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Lean is a name given to a popular drug combination of codeine and promethazine. This used to be sold legally in the United States, but has since been pulled from the market due to abuse.

Generic codeine/promethazine cough syrup contained 10 mg of codeine and 6.25 mg of promethazine per 5 mL of liquid.[1] However, doses considerably higher than this were used recreationally, reportedly by up to a factor of 25.[2]

Legality and Availability[edit]

United States[edit]

Codeine/promethazine remains legal to sell in the United States. However, all manufacturers have pulled their products from the market, and the cough syrup is no longer in stock in US pharmacies.[3] Some online pharmacies continue to sell old stock for extremely high prices, with 32 oz bottles selling for as high as $200.

Promethazine is prescription-only, but not a controlled substance, meaning that importation may be possible. Some pharmacies will ship promethazine to the United States.

Codeine is a controlled substance, but codeine combination products are only schedule V, meaning that importation may be possible. From here, the codeine could be refined using cold water extraction.


In the UK, both promethazine[4] and codeine combination products are available over-the-counter.

In France, both promethazine and codeine combination products are available over-the-counter.

Alternate Formulation[edit]

The alternate formulation of lean substitutes dihydrocodeine for codeine and diphenhydramine (Benadryl) for promethazine. Dihydrocodeine has about twice the potency of codeine, and is cheaper to obtain in many markets, partially due to the fact that it is less well-known. Diphenhydramine is available legally and is very inexpensive, with some stores selling it for about US$0.02 per 25 mg dose.


  1. http://www.drugs.com/dosage/codeine-promethazine.html
  2. http://www.thedailybeast.com/articles/2013/03/17/lil-wayne-hospitalization-what-the-hell-is-sizzurp.html
  3. https://www.vice.com/read/sizzurp-is-the-new-quaalude
  4. https://www.erowid.org/pharms/promethazine/promethazine_law.shtml