Comparative Pharmacology
Head-to-head clinical analysis: DURAGESIC 12 versus LEVORPHANOL TARTRATE.
Peer-Reviewed Evidence
Head-to-head clinical analysis: DURAGESIC 12 versus LEVORPHANOL TARTRATE.
DURAGESIC-12 vs LEVORPHANOL TARTRATE
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
Fentanyl is a potent synthetic opioid agonist that primarily binds to mu-opioid receptors in the central nervous system, leading to analgesic effects by increasing potassium conductance and decreasing calcium influx, thereby inhibiting ascending pain pathways and altering pain perception.
Levorphanol is a potent opioid analgesic that acts as a mu-opioid receptor agonist. It also has NMDA receptor antagonist activity, inhibits norepinephrine and serotonin reuptake, and acts as a sigma receptor agonist, contributing to its analgesic effects and reduced tolerance development.
Transdermal patch, initially 12 mcg/h applied every 72 hours in opioid-naive patients; titrate based on response and tolerance.
2 mg orally every 6-8 hours as needed for pain; for opioid-tolerant patients, doses up to 4 mg orally every 6-8 hours may be used. Parenterally: 1-2 mg subcutaneously or intramuscularly every 6-8 hours; may be given intravenously at 0.5-1 mg every 6-8 hours.
None Documented
None Documented
Terminal elimination half-life is approximately 20–27 hours (range 13–44 hours) after transdermal patch removal; prolonged in elderly, hepatic impairment, and with continuous use due to drug accumulation in skin and adipose tissue.
11-16 hours; extended in hepatic impairment (up to 30 hours).
Renal: approximately 75% as metabolites (primarily norfentanyl and other inactive metabolites) and <10% as unchanged fentanyl; fecal: approximately 9%; biliary: minor.
Renal: approximately 30% as unchanged drug and 50% as glucuronide conjugates; fecal: 20% via biliary excretion.
Category C
Category C
Opioid Analgesic
Opioid Analgesic