Ingredients and Preparation of Lean

Typically, the base for lean is a strong prescription cold medicine, specifically cough syrup that contains both promethazine and codeine. Other preparations use codeine/guaifenasin, hydrocodone/chlorphenamine, hydrocodone/APAP, and hydrocodone/homatropine. Over-the-counter cold medicines that contain dextromethorphan (often paired with guaifenasin or acetaminophen) as the active ingredient have also been used, as they do not require acquiring a prescription.

To create a drinkable mixture, the cough syrup is combined with soft drinks, especially fruit-flavored drinks such as Sprite, Mountain Dew, or Fanta, and is typically served in two foam cups.A hard candy, usually a Jolly Rancher, may be added to give the mixture a sweeter flavor. Masking the undesired taste may impair judgment of the potency, which is a factor in overdosing.