Comparative Pharmacology
Head-to-head clinical analysis: DURAGESIC 37 versus OXYMORPHONE HYDROCHLORIDE.
Peer-Reviewed Evidence
Head-to-head clinical analysis: DURAGESIC 37 versus OXYMORPHONE HYDROCHLORIDE.
DURAGESIC-37 vs OXYMORPHONE HYDROCHLORIDE
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.
Oxymorphone is a semi-synthetic opioid agonist that binds to mu-opioid receptors in the central nervous system, inhibiting ascending pain pathways and altering pain perception and response. It also has affinity for kappa and delta opioid receptors.
Initial: 25 mcg/hour transdermal patch applied every 72 hours. Titrate based on opioid tolerance. For opioid-naive patients: 12 mcg/hour patch.
Initial: 1 mg IV/IM every 3-4 hours as needed for moderate to severe pain; titrate to effect. For patient-controlled analgesia (PCA), 0.5 mg IV loading dose, then 0.25-0.5 mg every 6-15 minutes with lockout. Rectal suppository: 5 mg every 4-6 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: 7-9 hours (range 4-12 h in elderly/renal impairment). Clinically, steady-state achieved within 24-36 hours.
Primarily renal: 75% as metabolites (mostly norfentanyl) and <10% unchanged drug. Fecal: 9% via biliary elimination.
Primarily renal (90% as parent drug and metabolites); <1% fecal. Unchanged oxymorphone accounts for ~30% of urinary recovery.
Category C
Category C
Opioid Analgesic
Opioid Analgesic