Comparative Pharmacology
Head-to-head clinical analysis: BARHEMSYS versus PROMETHAZINE.
Peer-Reviewed Evidence
Head-to-head clinical analysis: BARHEMSYS versus PROMETHAZINE.
BARHEMSYS vs PROMETHAZINE
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
BARHEMSYS (amisulpride) is a selective dopamine D2/D3 receptor antagonist. It also has weak affinity for serotonin 5-HT2A and 5-HT2B receptors, with no significant activity at other dopamine or serotonin receptor subtypes. Its antiemetic effect is primarily mediated through blockade of D2 receptors in the chemoreceptor trigger zone (CTZ).
Promethazine is a phenothiazine derivative that acts as a potent histamine H1 receptor antagonist, thereby blocking the effects of histamine. It also has central anticholinergic, antiemetic, and sedative properties, likely mediated through antagonism at muscarinic, dopamine D2, and serotonin receptors in the brain.
BARHEMSYS (amisulpride) 10 mg intravenously over 2 minutes, once daily for prevention of postoperative nausea and vomiting.
12.5-25 mg IM or IV every 4-6 hours; also 25 mg PO or PR every 6-8 hours. Maximum 100 mg/day.
None Documented
None Documented
Clinical Note
moderatePromethazine + Risedronic acid
"Promethazine can cause an increase in the absorption of Risedronic acid resulting in an increased serum concentration and potentially a worsening of adverse effects."
Clinical Note
moderatePromethazine + Methylphenidate
"Promethazine can cause an increase in the absorption of Methylphenidate resulting in an increased serum concentration and potentially a worsening of adverse effects."
Clinical Note
moderatePromethazine + Artesunate
"The serum concentration of Artesunate can be increased when it is combined with Promethazine."
Clinical Note
moderateTerminal elimination half-life is approximately 24 hours, supporting once-daily dosing in most patients.
Terminal elimination half-life 9-16 hours; may be prolonged in hepatic impairment.
Renal excretion accounts for approximately 50% of the dose as unchanged drug; fecal elimination (including biliary) accounts for approximately 30-40%.
Renal (70-80% as metabolites, <1% unchanged); biliary/fecal minor.
Category C
Category A/B
Antiemetic
Antihistamine / Antiemetic
Promethazine + Clotrimazole
"The metabolism of Clotrimazole can be decreased when combined with Promethazine."