Comparative Pharmacology
Head-to-head clinical analysis: IONSYS versus OXAYDO.
Peer-Reviewed Evidence
Head-to-head clinical analysis: IONSYS versus OXAYDO.
IONSYS vs OXAYDO
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.
Oxycodone is a full opioid agonist with relative selectivity for mu-opioid receptors, although it can bind to kappa-opioid receptors at higher doses. The principal therapeutic action of oxycodone is analgesia. Like all full opioid agonists, there is no ceiling effect to analgesia for oxycodone.
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, 5-10 mg every 4-6 hours as needed for pain; maximum 60 mg per day.
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 is 3.5-5.5 hours for immediate-release oxycodone; clinically dose every 4-6 hours for sustained analgesia.
Renal: approximately 90% as fentanyl metabolites (mainly norfentanyl) and less than 10% as unchanged drug; fecal: less than 10%.
Primarily renal as unchanged drug and metabolites; ~90% excreted in urine (approx 10% unchanged oxycodone, rest as noroxycodone and oxymorphone conjugates) and <10% in feces via biliary elimination.
Category C
Category C
Opioid Analgesic
Opioid Analgesic