Comparative Pharmacology
Head-to-head clinical analysis: ALEVE PM versus PHERAZINE DM.
Peer-Reviewed Evidence
Head-to-head clinical analysis: ALEVE PM versus PHERAZINE DM.
ALEVE PM vs PHERAZINE DM
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.
Phererazine DM is a combination of promethazine (a phenothiazine derivative with antihistaminic, sedative, antiemetic, and anticholinergic properties) and dextromethorphan (a non-opioid antitussive that acts on the sigma-1 receptor and NMDA receptor antagonist). Promethazine blocks H1 receptors and reduces histamine-mediated symptoms, while dextromethorphan suppresses cough by central action on the cough center.
1 tablet (220 mg naproxen sodium / 25 mg diphenhydramine HCl) orally at bedtime as needed. Maximum: 2 tablets in 24 hours.
Adults: 1 tablet (promethazine 25 mg / dextromethorphan 30 mg) orally every 6-8 hours as needed; maximum 4 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.
Terminal elimination half-life: 3-4 hours in children; 5-6 hours in adults; up to 8 hours in elderly. Clinical context: Dosing interval adjustment needed in 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: 60-70% as unchanged drug and glucuronide conjugate; 15-20% fecal via biliary excretion.
Category C
Category C
NSAID/Antihistamine Combination
Antitussive/Antihistamine Combination