Comparative Pharmacology
Head-to-head clinical analysis: DURAGESIC 37 versus ROXICODONE.
Peer-Reviewed Evidence
Head-to-head clinical analysis: DURAGESIC 37 versus ROXICODONE.
DURAGESIC-37 vs ROXICODONE
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.
Oxycodone is a full opioid agonist with high affinity for mu-opioid receptors, also binding to kappa and delta receptors. It acts primarily on the central nervous system and gastrointestinal tract.
Initial: 25 mcg/hour transdermal patch applied every 72 hours. Titrate based on opioid tolerance. For opioid-naive patients: 12 mcg/hour patch.
5-15 mg orally every 4-6 hours as needed for pain; immediate-release formulation. Maximum 60 mg total daily dose for opioid-naive patients.
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.
3.5-5 hours for immediate-release; 4.5-5.5 hours for extended-release. Accumulation may occur with repeated dosing, especially in elderly or hepatic impairment.
Primarily renal: 75% as metabolites (mostly norfentanyl) and <10% unchanged drug. Fecal: 9% via biliary elimination.
Renal excretion: 70-80% as unchanged drug and metabolites (oxymorphone, noroxycodone); fecal: 10-20%.
Category C
Category C
Opioid Analgesic
Opioid Analgesic