Comparative Pharmacology
Head-to-head clinical analysis: DILAUDID versus STADOL.
Peer-Reviewed Evidence
Head-to-head clinical analysis: DILAUDID versus STADOL.
DILAUDID vs STADOL
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.
Partial agonist at mu-opioid receptors and agonist at kappa-opioid receptors in the CNS, altering pain perception and emotional response to pain.
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.
Butorphanol tartrate 1-2 mg IV or IM every 3-4 hours as needed for pain; alternatively, 0.5-1 mg IV every 3-4 hours. For nasal spray: 1 mg (one spray) in one nostril, may repeat in 60-90 minutes if needed; then 1 mg every 3-4 hours as needed.
None Documented
None Documented
2.5-3.5 hours (terminal); prolonged in hepatic/renal impairment
Terminal elimination half-life: 2.5-4 hours; clinically, prolonged in hepatic impairment (up to 10-12 hours) and elderly
Primarily renal (90% as hydromorphone-3-glucuronide and parent drug); <1% biliary/fecal
Renal: 85-90% as unchanged drug and metabolites (primarily as glucuronide conjugates); Fecal: <10%; Biliary: minimal
Category C
Category C
Opioid Analgesic
Opioid Analgesic