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In 2016 promethazine codeine syrup was prescribed about 4 million times in the U.S., according to data compiled by Bloomberg Intelligence, and brought in $15 million in sales—a slight decline from when Actavis was on the market.
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These figures are curiously small relative to the syrup’s cultural influence, but enough reaches the illegal market to keep it in the public eye.
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Promethazine HCl and codeine phosphate oral solution exposes patients and other users to the risks of opioid addiction, abuse, and misuse, which can lead to overdose and death.
Reserve promethazine HCl and codeine phosphate oral solution for use in adult patients for whom the benefits of cough suppression are expected to outweigh the risks, and in whom an adequate assessment of the etiology of the cough has been made
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Assess each patient’s risk prior to prescribing promethazine HCl and codeine phosphate oral solution, prescribe promethazine HCl and codeine phosphate oral solution for the shortest duration that is consistent with individual patient treatment goals, monitor all patients regularly for the development of addition or abuse, and refill only after reevaluation of the need for continued treatment .