Comparative Pharmacology
Head-to-head clinical analysis: KETOTIFEN FUMARATE versus PROMETHAZINE W CODEINE.
Peer-Reviewed Evidence
Head-to-head clinical analysis: KETOTIFEN FUMARATE versus PROMETHAZINE W CODEINE.
KETOTIFEN FUMARATE vs PROMETHAZINE W/ CODEINE
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
Antihistamine and mast cell stabilizer; inhibits release of histamine and other mediators from mast cells; also blocks histamine H1 receptors.
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.
1 mg orally twice daily; ophthalmic: 1 drop in each eye every 8-12 hours.
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
Terminal half-life 12-24 hours (mean 18 hours); requires twice-daily dosing after initial titration.
Promethazine: 10-19 hours (terminal). Codeine: 2.5-3.5 hours (terminal); prolonged in renal impairment.
Renal (50-70% as conjugates, <2% unchanged), fecal (<10%), with enterohepatic circulation.
Promethazine: renal (70% as metabolites, <1% unchanged), fecal (20-30%). Codeine: renal (90%, of which 5-10% unchanged, rest as metabolites), fecal (minor).
Category A/B
Category A/B
Antihistamine / Mast Cell Stabilizer
Antihistamine / Antiemetic