Comparative Pharmacology
Head-to-head clinical analysis: DURAGESIC 25 versus VICODIN ES.
Peer-Reviewed Evidence
Head-to-head clinical analysis: DURAGESIC 25 versus VICODIN ES.
DURAGESIC-25 vs VICODIN ES
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.
Hydrocodone is a mu-opioid receptor agonist; acetaminophen inhibits cyclooxygenase (COX) and modulates descending serotonergic pathways.
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.
Oral: 1 tablet (7.5 mg hydrocodone/300 mg acetaminophen) every 4-6 hours as needed for pain; maximum 6 tablets per day due to acetaminophen limit.
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
Hydrocodone: terminal half-life approximately 3.3-4.5 hours in adults, extended in hepatic or renal impairment. Acetaminophen: terminal half-life about 2-3 hours.
Renal (75% as metabolites, <10% unchanged); fecal (9%)
Hydrocodone: primarily renal (urine) as unchanged drug and metabolites (O-demethylation and 6-keto-reduction products); ~26% excreted unchanged. Acetaminophen: renal (urine), ~85% as glucuronide and sulfate conjugates, ~2% unchanged.
Category C
Category C
Opioid Analgesic
Opioid Analgesic