Comparative Pharmacology
Head-to-head clinical analysis: IONSYS versus MS CONTIN.
Peer-Reviewed Evidence
Head-to-head clinical analysis: IONSYS versus MS CONTIN.
IONSYS vs MS CONTIN
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
IONSYS is an iontophoretic delivery system for fentanyl, a mu-opioid receptor agonist. Fentanyl binds to mu-opioid receptors in the CNS, inhibiting ascending pain pathways and altering pain perception and emotional response.
Mu-opioid receptor agonist; binds to mu-opioid receptors in the CNS, modulating pain perception and emotional response to pain.
Apply one 40 mcg fentanyl iontophoretic transdermal system to skin on upper arm or chest; delivers 40 mcg per dose on-demand for up to 24 hours or 80 doses, whichever is shorter. Maximum 2 doses per hour, 6 doses per application. Patient must be opioid-tolerant.
Oral: 15-30 mg every 8-12 hours; adjust based on pain severity and prior opioid use. Extended-release tablets must be swallowed whole; do not crush or chew. For opioid-naïve patients, start at 15 mg every 12 hours.
None Documented
None Documented
Terminal elimination half-life: 16.3 ± 9.1 hours for fentanyl released from IONSYS; accounts for prolonged release from depot and is longer than intravenous fentanyl (3-12 hours).
Terminal elimination half-life: 11-13 hours (range 8-24 hours). In elderly or hepatic impairment, half-life may be prolonged; acute dosing half-life ~2-4 hours.
Renal: approximately 90% as fentanyl metabolites (mainly norfentanyl) and less than 10% as unchanged drug; fecal: less than 10%.
Renal: ~90% (mostly as morphine-3-glucuronide and morphine-6-glucuronide, with ~10% as unchanged morphine); Fecal: <10%
Category C
Category C
Opioid Analgesic
Opioid Analgesic