Comparative Pharmacology
Head-to-head clinical analysis: ACTIQ versus DILAUDID.
Peer-Reviewed Evidence
Head-to-head clinical analysis: ACTIQ versus DILAUDID.
ACTIQ vs DILAUDID
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
Opioid agonist; binds to mu-opioid receptors in the CNS, altering pain perception and response.
Dilaudid (hydromorphone) is a full opioid agonist with high affinity for mu-opioid receptors, producing analgesia by mimicking endogenous endorphins and enkephalins. It also activates kappa and delta opioid receptors to a lesser extent.
200 mcg transmucosally, titrated upward as needed; initial dose for opioid-tolerant patients is 200 mcg, with additional doses possible after 15 minutes if needed. Maximum 4 doses per episode. At least 4 hours between episodes.
Initial: 2-4 mg orally every 4-6 hours as needed; or 1-2 mg intramuscularly, subcutaneously, or intravenously every 4-6 hours as needed.
None Documented
None Documented
Terminal half-life 0.83–2 hours (mean 1.3 h) in adults; note that context: transmucosal absorption leads to rapid onset but short duration; half-life is not correlated with clinical effect due to oral transmucosal route and rapid redistribution.
2.5-3.5 hours (terminal); prolonged in hepatic/renal impairment
Primarily renal as metabolites (about 75% as metabolites, <10% unchanged). Fecal excretion accounts for <9%. Biliary excretion is minor.
Primarily renal (90% as hydromorphone-3-glucuronide and parent drug); <1% biliary/fecal
Category C
Category C
Opioid Analgesic
Opioid Analgesic