Comparative Pharmacology
Head-to-head clinical analysis: HYDRAMINE versus PROMETHAZINE W CODEINE.
Peer-Reviewed Evidence
Head-to-head clinical analysis: HYDRAMINE versus PROMETHAZINE W CODEINE.
HYDRAMINE vs PROMETHAZINE W/ CODEINE
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
Antagonist of histamine H1 receptors, preventing histamine-mediated responses such as vasodilation, bronchoconstriction, and increased capillary permeability.
Codeine is a prodrug converted to morphine, a mu-opioid receptor agonist, which inhibits nociceptive transmission; promethazine is a phenothiazine derivative with H1-receptor antagonism, anticholinergic, and antiemetic effects.
50-100 mg IV/IM every 4-6 hours, maximum 400 mg per day. Also available as 50 mg oral tablets.
10 mL (1 mg codeine, 6.25 mg promethazine per 5 mL) orally every 4-6 hours as needed for cough. Maximum: 60 mL per day. Do not exceed 5 days.
None Documented
None Documented
Clinical Note
moderateDiphenhydramine + Deferasirox
"The serum concentration of Deferasirox can be increased when it is combined with Diphenhydramine."
Clinical Note
moderateDiphenhydramine + Fluticasone propionate
"The risk or severity of adverse effects can be increased when Diphenhydramine is combined with Fluticasone propionate."
Clinical Note
moderateDiphenhydramine + Tenofovir disoproxil
"The metabolism of Tenofovir disoproxil can be decreased when combined with Diphenhydramine."
Clinical Note
moderateTerminal elimination half-life 5.7 hours, range 4.2-7.7 hours; prolonged in hepatic impairment (up to 15 hours in cirrhosis)
Promethazine: 10-19 hours (terminal). Codeine: 2.5-3.5 hours (terminal); prolonged in renal impairment.
Primarily renal (95%) as metabolites; <5% unchanged; 5% fecal
Promethazine: renal (70% as metabolites, <1% unchanged), fecal (20-30%). Codeine: renal (90%, of which 5-10% unchanged, rest as metabolites), fecal (minor).
Category C
Category A/B
Antihistamine
Antihistamine / Antiemetic
Diphenhydramine + Sulfisoxazole
"The metabolism of Sulfisoxazole can be decreased when combined with Diphenhydramine."