Comparative Pharmacology
Head-to-head clinical analysis: DEMEROL versus VICODIN ES.
Peer-Reviewed Evidence
Head-to-head clinical analysis: DEMEROL versus VICODIN ES.
DEMEROL vs VICODIN ES
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.
Hydrocodone is a mu-opioid receptor agonist; acetaminophen inhibits cyclooxygenase (COX) and modulates descending serotonergic pathways.
50-150 mg IM, IV, or SC every 3-4 hours as needed for pain; oral 50-150 mg every 3-4 hours.
Oral: 1 tablet (7.5 mg hydrocodone/300 mg acetaminophen) every 4-6 hours as needed for pain; maximum 6 tablets per day due to acetaminophen limit.
None Documented
None Documented
2.5-4 hours; prolonged in hepatic impairment (7-11 hours) and elderly.
Hydrocodone: terminal half-life approximately 3.3-4.5 hours in adults, extended in hepatic or renal impairment. Acetaminophen: terminal half-life about 2-3 hours.
Renal (90% as metabolites and unchanged drug; ~5% unchanged) and biliary/fecal (minor).
Hydrocodone: primarily renal (urine) as unchanged drug and metabolites (O-demethylation and 6-keto-reduction products); ~26% excreted unchanged. Acetaminophen: renal (urine), ~85% as glucuronide and sulfate conjugates, ~2% unchanged.
Category C
Category C
Opioid Analgesic
Opioid Analgesic