Comparative Pharmacology
Head-to-head clinical analysis: EMBEDA versus OPANA.
Peer-Reviewed Evidence
Head-to-head clinical analysis: EMBEDA versus OPANA.
EMBEDA vs OPANA
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
EMBEDA is a combination of morphine sulfate, a full opioid agonist, and naltrexone hydrochloride, an opioid antagonist. Morphine binds to mu-opioid receptors in the CNS, altering pain perception and response. Naltrexone is sequestered in the core and is released if the pellets are crushed or chewed, potentially precipitating withdrawal or blockade of morphine effects.
Mu-opioid receptor agonist; produces analgesia by binding to opioid receptors in the CNS, inhibiting ascending pain pathways and altering pain perception.
1 to 2 capsules orally every 12 hours, titrated to pain relief. Maximum daily dose: 100 mg naltrexone (equivalent to 100 mg morphine). Capsules must be swallowed whole.
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
Morphine: 2-4 hours; naltrexone: 4-13 hours (active metabolite 6β-naltrexol: 12-18 hours). Clinically, morphine's half-life is prolonged in hepatic or renal impairment.
Terminal elimination half-life is 11-16 hours (mean 14 hours) in adults; prolonged in hepatic impairment (up to 30 hours) and elderly.
Renal: ~60% (morphine), ~20% (naltrexone, in urine as unchanged drug and metabolites); biliary/fecal: ~10% (morphine-3-glucuronide and other metabolites).
Primarily renal (approximately 90% as conjugated metabolites, 10% unchanged); biliary/fecal elimination accounts for <10%.
Category C
Category C
Opioid Analgesic
Opioid Analgesic