What is Promethazine?
Antihistamines are very useful things, more commonly found over the counter they help negate some of the unfortunate symptoms of mild allergies. An extremely popular antihistamine with varied uses is Promethazine. Here we’re going to go into full detail about it and show you the good, bad and ugly side of Promethazine.
Made very popular by hip-hop artists and rappers, this antihistamine is more than it seems. We’ll get into its more unconventional and somewhat illegal use in a bit but first, let’s try to understand what Promethazine is exactly.
Promethazine is a medication that is popularly used as an antihistamine but is also used for a few other medical reasons. This drug is a strong and effective sedative and also has weak antipsychotic effects.
Developed in the mid-1940’s Promethazine goes by many different brand names in different countries. Originally it was developed to help improve on an existing antihistamine called diphenhydramine. Promethazine is also very popular as a part of many combination drug formulas. It can be found in both tablet and liquid forms and is often combined with paracetamol, codeine, pseudoephedrine and other drugs to help deliver results on various levels for the required use.
Most antihistamines are available over the counter, but with way, it’s combined and misuse of the drug, Promethazine requires a prescription.
Medical Uses of Promethazine – The Good
There are quite a few uses for Promethazine, here we’ll discuss the medical ones before we talk about the alternate uses. Medical uses for Promethazine include:
- For sedation
- To counteract post narcotic nausea
- As an antihistamine
- As a treatment for anaphylactic shock
- To treat a cough
- To treat motion or sea sickness
- To combat morning sickness in pregnant women
- To treat migraines
How does Promethazine work?
The first thing to understand about promethazine is that it belongs to a unique class of chemicals known as phenothiazine. While all drugs in this class are chemically related, they vary in their medicinal uses based on their properties.
Promethazine, in particular, is most popular for its use as an antihistamine and sedative properties. This means it’s a viable choice of treatment for those who suffer from allergies. It is also often combined with codeine in drug combinations that enhance its sedative properties.
Promethazine is fairly safe to take as long as you stick to the right dosage. In general, it is widely understood that too much of anything especially a chemical that is synthetic in nature is likely to cause problems if used irresponsibly.
Tablets for Promethazine come in three dosages – 12.5mg, 25mg, and 50mg. In the form of syrups, however, it can be more potent and is available in three different strength formulations – 25mg/ml, 25mg/5ml, and 25mg/25ml. With syrup based versions of promethazine it is very easy to be irresponsible and in its liquid form, it is misused for recreational use. We’ll go into this soon.
Side Effects of Promethazine – The Bad
Promethazine has been around for a long time and it was one of the first of its kind when it was developed, which always means that the newer versions that are somewhat safer don’t cay as many side effects as Promethazine.
Listed below are the side effects of the most common and well known to the more serious side effects:
- Dry mouth
- Confusion (Especially in the elderly)
- Feelings of chest discomfort (specific to people taking medication for high blood pressure)
- The feeling of pins and needles (Paresthesia)
- Feelings of restlessness
- Respiratory depression (in toddlers under the age of two or people with improper pulmonary function)
If used irresponsibly and if it interacts badly with other medication, the chances of side effects are more likely.
Promethazine is often combined with other drugs for medical purposes but it also interacts with drugs that it isn’t necessarily combined with. The list of drugs it interacts with is fairly long and includes anti-anxiety drugs, opioids (painkillers), Muscle relaxants, sleeping pills, anti-depressants, and anti-psychotics. It also reacts with alcohol.
Essentially any drug that works in a psychoactive nature or affects the brain in any way, promethazine interacts with it. This can go both ways, good and bad. It is generally considered unwise to combine Promethazine with any drug without consulting a doctor because one bad reaction is really all it takes.
Recreational Use – The Ugly
One of the most common and well-known combinations of Promethazine is with Codeine. Although it’s a combination that has been around for a long time, it has seen a popularity in recreational use in the last two decades or so.
This combination is mostly found in cough syrups and it’s this version that is commonly used for recreation. This brings us back to those hip-hop and rap artists we mentioned at the beginning of this article.
Made hugely popular by them, they also managed to spread the word far and wide. There is so much slang for the combination most of which are fairly well known to the point where some have their own Wikipedia page.
Slang for the promethazine and codeine combination include:
- Purple Drank
- Dirty sprite
- Texas tea
- Purple jelly
There are probably more but, these are probably the most well-known ones. This combo’s recreational use started sometimes in the early 1990s in Houston, Texas and from there, it spread like wildfire with hip-hop finding international popularity.
The ugly part of all this is that codeine is the probably the main culprit behind the effects while promethazine enhances them because of the way the two drugs interact. This means that promethazine alone is mostly useless. The main reason that it’s ever so popular though, is that the codeine makes this combo highly addictive and stopping use can lead to strong withdrawal symptoms.
The cough syrups that include these combos are not a problem in themselves, but they are often misused and consumed in higher dosages than recommended. Often mixed with Sprite or Mountain Dew it is particularly popular among teenagers who manage to get their hands on the cough syrup and mix it with soda to create its recreational effects.
Its psychological effects have been described as euphoric. It is accompanied by lethargy, impairment of motor-skills, drowsiness and a feeling of dissociation.
In high doses for recreational use, users can find themselves dealing with respiratory suppression and other nasty side effects of an otherwise safe drug when used responsibly. Opiate addictions can cause a bit of problem especially with regards to this combo because Respiratory depression which is one of the more serious side effects of using this combination irresponsibly (too much and too often) can even be fatal or cause serious hospitalization.
Promethazine by itself isn’t the problem, but it is aged in the sense that other drugs that perform similar functions but in a much safe manner are now available on the market. These alternatives are also not going to be of much use for recreational use.
There are so many alternatives to Promethazine for both safe treatment and harmless recreational use. Being responsible is the key and knowing what goes on behind the way we use a drug is vital. Misuse can stem from many reasons, but lack of education on the subject is perhaps one of the main culprits.
The problem with promethazine is the way it interacted with a highly addictive opioid. Its misuse can definitely cause a lot of problems and it is because of it combined with an opioid that this drug is controlled and only legal if you have a valid prescription.
The biggest problem with its recreational use is probably the fact that it can influence teenagers and younger minds that aren’t fully aware of the risks involved with taking a combination that can do more damage than good, and why? Because they heard their favorite hip hop artist or rapper rave about it in a song. Rapper lifestyles are famously over the top and riddled with controversy, so it’s somewhat understandable why teenagers might consider it cool or trendy to get on board with it. The problem is that it is suspected that 1 out of every 10 teenagers in the user has tried this combination.
Everything said and done, it is still pretty easy to get your hands on this famous recreational combination, you might want to consider alternatives that aren’t addictive and won’t put you in the hospital.
Sol Ruiz heads our Research Digest department. He graduated from the New York University where he obtained his Master’s Degree in Public Health.