Currently I have a bottle of Promethazine DM (Promethazine HCL 6.25mg, DXM 15 mg,7% Alcohol per every 5mL) as well as Tramadol/APAP (37.5 mg Tramadol, 375 mg of APAP)

I was looking into taking 3 Tramadols & 20mL’s of Promethazine DM.

here’s a chart of the dosages I would be taking;

Tramadol 112.5 mg, APAP 1125  mg, Promethazine 25 mg, DXM 60 mg21% Alcohol???

So I’m wondering if this combination would be too strong for my liver? What are the side effects?

Should I reduce the amount of Promethazine DM I’m taking? Any other things you’d like to warn me about?


Alcohol is an excipient in this syrup: 7% alcohol in 5 ml means that you will have 7 mg of alcohol in 5 ml, 21 mg in 15 ml; that is quite a little dosage and effects and risks should be unnoticeable. On the other hand the dosage of APAP is in the limit high of the daily recommended dosage (1000 mg/day).

But besides pharmacological negative effects there is a more important question (at least from my point of view)…will this combination and dosage have any pleasurable effects? In my opinion probably not. High dosages of tramadol in non-tolerant persons will probably produce adverse effects (nausea, vomiting, dizziness…) and antihistaminergic effect of promethazine will lead to an umconfortable sleepy sensation. It should be important to be in a quiet place, avoid dangerous activities and…prepare a plastic bag for vomiting.

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