Comparative Pharmacology
Head-to-head clinical analysis: HISTAFED versus PROMETHAZINE.
Peer-Reviewed Evidence
Head-to-head clinical analysis: HISTAFED versus PROMETHAZINE.
HISTAFED vs PROMETHAZINE
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
HISTAFED is a combination of pseudoephedrine, a sympathomimetic amine that acts as a decongestant by stimulating alpha-adrenergic receptors in the nasal mucosa causing vasoconstriction, and triprolidine, a first-generation antihistamine that competes with histamine for H1-receptor sites on effector cells in the gastrointestinal tract, blood vessels, and respiratory tract, thereby preventing histamine-mediated effects.
Promethazine is a phenothiazine derivative that acts as a potent histamine H1 receptor antagonist, thereby blocking the effects of histamine. It also has central anticholinergic, antiemetic, and sedative properties, likely mediated through antagonism at muscarinic, dopamine D2, and serotonin receptors in the brain.
60 mg orally every 4 to 6 hours as needed; maximum 360 mg per day.
12.5-25 mg IM or IV every 4-6 hours; also 25 mg PO or PR every 6-8 hours. Maximum 100 mg/day.
None Documented
None Documented
Clinical Note
moderatePromethazine + Risedronic acid
"Promethazine can cause an increase in the absorption of Risedronic acid resulting in an increased serum concentration and potentially a worsening of adverse effects."
Clinical Note
moderatePromethazine + Methylphenidate
"Promethazine can cause an increase in the absorption of Methylphenidate resulting in an increased serum concentration and potentially a worsening of adverse effects."
Clinical Note
moderatePromethazine + Artesunate
"The serum concentration of Artesunate can be increased when it is combined with Promethazine."
Clinical Note
moderate3-4 hours for pseudoephedrine component; shorter in children (2-3 h), prolonged in renal impairment
Terminal elimination half-life 9-16 hours; may be prolonged in hepatic impairment.
Renal (approximately 65% as unchanged drug and metabolites), biliary/fecal (35%)
Renal (70-80% as metabolites, <1% unchanged); biliary/fecal minor.
Category C
Category A/B
Antihistamine/Decongestant Combination
Antihistamine / Antiemetic
Promethazine + Clotrimazole
"The metabolism of Clotrimazole can be decreased when combined with Promethazine."