Comparative Pharmacology
Head-to-head clinical analysis: DURAGESIC 25 versus ULTRAM.
Peer-Reviewed Evidence
Head-to-head clinical analysis: DURAGESIC 25 versus ULTRAM.
DURAGESIC-25 vs ULTRAM
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.
Tramadol is a centrally acting synthetic opioid analgesic that binds to μ-opioid receptors and inhibits norepinephrine and serotonin reuptake.
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.
50-100 mg orally every 4-6 hours as needed for pain; maximum 400 mg/day (for extended-release: 100 mg once daily, titrated up to 300 mg once daily).
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
Tramadol: ~6 hours; M1 metabolite (O-desmethyltramadol): ~7 hours; prolonged in renal/hepatic impairment
Renal (75% as metabolites, <10% unchanged); fecal (9%)
Renal: ~90% (tramadol and metabolites; conjugated metabolites are major), Fecal: ~10%
Category C
Category C
Opioid Analgesic
Opioid Analgesic