Comparative Pharmacology
Head-to-head clinical analysis: CLOPRA versus PROMETHAZINE HYDROCHLORIDE AND DEXTROMETHORPHAN HYDROBROMIDE.
Peer-Reviewed Evidence
Head-to-head clinical analysis: CLOPRA versus PROMETHAZINE HYDROCHLORIDE AND DEXTROMETHORPHAN HYDROBROMIDE.
CLOPRA vs PROMETHAZINE HYDROCHLORIDE AND DEXTROMETHORPHAN HYDROBROMIDE
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 acts as a histamine H1 receptor antagonist, antiemetic, and sedative. Dextromethorphan is a cough suppressant that acts as an NMDA receptor antagonist and sigma-1 receptor agonist.
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.
For cough and upper respiratory symptoms: 5 mL (containing promethazine hydrochloride 6.25 mg and dextromethorphan hydrobromide 15 mg) orally every 4 to 6 hours, not to exceed 30 mL in 24 hours.
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 (mean 12 hours). Dextromethorphan: extensive metabolizers (CYP2D6) 3-5 hours; poor metabolizers 20-30 hours. Clinical context: accumulation with repeated dosing, especially in poor metabolizers.
Renal (50-70% as unchanged drug and metabolites); fecal (20-30%); biliary (minor ~5%)
Promethazine: primarily hepatic metabolism, renal excretion of metabolites (~70%, <1% unchanged); fecal excretion (20-30%). Dextromethorphan: hepatic metabolism, renal excretion of metabolites and <1% unchanged drug.
Category C
Category A/B
Antiemetic/Prokinetic Agent
Antihistamine / Antiemetic
Metoclopramide + Clotrimazole
"The metabolism of Clotrimazole can be decreased when combined with Metoclopramide."