Comparative Pharmacology
Head-to-head clinical analysis: DURAGESIC 25 versus IONSYS.
Peer-Reviewed Evidence
Head-to-head clinical analysis: DURAGESIC 25 versus IONSYS.
DURAGESIC-25 vs IONSYS
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
Fentanyl is a mu-opioid receptor agonist that produces analgesia and sedation by mimicking endogenous opioids in the central nervous system.
IONSYS is an iontophoretic delivery system for fentanyl, a mu-opioid receptor agonist. Fentanyl binds to mu-opioid receptors in the CNS, inhibiting ascending pain pathways and altering pain perception and emotional response.
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.
Apply one 40 mcg fentanyl iontophoretic transdermal system to skin on upper arm or chest; delivers 40 mcg per dose on-demand for up to 24 hours or 80 doses, whichever is shorter. Maximum 2 doses per hour, 6 doses per application. Patient must be opioid-tolerant.
None Documented
None Documented
Terminal elimination half-life 22-25 hours (range 13-31 h) after 72-h transdermal application; prolonged in elderly, hepatic or renal impairment
Terminal elimination half-life: 16.3 ± 9.1 hours for fentanyl released from IONSYS; accounts for prolonged release from depot and is longer than intravenous fentanyl (3-12 hours).
Renal (75% as metabolites, <10% unchanged); fecal (9%)
Renal: approximately 90% as fentanyl metabolites (mainly norfentanyl) and less than 10% as unchanged drug; fecal: less than 10%.
Category C
Category C
Opioid Analgesic
Opioid Analgesic