Promethazine Withdrawal Effects and Timeline

Promethazine is a first-generation antihistamine belonging to a class of medications known as phenothiazines. 

The generic medication is used to treat conditions including:

  • Nausea and vomiting
  • Allergic conditions
  • Motion sickness
  • Post-surgery pain relief

Promethazine has sedative properties. This is why it is often included as an ingredient in sleep aids, as well as in cough syrup and cold medicines that induce drowsiness.

Used in isolation, promethazine is not especially additive. This study highlights the fact that just 354 cases of promethazine abuse were noted by NPDS (National Poison Data System) in the decade from 2002 to 2012. Among these cases, less than one in five required hospitalization.

Regrettably, promethazine is frequently used in combination with other substances, notably codeine. Codeine is classified as an opioid analgesic and is a schedule II controlled substance. Like all narcotics under this schedule, codeine has a strong potential for abuse that can trigger both physical and psychological dependence.

Today’s guide to promethazine withdrawal focuses on the substance when used in combination with codeine. This potent combination has been popularized in the form of lean, also known as purple drank. 

What can you expect from promethazine withdrawal, then?


Promethazine withdrawal typically also involves withdrawal from codeine. This is the most challenging aspect of detox

The sustained use of codeine can cause tolerance to form rapidly. This means you will require more of the medication to achieve the same effects. If you start using more opioids, physical dependence can rapidly develop. This occurs as your body becomes accustoms to the constant presence of opioids and adapts accordingly.

Abruptly discontinuing the use of combination promethazine and codeine products will cause unpleasant withdrawal symptoms to manifest. Withdrawal symptoms can be so intense that many people continue using opioids to avoid the presentation of promethazine and codeine side effects. 

Codeine is a short-acting opioid. Effects typically last for between 4 and 6 hours. If you are detoxing from promethazine and a short-acting opioid like codeine, withdrawal symptoms often manifest as soon as 8 to 24 hours after the last dose.

In almost all cases, a medically supervised detox offers the safest and smoothest route to recovery from promethazine and codeine addiction.


If you need to detox from promethazine and codeine, you can expect to encounter physically painful symptoms alongside mental anguish. 

These are the most common promethazine withdrawal effects 

  • Nausea
  • Vomiting
  • Diarrhea
  • Teary eyes
  • Runny nose
  • Anxiety
  • Depression
  • Cravings
  • Yawning
  • Sweating
  • Headaches
  • Muscle pain
  • Restlessness
  • Dysphoria
  • Insomnia
  • Goosebumps
  • Stomach cramps
  • Fever
  • Accelerated heartbeat


promethazine withdrawal timeline infographic

Most promethazine withdrawal side effects should subside after a week or so. 

While everyone has a slightly different experience during drug withdrawal and detox, promethazine withdrawal can be divided into three distinct phases. 

  • Phase 1 of promethazine withdrawal (days 1 to 4): During the first four days of promethazine withdrawal. Nausea, vomiting, headaches, and muscle soreness characterize this stage of detox as promethazine and codeine leave your system. The sedative effects of the medications will dissipate 24 hours after the last dose.
  • Phase 2 of promethazine withdrawal (days 5 to 7): Toward the end of the first week of promethazine and codeine withdrawal, some physical symptoms subside. New symptoms present. Rather than feeling shaky, sweaty, and nauseated, you may feel fatigued and dehydrated. These symptoms stem from the first four days of withdrawal and should soon dissipate. This phase of the promethazine withdrawal timeline also involves the presentation of psychological withdrawal symptoms. Depression often sets in and cravings for opioids still persist. If you detox in a clinical setting, you will minimize the likelihood of relapsing to alleviate withdrawal.
  • Phase 3 of promethazine withdrawal (days 8 onward): During the final phase of withdrawal from promethazine and codeine, all physical symptoms will have subsided. Physical detox is now complete. Cravings and psychological effects may linger for up to one month.


Although the physical withdrawal symptoms associated with promethazine are not usually life-threatening, the substance is often used in combination with codeine. Like all opioids, codeine can trigger intensely uncomfortable side effects that are best managed in a clinical setting.

A licensed medical detox center offers you access to medications to reduce the severity of withdrawal symptoms and cravings. These FDA-approved medications can also be effective during ongoing therapy, discouraging further substance use and promoting abstinence.

Additionally, around-the-clock medical supervision will reduce the chance of complications arising from opioid withdrawal becoming life-threatening.

Detoxing from promethazine and codeine at home is inadvisable and potentially dangerous.


During promethazine withdrawal, you may experience more severe pain, especially if you are suffering from a chronic pain condition.

Those with anxiety or panic disorders may find that they have panic attacks or episodes of anxiety during promethazine withdrawal. These complications can be mitigated in a clinical setting. 

Setting these issues aside, most people find that promethazine withdrawal is straightforward. If codeine is added to the equation, withdrawal becomes more uncomfortable and should always be undertaken with medical supervision.


If you are addicted to promethazine and codeine, we can help you address the physical and psychological aspects of opioid use disorder at Gratitude Lodge. We have affordable and pet-friendly Southern California rehab centers located in Long Beach, and Newport Beach

To streamline the promethazine withdrawal process, engage with our supervised medical detox program. FDA-approved medications can alleviate cravings and withdrawal symptoms, and you have access to continuous clinical and emotional care.

After a week or so, you will be physically stabilized and ready to transition directly into a 30-day inpatient rehab program. If you feel that you require less support and structure in your recovery, our IOP (intensive outpatient program) is a more flexible and affordable alternative to residential rehab. 

MAT (medication-assisted treatment) can be beneficial throughout ongoing treatment for opioid use disorders. In addition to MAT, you can take advantage of the following services and interventions at Gratitude Lodge:

  • Psychotherapy (talk therapies like CBT and DBT)
  • Individual counseling
  • Group therapy
  • Family therapy
  • Holistic therapies
  • Daily meetings
  • 12-step immersion program

When you are ready to move beyond promethazine abuse, reach out to Gratitude Lodge’s young adult rehab and get help by calling (800) 994-2184.

Questions? Call Our Team Today!

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