Comparative Pharmacology
Head-to-head clinical analysis: DEMEROL versus ULTIVA.
Peer-Reviewed Evidence
Head-to-head clinical analysis: DEMEROL versus ULTIVA.
DEMEROL vs ULTIVA
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.
Selective mu-opioid receptor agonist with rapid onset and short duration of action; produces analgesia without significant histamine release.
50-150 mg IM, IV, or SC every 3-4 hours as needed for pain; oral 50-150 mg every 3-4 hours.
IV bolus: 1 mcg/kg over 30-60 seconds, then continuous IV infusion: 0.25-1 mcg/kg/min for intraoperative analgesia. For general anesthesia induction: 0.5-1 mcg/kg IV bolus; maintenance: 0.25-1 mcg/kg/min IV infusion.
None Documented
None Documented
2.5-4 hours; prolonged in hepatic impairment (7-11 hours) and elderly.
Terminal elimination half-life is 3-10 minutes (context-sensitive half-time is 3-4 minutes independent of infusion duration due to rapid ester hydrolysis). Clinically, recovery is rapid and predictable even after prolonged infusions, with full recovery within 5-10 minutes of discontinuation.
Renal (90% as metabolites and unchanged drug; ~5% unchanged) and biliary/fecal (minor).
Remifentanil is metabolized by non-specific blood and tissue esterases to a virtually inactive metabolite (remifentanil acid, 1/4600 potency). Renal excretion accounts for approximately 90% of the metabolite; fecal elimination is minimal (<5%).
Category C
Category C
Opioid Analgesic
Opioid Analgesic