Comparative Pharmacology
Head-to-head clinical analysis: DURAGESIC 75 versus LEVO DROMORAN.
Peer-Reviewed Evidence
Head-to-head clinical analysis: DURAGESIC 75 versus LEVO DROMORAN.
DURAGESIC-75 vs LEVO-DROMORAN
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
Fentanyl is a potent opioid agonist primarily at the mu-opioid receptor, exerting its analgesic effects by mimicking endogenous endorphins and enkephalins to activate G-protein-coupled inwardly rectifying potassium channels, leading to hyperpolarization and reduced neuronal excitability in pain pathways.
Levo-dromoran (levorphanol) is a potent opioid agonist primarily at mu-opioid receptors, with additional agonist activity at kappa and delta opioid receptors. It also acts as an NMDA receptor antagonist and inhibits serotonin and norepinephrine reuptake, contributing to its analgesic effects.
Adults: Apply one 75 mcg/hr transdermal patch every 72 hours. Start with lower dose in opioid-naive patients.
2 mg orally every 6-8 hours as needed for pain; 2-4 mg intramuscularly or subcutaneously every 6-8 hours; intravenous administration: 1-2 mg slowly (over 2-3 minutes) every 6-8 hours.
None Documented
None Documented
22-25 hours after removal of patch; increased in elderly, hepatic/renal impairment
Terminal elimination half-life is 15-30 hours (mean 22 hours) in adults; prolonged in hepatic or renal impairment, requiring dose adjustment.
Renal (75% as metabolites, <10% unchanged), fecal (25%)
Primarily renal (approximately 60% as unchanged drug and metabolites); biliary/fecal elimination accounts for about 30%.
Category C
Category C
Opioid Analgesic
Opioid Analgesic