Comparative Pharmacology
Head-to-head clinical analysis: ALEVE PM versus KETOROLAC TROMETHAMINE.
Peer-Reviewed Evidence
Head-to-head clinical analysis: ALEVE PM versus KETOROLAC TROMETHAMINE.
ALEVE PM vs KETOROLAC TROMETHAMINE
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.
Ketorolac tromethamine is a nonsteroidal anti-inflammatory drug (NSAID) that inhibits cyclooxygenase (COX-1 and COX-2) enzymes, reducing prostaglandin synthesis, thereby decreasing pain and inflammation.
1 tablet (220 mg naproxen sodium / 25 mg diphenhydramine HCl) orally at bedtime as needed. Maximum: 2 tablets in 24 hours.
10 mg orally every 4-6 hours, not to exceed 40 mg per day; or 15-30 mg intramuscularly or intravenously every 6 hours, not to exceed 120 mg per day (maximum 60 mg for single dose).
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.
Terminal half-life is 5-6 hours in young adults, prolonged to 9-10 hours in elderly patients (≥65 years) and up to 12-15 hours in renal impairment (CrCl <30 mL/min). Context: q6h dosing interval recommended; accumulation risk in elderly/renal 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.
Primarily renal excretion: ~92% of dose excreted in urine as parent drug (60%) and metabolites (p-hydroxyketorolac, conjugated forms). Fecal excretion accounts for ~6%. Biliary excretion is minimal.
Category C
Category D/X
NSAID/Antihistamine Combination
NSAID