Comparative Pharmacology
Head-to-head clinical analysis: CLOPRA versus PROMETHAZINE HYDROCHLORIDE AND CODEINE PHOSPHATE.
Peer-Reviewed Evidence
Head-to-head clinical analysis: CLOPRA versus PROMETHAZINE HYDROCHLORIDE AND CODEINE PHOSPHATE.
CLOPRA vs PROMETHAZINE HYDROCHLORIDE AND CODEINE PHOSPHATE
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
Clopra (metoclopramide) is a dopamine D2 receptor antagonist and a 5-HT4 receptor agonist, enhancing gastrointestinal motility and having antiemetic effects via central and peripheral actions.
Promethazine is a phenothiazine derivative that antagonizes histamine H1 receptors, reducing allergic symptoms; it also has anticholinergic, antiemetic, and sedative effects. Codeine is an opioid agonist at mu-opioid receptors, producing analgesia and antitussive effects by central mechanisms.
Clopra (metoclopramide) 10 mg orally or intramuscularly 30 minutes before meals and at bedtime; maximum 30 mg/day. For intravenous administration, give 10 mg over 1-2 minutes.
Adults: 5 mL (containing promethazine 6.25 mg and codeine 10 mg) orally every 4-6 hours as needed; maximum 30 mL per day.
None Documented
None Documented
Clinical Note
moderateMetoclopramide + Haloperidol
"The risk or severity of adverse effects can be increased when Metoclopramide is combined with Haloperidol."
Clinical Note
moderateMetoclopramide + Quinagolide
"The therapeutic efficacy of Quinagolide can be decreased when used in combination with Metoclopramide."
Clinical Note
moderateMetoclopramide + Cyclosporine
"Metoclopramide can cause an increase in the absorption of Cyclosporine resulting in an increased serum concentration and potentially a worsening of adverse effects."
Clinical Note
moderateTerminal elimination half-life 6-8 hours (prolonged in renal impairment; up to 20 hours in severe CKD)
Promethazine: 10-19 hours (range 5-30h); Codeine: 2.5-4 hours (rapidly metabolized); Clinical context: sustained antitussive effect from codeine despite short half-life. Half-life of promethazine extends with hepatic impairment.
Renal (50-70% as unchanged drug and metabolites); fecal (20-30%); biliary (minor ~5%)
Renal: Codeine and metabolites ~90% (free and conjugated), Promethazine and metabolites primarily renal; minor biliary/fecal (<5% for codeine, ~6% for promethazine).
Category C
Category A/B
Antiemetic/Prokinetic Agent
Antihistamine / Antiemetic
Metoclopramide + Clotrimazole
"The metabolism of Clotrimazole can be decreased when combined with Metoclopramide."