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Drugs & treatments

“Purple drank”: When cough syrup becomes a lethal drug

October 12, 2018

It has already sent several celebrities to hospital, including singers, rappers and professional athletes, and it is known as a widespread drug among the rap community of the South of the United States. That’s why Actavis, a company that produces the preparation with its characteristic purple color, has stopped the production and sales of the powerful cough syrup nicknamed “Prometh” because of its recreational use in a cocktail known as “purple drank“. This drug, popular in the United States, was in fact withdrawn because it was held responsible for some deaths. We talked about this issue with Dr. Maria Fazio, head of the Humanitas pharmacy.


A potentially lethal cocktail

The main ingredient of “purple drank“, a potentially lethal cocktail with a characteristic purple color, is Actavis’ “Prometh” cough syrup, recently suspended because it contains prometazine and codeine, two substances that, if mixed, could be used by drug dealers for “recreational” use. To look like a drug, this potentially “killer” cough syrup is cut with soda, candy and sometimes alcohol.


Prometazine hydrochloride belongs to the class of phenothiazines, a class of drugs that is used in various antihistamine and antipsychotic preparations. If taken alone, prometazine usually has no psychotropic effects but if mixed with other depressive drugs such as codeine and alcohol it can be used as a drug.


The body in fact metabolizes Codeine into Morphine. In Actavis cough syrup, codeine is used to suppress coughing, but it can also cause intoxication, analgesia and euphoria.


Symptoms and effects of “purple drink”

Side effects of abusing the cough syrup include respiratory failure, drowsiness, and hypotension, all leading to sudden death. These are some of the symptoms experienced by those who have misused Actavis’ cough syrup mixed with other substances. Overdose of prometazine can also cause anticholinergic symptoms such as hyperthermia, dry skin and dry mucous membranes, delirium, pupil dilation, spasticity, and even loss of voluntary movement (ataxia).


The positive news is that Actavis has now ceased the production and sale of Prometh. It remains to be seen whether those who abuse the “purple drink” will find another way to prepare a cocktail full of promethazine and opioids.

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