Comparative Pharmacology
Head-to-head clinical analysis: DILAUDID versus DURAGESIC 25.
Peer-Reviewed Evidence
Head-to-head clinical analysis: DILAUDID versus DURAGESIC 25.
DILAUDID vs DURAGESIC-25
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
Dilaudid (hydromorphone) is a full opioid agonist with high affinity for mu-opioid receptors, producing analgesia by mimicking endogenous endorphins and enkephalins. It also activates kappa and delta opioid receptors to a lesser extent.
Fentanyl is a mu-opioid receptor agonist that produces analgesia and sedation by mimicking endogenous opioids in the central nervous system.
Initial: 2-4 mg orally every 4-6 hours as needed; or 1-2 mg intramuscularly, subcutaneously, or intravenously every 4-6 hours as needed.
Apply 25 mcg/hour transdermally every 72 hours; initial dose in opioid-naive patients: 25 mcg/hour is not recommended; use lower strength or immediate-release opioid first.
None Documented
None Documented
2.5-3.5 hours (terminal); prolonged in hepatic/renal impairment
Terminal elimination half-life 22-25 hours (range 13-31 h) after 72-h transdermal application; prolonged in elderly, hepatic or renal impairment
Primarily renal (90% as hydromorphone-3-glucuronide and parent drug); <1% biliary/fecal
Renal (75% as metabolites, <10% unchanged); fecal (9%)
Category C
Category C
Opioid Analgesic
Opioid Analgesic