Comparative Pharmacology
Head-to-head clinical analysis: DEMEROL versus IONSYS.
Peer-Reviewed Evidence
Head-to-head clinical analysis: DEMEROL versus IONSYS.
DEMEROL vs IONSYS
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
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.
IONSYS is an iontophoretic delivery system for fentanyl, a mu-opioid receptor agonist. Fentanyl binds to mu-opioid receptors in the CNS, inhibiting ascending pain pathways and altering pain perception and emotional response.
50-150 mg IM, IV, or SC every 3-4 hours as needed for pain; oral 50-150 mg every 3-4 hours.
Apply one 40 mcg fentanyl iontophoretic transdermal system to skin on upper arm or chest; delivers 40 mcg per dose on-demand for up to 24 hours or 80 doses, whichever is shorter. Maximum 2 doses per hour, 6 doses per application. Patient must be opioid-tolerant.
None Documented
None Documented
2.5-4 hours; prolonged in hepatic impairment (7-11 hours) and elderly.
Terminal elimination half-life: 16.3 ± 9.1 hours for fentanyl released from IONSYS; accounts for prolonged release from depot and is longer than intravenous fentanyl (3-12 hours).
Renal (90% as metabolites and unchanged drug; ~5% unchanged) and biliary/fecal (minor).
Renal: approximately 90% as fentanyl metabolites (mainly norfentanyl) and less than 10% as unchanged drug; fecal: less than 10%.
Category C
Category C
Opioid Analgesic
Opioid Analgesic