Comparative Pharmacology
Head-to-head clinical analysis: DARVON versus DURAGESIC 12.
Peer-Reviewed Evidence
Head-to-head clinical analysis: DARVON versus DURAGESIC 12.
DARVON vs DURAGESIC-12
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
Propoxyphene is a mu-opioid receptor agonist that inhibits ascending pain pathways by binding to opioid receptors in the CNS, altering pain perception. It also has weak local anesthetic effects.
Fentanyl is a potent synthetic opioid agonist that primarily binds to mu-opioid receptors in the central nervous system, leading to analgesic effects by increasing potassium conductance and decreasing calcium influx, thereby inhibiting ascending pain pathways and altering pain perception.
Propoxyphene hydrochloride (Darvon) for moderate to severe pain: 65 mg orally every 4 hours as needed; maximum 390 mg/day.
Transdermal patch, initially 12 mcg/h applied every 72 hours in opioid-naive patients; titrate based on response and tolerance.
None Documented
None Documented
6-12 hours (parent drug); norpropoxyphene half-life 30-36 hours, accumulates with repeated dosing, increasing risk of toxicity.
Terminal elimination half-life is approximately 20–27 hours (range 13–44 hours) after transdermal patch removal; prolonged in elderly, hepatic impairment, and with continuous use due to drug accumulation in skin and adipose tissue.
Primarily hepatic metabolism to norpropoxyphene, then renal excretion of metabolites; <20% excreted unchanged in urine; minor biliary/fecal elimination.
Renal: approximately 75% as metabolites (primarily norfentanyl and other inactive metabolites) and <10% as unchanged fentanyl; fecal: approximately 9%; biliary: minor.
Category C
Category C
Opioid Analgesic
Opioid Analgesic