Comparative Pharmacology
Head-to-head clinical analysis: ALEVE PM versus INDOMETHACIN.
Peer-Reviewed Evidence
Head-to-head clinical analysis: ALEVE PM versus INDOMETHACIN.
ALEVE PM vs INDOMETHACIN
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.
Non-selective cyclooxygenase (COX-1 and COX-2) inhibitor, reducing prostaglandin synthesis.
1 tablet (220 mg naproxen sodium / 25 mg diphenhydramine HCl) orally at bedtime as needed. Maximum: 2 tablets in 24 hours.
25-50 mg orally 2-3 times daily; maximum 200 mg/day. Also available as 75 mg sustained-release capsule orally once daily, or 50 mg rectally 3-4 times daily.
None Documented
None Documented
Clinical Note
moderateIndomethacin + Gatifloxacin
"Indomethacin may increase the neuroexcitatory activities of Gatifloxacin."
Clinical Note
moderateIndomethacin + Rosoxacin
"Indomethacin may increase the neuroexcitatory activities of Rosoxacin."
Clinical Note
moderateIndomethacin + Levofloxacin
"Indomethacin may increase the neuroexcitatory activities of Levofloxacin."
Clinical Note
moderateIndomethacin + Trovafloxacin
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.
Terminal elimination half-life is approximately 4.5 hours (range 2.6-11.2 hours) in adults; prolonged in neonates (up to 17 hours) and in patients with renal impairment or cholestasis; clinical context: dosing interval adjustments needed in hepatic or renal disease.
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.
Renal excretion of unchanged drug and metabolites (approximately 60% as parent drug and glucuronide conjugate; 23% as O-desmethyl metabolite; 13% as glucuronide of O-desmethyl metabolite); biliary/fecal elimination accounts for 30-40%, primarily as glucuronide conjugates.
Category C
Category D/X
NSAID/Antihistamine Combination
NSAID
"Indomethacin may increase the neuroexcitatory activities of Trovafloxacin."