Comparative Pharmacology
Head-to-head clinical analysis: DURAGESIC 25 versus OXYCONTIN.
Peer-Reviewed Evidence
Head-to-head clinical analysis: DURAGESIC 25 versus OXYCONTIN.
DURAGESIC-25 vs OXYCONTIN
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.
Oxycodone is a full opioid agonist with relative selectivity for the mu-opioid receptor, although it can bind to other opioid receptors at higher doses. The principal therapeutic action of oxycodone is analgesia. Like all full opioid agonists, there is no ceiling effect for analgesia with oxycodone. Clinically, dosage is titrated to provide adequate analgesia and may be limited by adverse reactions, including respiratory and CNS depression.
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.
10 mg orally every 12 hours; titrate based on pain severity and prior opioid exposure.
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
4.5-5.0 hours (immediate-release); controlled-release OXYCONTIN has an apparent half-life of 4.5-8.7 hours. Terminal half-life is ~3.5-4 hours for immediate-release, reflecting context-sensitive elimination.
Renal (75% as metabolites, <10% unchanged); fecal (9%)
Primarily renal (90% as metabolites, 10% unchanged). Also biliary/fecal (10%).
Category C
Category C
Opioid Analgesic
Opioid Analgesic