Comparative Pharmacology
Head-to-head clinical analysis: ALEVE PM versus KETOROLAC TROMETHAMINE AND PHENYLEPHRINE HYDROCHLORIDE.
Peer-Reviewed Evidence
Head-to-head clinical analysis: ALEVE PM versus KETOROLAC TROMETHAMINE AND PHENYLEPHRINE HYDROCHLORIDE.
ALEVE PM vs KETOROLAC TROMETHAMINE AND PHENYLEPHRINE HYDROCHLORIDE
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 is a nonsteroidal anti-inflammatory drug (NSAID) that inhibits cyclooxygenase (COX-1 and COX-2), reducing prostaglandin synthesis. Phenylephrine is a selective alpha-1 adrenergic receptor agonist, causing vasoconstriction.
1 tablet (220 mg naproxen sodium / 25 mg diphenhydramine HCl) orally at bedtime as needed. Maximum: 2 tablets in 24 hours.
Ophthalmic: 1 drop of the combination (ketorolac tromethamine 0.45% and phenylephrine hydrochloride 1%) into the operative eye three times daily, beginning 1 day prior to surgery and continuing on the day of surgery and for 2 weeks postoperatively.
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.
Ketorolac: 2.4-8.6 hours (mean 5.3 hours) in young adults; prolonged in elderly (up to 13.9 hours) and renal impairment. Phenylephrine: 2-3 hours.
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.
Ketorolac: ~92% renal (60% as unchanged drug, 32% as metabolites), 6% fecal. Phenylephrine: primarily renal as metabolites (sulfate conjugates) with <1% unchanged.
Category C
Category D/X
NSAID/Antihistamine Combination
NSAID