Comparative Pharmacology
Head-to-head clinical analysis: APREPITANT versus PHENYLEPHRINE HYDROCHLORIDE AND PROMETHAZINE HYDROCHLORIDE.
Peer-Reviewed Evidence
Head-to-head clinical analysis: APREPITANT versus PHENYLEPHRINE HYDROCHLORIDE AND PROMETHAZINE HYDROCHLORIDE.
APREPITANT vs PHENYLEPHRINE HYDROCHLORIDE AND PROMETHAZINE HYDROCHLORIDE
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
Selective high-affinity antagonist of the human substance P/neurokinin 1 (NK1) receptor, inhibiting emesis by blocking the binding of substance P in the central nervous system.
Phenylephrine is a selective alpha-1 adrenergic receptor agonist causing vasoconstriction; promethazine is a phenothiazine derivative that blocks histamine H1 receptors and has anticholinergic, antiemetic, and sedative effects.
125 mg orally once on day 1, then 80 mg orally once on days 2 and 3 of a 3-day chemotherapy regimen, given 1 hour before chemotherapy. Alternatively, a single 165 mg oral dose for prevention of postoperative nausea and vomiting.
IV: 0.1-0.5 mg phenylephrine and 12.5-25 mg promethazine as a single dose.
None Documented
None Documented
Clinical Note
moderateAprepitant + Torasemide
"The metabolism of Torasemide can be increased when combined with Aprepitant."
Clinical Note
moderateAprepitant + Lornoxicam
"The metabolism of Lornoxicam can be increased when combined with Aprepitant."
Clinical Note
moderateAprepitant + Aceclofenac
"The metabolism of Aceclofenac can be increased when combined with Aprepitant."
Clinical Note
moderateAprepitant + Zaltoprofen
Terminal elimination half-life is approximately 9 to 13 hours in adults, allowing once-daily dosing. In pediatric patients, half-life may be shorter (about 5-6 hours).
Phenylephrine: 2-3 hours (terminal). Promethazine: 10-14 hours (terminal in adults; prolonged in elderly and hepatic impairment).
Aprepitant is eliminated primarily by metabolism; less than 5% is excreted unchanged in urine or feces. Approximately 50% of a dose is recovered in feces (mostly metabolites) and 10% in urine.
Phenylephrine: renal (80% as unchanged drug and sulfate conjugates). Promethazine: renal (70-80% as metabolites and unchanged drug), fecal (20-30%).
Category C
Category A/B
Antiemetic
Antihistamine / Antiemetic
"The metabolism of Zaltoprofen can be increased when combined with Aprepitant."