Comparative Pharmacology
Head-to-head clinical analysis: DURAGESIC 75 versus VICODIN ES.
Peer-Reviewed Evidence
Head-to-head clinical analysis: DURAGESIC 75 versus VICODIN ES.
DURAGESIC-75 vs VICODIN ES
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.
Hydrocodone is a mu-opioid receptor agonist; acetaminophen inhibits cyclooxygenase (COX) and modulates descending serotonergic pathways.
Adults: Apply one 75 mcg/hr transdermal patch every 72 hours. Start with lower dose in opioid-naive patients.
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
22-25 hours after removal of patch; increased in elderly, hepatic/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 (25%)
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