Comparative Pharmacology
Head-to-head clinical analysis: DURAGESIC 37 versus OPANA.
Peer-Reviewed Evidence
Head-to-head clinical analysis: DURAGESIC 37 versus OPANA.
DURAGESIC-37 vs OPANA
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
Fentanyl binds to mu-opioid receptors, activating G-protein coupled receptor signaling, leading to inhibition of adenylate cyclase, decreased cAMP production, and modulation of ion channels (increased potassium efflux, decreased calcium influx). This results in reduced neuronal excitability, inhibition of nociceptive transmission, and altered pain perception. Additionally, fentanyl may interact with other opioid receptors (kappa, delta) with lower affinity.
Mu-opioid receptor agonist; produces analgesia by binding to opioid receptors in the CNS, inhibiting ascending pain pathways and altering pain perception.
Initial: 25 mcg/hour transdermal patch applied every 72 hours. Titrate based on opioid tolerance. For opioid-naive patients: 12 mcg/hour patch.
5-20 mg orally every 4-6 hours as needed for pain; extended-release tablets: 5 mg orally every 12 hours, titrated up to 20 mg every 12 hours.
None Documented
None Documented
Terminal elimination half-life 20-27 hours (range 13-42 h) after transdermal removal; due to continuous absorption from skin depot, effective half-life is longer during patch wear.
Terminal elimination half-life is 11-16 hours (mean 14 hours) in adults; prolonged in hepatic impairment (up to 30 hours) and elderly.
Primarily renal: 75% as metabolites (mostly norfentanyl) and <10% unchanged drug. Fecal: 9% via biliary elimination.
Primarily renal (approximately 90% as conjugated metabolites, 10% unchanged); biliary/fecal elimination accounts for <10%.
Category C
Category C
Opioid Analgesic
Opioid Analgesic