Talk:Promethazine

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Death may occur when promethazine is combined with other depressants, such as opioids, benzodiazepines, barbiturates, thienodiazepines or other GABAergic substances like alcohol.[1]

Additionally, promethazine is an anticholinergic, and at high doses it may cause delirium and extremely unpleasant if not dangerous experiences. Please be extremely careful when trying this pharmaceutical and use responsible use practices such as always having a tripsitter when using promethazine, especially at high doses.

Summary sheet: Promethazine
Promethazine
Promethazine.svg
Chemical Nomenclature
Common names Phenergan
Substitutive name Promethazine
Systematic name N,N,α-trimethyl-10H-phenothiazine-10-ethanamine
Class Membership
Psychoactive class Depressant / Deliriant
Chemical class Phenothiazine
Routes of Administration

WARNING: Always start with lower doses due to differences between individual body weight, tolerance, metabolism, and personal sensitivity. See responsible use section.



Oral
Dosage
Threshold 15 - 25 mg
Light 25 - 50 mg
Common 50 - 75 mg
Strong 75 - 100 mg
Heavy 100 mg +
Duration
Total x - x hours
Onset x - x minutes
Come up x - x minutes
Peak x - x hours
Offset x - x hours
After effects x hours









DISCLAIMER: PW's dosage information is gathered from users and resources for educational purposes only. It is not a recommendation and should be verified with other sources for accuracy.


Promethazine (commonly sold as Phenergan and popularly known as one of the two active ingredients in "lean") is a first-generation antihistamine of the phenothiazine chemical class that produces muscle relaxing, nausea relieving and strong sedative effects when administered. It also reduces motion sickness and has anticholinergic properties.

Promethazine was developed in the mid-1940s when a team of scientists from Rhône-Poulenc laboratories was able to synthesize it from phenothiazine and a diamine side chain of diphenhydramine.[2] It was previously used as an antipsychotic,[3] although it is generally not administered for this purpose now. It has approximately 1/10 of the antipsychotic strength of chlorpromazine.

Today, promethazine is available in many countries under many brand names. Promethazine has been shown to have quality hypnotic effects and is sometimes used for this purpose.[4]

History and culture

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Promethazine became popular among the Houston rap and hip-hop scene in around 1990[5], and the trend resurfaced in around 2015 to 2016. Often, it was combined with the opiate drug codeine in a preparation called "lean." Lean usually consists of ice, Sprite or a citrus soda, the promethazine/codeine cough syrup, and sometimes, jolly ranchers added for flavor.

Chemistry

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Promethazine is a phenothiazine-based compound.

Pharmacology

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Promethazine is a direct antagonist of histamine H1 receptors, whereas diphenhydramine is an inverse agonist. It is also an antagonist of muscarinic acetylcholine receptors, which is likely the cause of sedation and delirium that occurs with higher doses. It blocks dopaminergic D2 receptors, but weakly. [citation needed]

Subjective effects

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Physical effects

Cognitive effects

  • Anxiety or Anxiety suppression - Anxiety rarely occurs in high doses and may occur as a result of delirium.[citation needed] Usually, promethazine acts as an anti-anxiety agent.
  • Delirium and confusion[7] - In low to moderate doses, promethazine presents a harmless sense of being confused or delirious. In high doses and overdose, it can become (but rarely does) so severe that the patient or user experiences excited delirium, a state of severe agitation and confusion.

Experience reports

There are currently no anecdotal reports which describe the effects of this compound within our experience index. Additional experience reports can be found here:

Toxicity and harm potential

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We also recommend that you conduct independent research and use harm reduction practices when using this substance.

It is strongly recommended that one use harm reduction practices when using this substance.

Lethal dosage

Tolerance and addiction potential

Dangerous interactions

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Although many psychoactive substances are reasonably safe to use on their own, they can quickly become dangerous or even life-threatening when taken with other substances. The following lists some known dangerous combinations, but cannot be guaranteed to include all of them. Independent research should always be conducted to ensure that a combination of two or more substances is safe to consume. Some interactions listed have been sourced from TripSit. Promethazine, because of its extensive pharmacology, has many interactions. According to the interactions checker on Drugs.com, promethazine is known to interact with over 1000 other prescription and OTC drugs.

  • Depressants (1,4-Butanediol, 2-methyl-2-butanol, alcohol, barbiturates, GHB/GBL, methaqualone, opioids) - This combination can result in dangerous or even fatal levels of respiratory depression. These substances potentiate the muscle relaxation, sedation and amnesia caused by one another and can lead to unexpected loss of consciousness at high doses. There is also an increased risk of vomiting during unconsciousness and death from the resulting suffocation. If this occurs, users should try to fall asleep in the recovery position or have a friend move them into it.
  • Anti-dopaminergics - Because promethazine also blocks dopamine receptors, other drugs and substances that do this will increase the chances of developing acute or tardive dyskinesia, neuroleptic malignant syndrome, or parkinsonism. [citation needed]
  • Anticholinergics - Promethazine with anticholinergics (or antimuscarinics) can cause increased blocking of acetylcholine, being potentially dangerous with cardiovascular effects as well as delirium. [citation needed]
  • Stimulants - Due to promethazine's excitatory cardiac effect, combining it with stimulants poses a risk of an abnormal heart rhythm, severe tachycardia, or a heart attack as well as other cardiovascular events.

Legal status

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See also

External links

Literature

References

  1. Risks of Combining Depressants (Tripsit) | https://tripsit.me/combining-depressants/
  2. Li, Jie Jack (2006). Laughing Gas, Viagra, and Lipitor: The Human Stories behind the Drugs We Use. United Kingdom: Oxford University Press. p. 146. ISBN 9780199885282. Retrieved July 9, 2016.
  3. https://web.archive.org/web/20110718172715/http://www.cja-jca.org/cgi/reprint/6/4/375.pdf. Archived from the original (PDF) on July 18, 2011. Retrieved October 30, 2008
  4. Adam K & Oswald, I. (1986). The hypnotic effects of an antihistamine: promethazine. British journal of clinical pharmacology, 22(6), 715-717.
  5. (2005) Tamara Palmer. Country Fried Soul: Adventures in Dirty South Hip-Hop
  6. Tsay, M. E., Procopio, G., Anderson, B. D., & Klein-Schwartz, W. (2015). Abuse and intentional misuse of promethazine reported to US poison centers: 2002 to 2012. Journal of addiction medicine, 9(3), 233-237. | PubMed Link: https://www.ncbi.nlm.nih.gov/pubmed/25822213
  7. Tsay, M. E., Procopio, G., Anderson, B. D., & Klein-Schwartz, W. (2015). Abuse and intentional misuse of promethazine reported to US poison centers: 2002 to 2012. Journal of addiction medicine, 9(3), 233-237. | PubMed Link: https://www.ncbi.nlm.nih.gov/pubmed/25822213