Phenothiazine Withdrawal Guide

An image of Karena Mathis, author for gratitude lodge
Authored By:

Karena Mathis

Edited By

Amy Leifeste

Medically Reviewed By

Sean O'Neill
MS, LMFT 112879

Explore treatment options today. For general drug info, contact your doctor.

Phenothiazine Withdrawal Guide

Authored By:

Karena Mathis

Edited By

Amy Leifeste

Explore treatment options today. For general drug info, contact your doctor.

Promethazine Withdrawal Effects and Timeline


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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?

WHAT IS INVOLVED IN THE PROMETHAZINE WITHDRAWAL PROCESS?

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.

PROMETHAZINE WITHDRAWAL SYMPTOMS

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

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.

HOW TO MANAGE PROMETHAZINE WITHDRAWAL

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.

WHAT FACTORS CAN COMPLICATE PROMETHAZINE WITHDRAWAL?

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.

GET HELP FOR PROMETHAZINE ADDICTION AT GRATITUDE LODGE

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 844-576-0144.

Questions? Call Our Team Today!

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Hello I'm Rhonda Alcoholic I Can Actually Say Gratitude Lodge did it's work on person like myself. This place I will give Millions thumbs up. I felt at work was welcome with opening arms. The Case Manager Roger and The Therapist Joe Is truly appreciate and amazing. Brung me back to reality helped me understand that I wasn't alone through this addiction I am battling. If You or Anyone looking for a detox and rehab this is the most beautiful place to get back we're you need to be.. All the team Staff's is so so amazing not just one all of them show so much support and love to everyone.. Give Gratitude Lodge a 💯
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Gratitude Lodge is a great organization for anyone looking for a safe, supportive place to begin their recovery journey. If you're looking for a safe detox followed by a 30-day residential treatment stay, Gratitude Lodge provides an environment where you can step away from the chaos, find yourself, and surround yourself with supportive and encouraging people who genuinely want to see you succeed. The facility provides a safe, clean environment with wraparound case management, therapy, peer support, and a strong focus on helping each person become mentally, physically, and emotionally stable. Recovery isn't easy, but having the right environment and the right people around you can make a huge difference. If you or someone you love is struggling, reach out to Gratitude Lodge and take that first step. Five-star. Top-of-the-line treatment. A place where recovery is taken seriously. Respectfully, James T Krier
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I had an incredible experience at Gratitude Lodge during my 30-day alcohol treatment program. From the moment I arrived, I felt welcomed, supported, and genuinely cared for. The staff was absolutely amazing—from the facilitators and clinical team to the people who helped with transportation and the day-to-day experience. Everyone I interacted with was compassionate, professional, and truly invested in helping me succeed. The facility itself is a really comfortable, welcoming home rather than feeling like a traditional treatment facility. The amenities were great, the food was excellent, and the overall environment made it much easier to focus on recovery and personal growth. I also really appreciated the variety of panels, groups, and facilitators throughout the program. Having transportation available to the gym, AA meetings, and other activities was incredibly helpful and allowed us to stay active and connected to the recovery community. One of the things that really stood out to me was the extracurricular activities. Recovery wasn’t just about sitting in groups all day. We had opportunities to get outside and enjoy some of the incredible surroundings, including trips to the beach, paddle boarding and kayaking in the Back Bay, visits to Crystal Cove, and having lunch together on the Balboa Peninsula. Those experiences created some great memories and gave us opportunities to connect with each other in a completely different setting. Most importantly, I left Gratitude Lodge feeling like I had been given the tools, support, and perspective I needed to continue my recovery. I am extremely grateful for the experience and for everyone there who played a part in it. I would highly recommend Gratitude Lodge to anyone who is looking for help with drug or alcohol addiction. If you’re willing to put in the work, I believe this is a place where you can feel supported, comfortable, and surrounded by people who genuinely want to see you succeed. Special shout outs to Roger and Joe on the clinical team, and the techs; McKayla, Claire, Luke, Felipe, Josh, Jordan, and Ayden!
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I had the pleasure of touring this detox and residential treatment facility, and I was truly impressed. From the moment I arrived, I was warmly greeted by the staff and clinical team. It was clear that they genuinely care about the people they serve and take the time to engage with each individual, making you feel like more than just a number. They also have a chef on-site who was cooking while I was there, and the delicious smell throughout the house made the environment feel even more welcoming and comforting. The location is amazing--just minutes away from Long Beach, with beautiful views of the water that create a peaceful, relaxing, and therapeutic atmosphere. Overall, I was amazed by this facility and would highly recommend it to anyone struggling with substance abuse and/or mental health challenges. The staff, environment, and level of care truly stood out to me.
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