Comparative Pharmacology
Head-to-head clinical analysis: APADAZ versus DEMEROL.
Peer-Reviewed Evidence
Head-to-head clinical analysis: APADAZ versus DEMEROL.
APADAZ vs DEMEROL
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
APADAZ is a combination of benzhydrocodone, a prodrug of hydrocodone, and acetaminophen. Hydrocodone acts as a full mu-opioid receptor agonist, inhibiting ascending pain pathways and altering pain perception. Acetaminophen's mechanism involves inhibition of cyclooxygenase (COX) enzymes, particularly in the CNS, and modulation of serotonergic pathways, contributing to analgesia and antipyresis.
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.
Each tablet contains benzhydrocodone 4.08 mg (hydrocodone 3.33 mg) and acetaminophen 325 mg. One to 2 tablets every 4 to 6 hours as needed for pain; maximum 12 tablets per 24 hours.
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: 2-4 hours for benzhydrocodone; context: immediate-release, dosing every 4-6 hours.
2.5-4 hours; prolonged in hepatic impairment (7-11 hours) and elderly.
Renal: ~90% as conjugates, ~10% unchanged; fecal: minimal; enterohepatic recirculation occurs.
Renal (90% as metabolites and unchanged drug; ~5% unchanged) and biliary/fecal (minor).
Category C
Category C
Opioid Analgesic
Opioid Analgesic