Comparative Pharmacology
Head-to-head clinical analysis: CLOPRA versus PROMETHAZINE WITH CODEINE.
Peer-Reviewed Evidence
Head-to-head clinical analysis: CLOPRA versus PROMETHAZINE WITH CODEINE.
CLOPRA vs PROMETHAZINE WITH CODEINE
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 at H1 receptors, acting as a sedative and antiemetic. Codeine is an opioid agonist at mu-opioid receptors, producing analgesia and antitussive effects via central nervous system depression.
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.
10-20 mg promethazine and 10-20 mg codeine (based on phosphate) orally every 4-6 hours as needed for cough; maximum daily codeine dose 120 mg.
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 hours (mean 12 hours), clinically significant for sedation duration. Codeine: 2.5-4 hours (mean 3 hours), with active metabolite morphine 2-3 hours.
Renal (50-70% as unchanged drug and metabolites); fecal (20-30%); biliary (minor ~5%)
Promethazine: renal 70% as metabolites and unchanged drug, biliary/fecal 20-30%. Codeine: renal 90% (5-15% unchanged, rest as morphine and conjugates), fecal <10%.
Category C
Category A/B
Antiemetic/Prokinetic Agent
Antihistamine / Antiemetic
Metoclopramide + Clotrimazole
"The metabolism of Clotrimazole can be decreased when combined with Metoclopramide."