Comparative Pharmacology
Head-to-head clinical analysis: ALEVE PM versus IBUPROFEN AND DIPHENHYDRAMINE CITRATE.
Peer-Reviewed Evidence
Head-to-head clinical analysis: ALEVE PM versus IBUPROFEN AND DIPHENHYDRAMINE CITRATE.
ALEVE PM vs IBUPROFEN AND DIPHENHYDRAMINE CITRATE
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.
Ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID) that inhibits cyclooxygenase (COX-1 and COX-2) enzymes, reducing prostaglandin synthesis and thereby decreasing pain, fever, and inflammation. Diphenhydramine citrate is an antihistamine that antagonizes histamine H1 receptors, producing sedative and anticholinergic effects.
1 tablet (220 mg naproxen sodium / 25 mg diphenhydramine HCl) orally at bedtime as needed. Maximum: 2 tablets in 24 hours.
Ibuprofen 200 mg + Diphenhydramine citrate 38 mg (equivalent to diphenhydramine HCl 25 mg) orally every 4-6 hours as needed, not to exceed Ibuprofen 1200 mg/day or Diphenhydramine citrate 152 mg/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.
Ibuprofen: terminal elimination half-life approximately 1.8-2.5 hours in adults; prolonged in elderly and patients with hepatic impairment. Diphenhydramine: terminal elimination half-life ranges from 4 to 10 hours (mean 7 hours); may be prolonged in elderly and hepatic impairment.
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.
Ibuprofen: renal elimination of metabolites (approximately 90%) and unchanged drug (approximately 10%); fecal elimination <5%. Diphenhydramine: primarily renal elimination (approximately 60-70% as metabolites, 1-2% unchanged); fecal elimination approximately 10-15%.
Category C
Category D/X
NSAID/Antihistamine Combination
NSAID