Comparative Pharmacology
Head-to-head clinical analysis: ALEVE PM versus HYDROCODONE BITARTRATE AND IBUPROFEN.
Peer-Reviewed Evidence
Head-to-head clinical analysis: ALEVE PM versus HYDROCODONE BITARTRATE AND IBUPROFEN.
ALEVE PM vs HYDROCODONE BITARTRATE AND IBUPROFEN
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
Diphenhydramine is a histamine H1 receptor antagonist that competes with histamine for binding at H1 receptor sites, reducing symptoms of allergic reactions and causing sedation. Naproxen is a nonsteroidal anti-inflammatory drug (NSAID) that inhibits cyclooxygenase (COX) enzymes, decreasing synthesis of prostaglandins, which reduces pain and inflammation.
Hydrocodone is a semisynthetic opioid agonist with selectivity for mu-opioid receptors, producing analgesia and sedation. Ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID) that inhibits cyclooxygenase (COX-1 and COX-2), reducing prostaglandin synthesis, thereby providing anti-inflammatory, analgesic, and antipyretic effects.
1 tablet (220 mg naproxen sodium / 25 mg diphenhydramine HCl) orally at bedtime as needed. Maximum: 2 tablets in 24 hours.
One tablet (hydrocodone bitartrate 5 mg/ibuprofen 200 mg) orally every 4 to 6 hours as needed for pain; maximum 5 tablets per day.
None Documented
None Documented
Naproxen: 12-17 hours (mean 13.6 hours); sufficient for twice-daily dosing; prolonged in renal impairment. Diphenhydramine: 2.4-9.3 hours (mean 5.5 hours); longer in elderly, hepatic impairment.
Hydrocodone: 3.8-4.5 hours (immediate release); Ibuprofen: 1.8-2.5 hours (racemic, S-enantiomer slightly shorter). Clinical context: dosing every 4-6 hours due to hydrocodone half-life.
Naproxen: renal (95% as unchanged drug and metabolites, primarily as naproxen and 6-O-desmethyl naproxen). Diphenhydramine: renal (50-60% as unchanged drug and metabolites, primarily as diphenhydramine and nor diphenhydramine); small amounts in feces.
Hydrocodone: primarily renal (60-70% as metabolites, <12% unchanged); Ibuprofen: primarily renal (90% as metabolites and conjugates, <1% unchanged), minor biliary/fecal.
Category C
Category D/X
NSAID/Antihistamine Combination
NSAID