Comparative Pharmacology
Head-to-head clinical analysis: ALFENTANIL versus VICODIN HP.
Peer-Reviewed Evidence
Head-to-head clinical analysis: ALFENTANIL versus VICODIN HP.
ALFENTANIL vs VICODIN HP
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
Alfentanil is a potent, short-acting synthetic opioid analgesic that primarily acts as a mu-opioid receptor agonist. It binds to mu-opioid receptors in the central nervous system, leading to G-protein coupled activation of inwardly rectifying potassium channels and inhibition of voltage-gated calcium channels, resulting in hyperpolarization and reduced neurotransmitter release. This produces analgesia, sedation, and respiratory depression.
Hydrocodone is a mu-opioid receptor agonist that inhibits ascending pain pathways; acetaminophen inhibits cyclooxygenase and has antipyretic effects.
Initial IV bolus of 5-20 mcg/kg; maintenance infusion of 0.5-1.5 mcg/kg/min; incremental boluses of 5-10 mcg/kg as needed. Induction of anesthesia: 50-100 mcg/kg IV.
One tablet (hydrocodone bitartrate 10 mg/acetaminophen 660 mg) orally every 4-6 hours as needed for pain; maximum 6 tablets per day.
None Documented
None Documented
Clinical Note
moderateAlfentanil + Torasemide
"The risk or severity of adverse effects can be increased when Alfentanil is combined with Torasemide."
Clinical Note
moderateAlfentanil + Etacrynic acid
"The risk or severity of adverse effects can be increased when Alfentanil is combined with Etacrynic acid."
Clinical Note
moderateAlfentanil + Furosemide
"The risk or severity of adverse effects can be increased when Alfentanil is combined with Furosemide."
Clinical Note
moderateAlfentanil + Bumetanide
Terminal elimination half-life: 90–111 minutes (1.5–1.85 hours). Clinically, context-sensitive half-time is short (~40 min after 3-hour infusion) due to rapid redistribution and metabolism.
Hydrocodone: 3.8-5.5 hours (mean 4.5 h). Acetaminophen: 2-3 hours. Clinical context: dosing interval every 4-6 hours for acute pain.
Primarily hepatic metabolism via CYP3A4; <1% excreted unchanged in urine; metabolites (mainly noralfentanil) excreted renally. Biliary/fecal excretion of metabolites accounts for ~30%.
Primarily renal: hydrocodone is eliminated as conjugated metabolites (glucuronides) ~80%; unchanged drug ~5%. Biliary/fecal: minor, <10%.
Category C
Category C
Opioid Analgesic
Opioid Analgesic
"The risk or severity of adverse effects can be increased when Alfentanil is combined with Bumetanide."