Comparative Pharmacology
Head-to-head clinical analysis: EMBEDA versus VICODIN.
Peer-Reviewed Evidence
Head-to-head clinical analysis: EMBEDA versus VICODIN.
EMBEDA vs VICODIN
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.
VICODIN (hydrocodone/acetaminophen) is a combination opioid agonist and analgesic. Hydrocodone acts on mu-opioid receptors in the CNS to alter pain perception and response; acetaminophen inhibits cyclooxygenase (COX) activity, likely in the CNS, reducing prostaglandin synthesis and providing antipyretic effects.
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.
1-2 tablets (hydrocodone 5-10 mg and acetaminophen 300-325 mg) orally every 4-6 hours as needed for pain; maximum daily acetaminophen dose 4 g.
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.
Hydrocodone: 3.8-6.4 hours (terminal); Acetaminophen: 2-3 hours (terminal). Clinically, steady-state achieved in 1-2 days.
Renal: ~60% (morphine), ~20% (naltrexone, in urine as unchanged drug and metabolites); biliary/fecal: ~10% (morphine-3-glucuronide and other metabolites).
Hydrocodone: primarily renal (~60% as metabolites, 12% unchanged); minor biliary. Acetaminophen: renal (90-100% as metabolites, 2-4% unchanged).
Category C
Category C
Opioid Analgesic
Opioid Analgesic