Comparative Pharmacology
Head-to-head clinical analysis: CLOPRA versus PROMETHAZINE W DEXTROMETHORPHAN.
Peer-Reviewed Evidence
Head-to-head clinical analysis: CLOPRA versus PROMETHAZINE W DEXTROMETHORPHAN.
CLOPRA vs PROMETHAZINE W/ DEXTROMETHORPHAN
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 and antiemetic; dextromethorphan is a non-opioid antitussive 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.
5 mL (containing promethazine 6.25 mg and dextromethorphan 15 mg) orally every 4-6 hours as needed, not to exceed 30 mL (promethazine 37.5 mg, dextromethorphan 90 mg) per 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: 9-16 h; dextromethorphan: 3-5 h (extensive metabolizers), 30-50 h (poor metabolizers). Clinical context: dosing interval typically 4-6 h for dextromethorphan; promethazine accumulates with repeated dosing.
Renal (50-70% as unchanged drug and metabolites); fecal (20-30%); biliary (minor ~5%)
Renal: promethazine ~6% unchanged, dextromethorphan ~0.5% unchanged; metabolites primarily renal. Biliary/fecal: minor routes for both.
Category C
Category A/B
Antiemetic/Prokinetic Agent
Antihistamine / Antiemetic
Metoclopramide + Clotrimazole
"The metabolism of Clotrimazole can be decreased when combined with Metoclopramide."