Sedatives & Hypnotics
Promethazine (Phenergan)
Street names: Phenergan, Prometh, Lean ingredient, Sizzurp component
Overdose? Act now. Call emergency services — say "unresponsive, not breathing". Give naloxone for opioid-like signs. Hotlines
⚡What it does
- Sedating antihistamine: potentiation of opioids and codeine — the lean engine
- Anti-nausea, anti-motion-sickness
⚠Key risks
- THE LEAN MULTIPLIER: promethazine deepens codeine's respiratory depression — the combination in purple drank is part of why it kills
- IV promethazine: severe tissue necrosis (the famous black-box warning)
- Sedation, confusion in elders (Beers criteria)
- OTC availability drives combo misuse
✚Overdose signs
- Deep sedation
- Slow breathing (with codeine)
- Injection-site necrosis
📋Quick facts
Also known asPhenergan, Prometh, Lean ingredient, Sizzurp component
CategorySedatives & Hypnotics
Schedule / classRx US; OTC UK/EU (pharmacy); not controlled
Appearance25 mg tablets, syrup (the purple), injection
Street price~$0.20–$1 per tablet; syrup $5–$15
Legal statusRx US; OTC-UK/pharmacy-EU; unscheduled
Last updated2026-09-18
Sources: FDA, NHS
Category comparison — Sedatives & Hypnotics
| Substance | Class | Top risks | Street price |
|---|---|---|---|
| Promethazine (Phenergan) | Rx US; OTC UK/EU | THE LEAN MULTIPLIER: promethazine deepens codeine's respiratory depression — the combination in purple drank is part of why it kills; IV promethazine: severe tissue necrosis (the famous black-box warning) | ~$0.20–$1 per tablet |
| Purple Drank (Lean / Codeine Syrup) | Schedule V | RESPIRATORY DEPRESSION — the mix slows breathing; deaths (DJ Screw, Pimp C, many others); Promethazine potentiates codeine's respiratory danger | Rx bottle $50–$300 diverted |
| Codeine 30/500 mg (co-codamol) | Schedule V / Rx | Paracetamol component destroys the liver at high doses; Lean + alcohol risks fatal respiratory depression | ~$2–$10 per tablet |
| Hydroxyzine (Vistaril / Atarax) | Rx-only — not controlled | Not euphoric — dependence rare; the harm is oversedation and combos; QT-prolongation caution (heart rhythm) | ~$0.20–$1 per tablet |
Street prices are regional estimates. Potency and cuts vary constantly.
?Frequently asked questions
What does Promethazine (Phenergan) look like?
25 mg tablets, syrup (the purple), injection
What are the signs of a Promethazine (Phenergan) overdose?
Deep sedation; Slow breathing (with codeine); Injection-site necrosis Call emergency services immediately.
How addictive is it?
THE LEAN MULTIPLIER: promethazine deepens codeine's respiratory depression — the combination in purple drank is part of why it kills Dependence can develop with regular use.