misuse, often referred to as “lean,” “purple drank,” or “sizzurp” when mixed with soda. Such use dramatically increases the risk of overdose and death.

Contraindications

• Age under 18
• History of opioid addiction or respiratory conditions
• Pregnancy (risk of neonatal opioid withdrawal syndrome)
• Concurrent use with other CNS depressants

Important Note: This is a neutral, educational overview based on FDA labeling and medical sources. Promethazine Codeine Oral Solution is a controlled prescription medication with substantial risks of misuse, addiction, respiratory depression, and overdose. This information does not encourage use. Only take it exactly as prescribed by a licensed healthcare provider. Misuse can be fatal. Consult a doctor or pharmacist for any medical concerns and comply with all local laws.