Comparative Pharmacology
Head-to-head clinical analysis: BUTRANS versus DURAGESIC 25.
Peer-Reviewed Evidence
Head-to-head clinical analysis: BUTRANS versus DURAGESIC 25.
BUTRANS vs DURAGESIC-25
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.
Fentanyl is a mu-opioid receptor agonist that produces analgesia and sedation by mimicking endogenous opioids in the central nervous system.
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.
Apply 25 mcg/hour transdermally every 72 hours; initial dose in opioid-naive patients: 25 mcg/hour is not recommended; use lower strength or immediate-release opioid first.
None Documented
None Documented
Terminal half-life: 4-6 hours in healthy adults; prolonged to 12-18 hours in elderly or renal impairment
Terminal elimination half-life 22-25 hours (range 13-31 h) after 72-h transdermal application; prolonged in elderly, hepatic or renal impairment
Renal: 60-70% as unchanged drug and metabolites; biliary/fecal: 20-30%
Renal (75% as metabolites, <10% unchanged); fecal (9%)
Category C
Category C
Opioid Analgesic
Opioid Analgesic