Comparative Pharmacology
Head-to-head clinical analysis: ABSTRAL versus DEMEROL.
Peer-Reviewed Evidence
Head-to-head clinical analysis: ABSTRAL versus DEMEROL.
ABSTRAL vs DEMEROL
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
Fentanyl is a potent mu-opioid receptor agonist, producing analgesia and sedation by activating G-protein coupled opioid receptors in the central nervous system.
Meperidine is an opioid agonist that binds to mu-opioid receptors in the central nervous system, mimicking endogenous endorphins to produce analgesia, sedation, and euphoria. It also has additional weak actions at kappa and delta receptors.
For breakthrough pain in opioid-tolerant patients: initial dose 100 mcg sublingual tablet, titrate across strengths (100, 200, 300, 400, 600, 800 mcg) as needed; maximum 2 doses per episode, minimum 2 hours between episodes.
50-150 mg IM, IV, or SC every 3-4 hours as needed for pain; oral 50-150 mg every 3-4 hours.
None Documented
None Documented
Terminal elimination half-life: 6-10 hours (mean 8 hours); prolonged in elderly and hepatic impairment
2.5-4 hours; prolonged in hepatic impairment (7-11 hours) and elderly.
Renal: ~70% as metabolites (primarily fentanyl conjugates and norfentanyl), ~10% unchanged; Fecal: ~9%; Biliary: minimal
Renal (90% as metabolites and unchanged drug; ~5% unchanged) and biliary/fecal (minor).
Category C
Category C
Opioid Analgesic
Opioid Analgesic