Comparative Pharmacology
Head-to-head clinical analysis: BARHEMSYS versus PROMETHAZINE W CODEINE.
Peer-Reviewed Evidence
Head-to-head clinical analysis: BARHEMSYS versus PROMETHAZINE W CODEINE.
BARHEMSYS vs PROMETHAZINE W/ CODEINE
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).
Codeine is a prodrug converted to morphine, a mu-opioid receptor agonist, which inhibits nociceptive transmission; promethazine is a phenothiazine derivative with H1-receptor antagonism, anticholinergic, and antiemetic effects.
BARHEMSYS (amisulpride) 10 mg intravenously over 2 minutes, once daily for prevention of postoperative nausea and vomiting.
10 mL (1 mg codeine, 6.25 mg promethazine per 5 mL) orally every 4-6 hours as needed for cough. Maximum: 60 mL per day. Do not exceed 5 days.
None Documented
None Documented
Terminal elimination half-life is approximately 24 hours, supporting once-daily dosing in most patients.
Promethazine: 10-19 hours (terminal). Codeine: 2.5-3.5 hours (terminal); prolonged in renal impairment.
Renal excretion accounts for approximately 50% of the dose as unchanged drug; fecal elimination (including biliary) accounts for approximately 30-40%.
Promethazine: renal (70% as metabolites, <1% unchanged), fecal (20-30%). Codeine: renal (90%, of which 5-10% unchanged, rest as metabolites), fecal (minor).
Category C
Category A/B
Antiemetic
Antihistamine / Antiemetic