Comparative Pharmacology
Head-to-head clinical analysis: DEMEROL versus LAZANDA.
Peer-Reviewed Evidence
Head-to-head clinical analysis: DEMEROL versus LAZANDA.
DEMEROL vs LAZANDA
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.
Fentanyl is a μ-opioid receptor agonist. It binds to μ-opioid receptors in the central nervous system, activating G-protein-coupled receptors to inhibit adenylate cyclase, reduce cAMP production, and modulate ion channels, leading to decreased neurotransmitter release (e.g., substance P, glutamate) and hyperpolarization of neurons, resulting in analgesia and sedation.
50-150 mg IM, IV, or SC every 3-4 hours as needed for pain; oral 50-150 mg every 3-4 hours.
100 mcg (one spray) intranasally as needed for breakthrough pain; may repeat once after 15-30 minutes if needed; do not exceed 2 doses per episode and 4 doses per day.
None Documented
None Documented
2.5-4 hours; prolonged in hepatic impairment (7-11 hours) and elderly.
Terminal elimination half-life: 6–10 hours (mean approximately 7 hours) following nasal administration; prolonged in hepatic impairment.
Renal (90% as metabolites and unchanged drug; ~5% unchanged) and biliary/fecal (minor).
Renal excretion of metabolites (mostly fentanyl metabolites, primarily norfentanyl): approximately 75%; fecal excretion: approximately 9%; less than 10% excreted as unchanged fentanyl in urine.
Category C
Category C
Opioid Analgesic
Opioid Analgesic