Comparative Pharmacology
Head-to-head clinical analysis: DILAUDID versus DURAGESIC 75.
Peer-Reviewed Evidence
Head-to-head clinical analysis: DILAUDID versus DURAGESIC 75.
DILAUDID vs DURAGESIC-75
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 potent opioid agonist primarily at the mu-opioid receptor, exerting its analgesic effects by mimicking endogenous endorphins and enkephalins to activate G-protein-coupled inwardly rectifying potassium channels, leading to hyperpolarization and reduced neuronal excitability in pain pathways.
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.
Adults: Apply one 75 mcg/hr transdermal patch every 72 hours. Start with lower dose in opioid-naive patients.
None Documented
None Documented
2.5-3.5 hours (terminal); prolonged in hepatic/renal impairment
22-25 hours after removal of patch; increased in elderly, hepatic/renal impairment
Primarily renal (90% as hydromorphone-3-glucuronide and parent drug); <1% biliary/fecal
Renal (75% as metabolites, <10% unchanged), fecal (25%)
Category C
Category C
Opioid Analgesic
Opioid Analgesic