Comparative Pharmacology
Head-to-head clinical analysis: DEMEROL versus ORAMORPH SR.
Peer-Reviewed Evidence
Head-to-head clinical analysis: DEMEROL versus ORAMORPH SR.
DEMEROL vs ORAMORPH SR
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.
Morphine is a full opioid agonist with relative selectivity for the mu-opioid receptor, although it can interact with other opioid receptors at higher doses. Binding to mu-opioid receptors in the central nervous system (CNS) and peripheral tissues results in analgesia, euphoria, sedation, respiratory depression, and physical dependence. Morphine also activates descending inhibitory pathways and inhibits ascending nociceptive transmission.
50-150 mg IM, IV, or SC every 3-4 hours as needed for pain; oral 50-150 mg every 3-4 hours.
10-30 mg orally every 8-12 hours, sustained-release; titrate as needed for pain.
None Documented
None Documented
2.5-4 hours; prolonged in hepatic impairment (7-11 hours) and elderly.
2–4 hours in adults; in controlled-release formulation, effective half-life is prolonged due to sustained absorption. Clinically, steady-state is achieved in 1–2 days.
Renal (90% as metabolites and unchanged drug; ~5% unchanged) and biliary/fecal (minor).
Renal (approximately 90% as morphine-3-glucuronide and morphine-6-glucuronide, minor amounts of unchanged morphine, and other conjugates); biliary/fecal (approximately 10%).
Category C
Category C
Opioid Analgesic
Opioid Analgesic