Comparative Pharmacology
Head-to-head clinical analysis: BUTRANS versus DARVON N.
Peer-Reviewed Evidence
Head-to-head clinical analysis: BUTRANS versus DARVON N.
BUTRANS vs DARVON-N
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
Buprenorphine is a partial mu-opioid receptor agonist and a weak kappa-opioid receptor antagonist. It binds with high affinity to mu-opioid receptors, producing analgesic and opioid effects with a ceiling effect on respiratory depression.
Propoxyphene is a weak mu-opioid receptor agonist that produces analgesia by binding to opioid receptors in the central nervous system, altering the perception of and response to pain. Its metabolite norpropoxyphene has local anesthetic and sodium channel blocking effects, which may contribute to cardiac toxicity.
Apply one BUTRANS (buprenorphine) transdermal system to a clean, dry, non-irritated, and non-hairy area of the chest, back, flank, or upper arm. Initial dose: 5 mcg/h for opioid-naïve patients; titrate based on pain control and tolerability. Maximum dose: 20 mcg/h. Replace every 7 days. Rotate application sites.
100 mg orally every 4 hours as needed for pain; maximum 600 mg per day.
None Documented
None Documented
Terminal half-life: 4-6 hours in healthy adults; prolonged to 12-18 hours in elderly or renal impairment
Propoxyphene: 6-12 hours; norpropoxyphene: 30-36 hours. Accumulation of norpropoxyphene on repeated dosing increases risk of toxicity.
Renal: 60-70% as unchanged drug and metabolites; biliary/fecal: 20-30%
Primarily renal (approximately 70% as unchanged drug and glucuronide conjugates); minor biliary/fecal elimination (25-30%).
Category C
Category C
Opioid Analgesic
Opioid Analgesic