Comparative Pharmacology
Head-to-head clinical analysis: ABSTRAL versus STADOL.
Peer-Reviewed Evidence
Head-to-head clinical analysis: ABSTRAL versus STADOL.
ABSTRAL vs STADOL
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.
Partial agonist at mu-opioid receptors and agonist at kappa-opioid receptors in the CNS, altering pain perception and emotional response to pain.
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.
Butorphanol tartrate 1-2 mg IV or IM every 3-4 hours as needed for pain; alternatively, 0.5-1 mg IV every 3-4 hours. For nasal spray: 1 mg (one spray) in one nostril, may repeat in 60-90 minutes if needed; then 1 mg every 3-4 hours as needed.
None Documented
None Documented
Terminal elimination half-life: 6-10 hours (mean 8 hours); prolonged in elderly and hepatic impairment
Terminal elimination half-life: 2.5-4 hours; clinically, prolonged in hepatic impairment (up to 10-12 hours) and elderly
Renal: ~70% as metabolites (primarily fentanyl conjugates and norfentanyl), ~10% unchanged; Fecal: ~9%; Biliary: minimal
Renal: 85-90% as unchanged drug and metabolites (primarily as glucuronide conjugates); Fecal: <10%; Biliary: minimal
Category C
Category C
Opioid Analgesic
Opioid Analgesic