Comparative Pharmacology
Head-to-head clinical analysis: IONSYS versus OXYMORPHONE HYDROCHLORIDE.
Peer-Reviewed Evidence
Head-to-head clinical analysis: IONSYS versus OXYMORPHONE HYDROCHLORIDE.
IONSYS vs OXYMORPHONE HYDROCHLORIDE
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.
Oxymorphone is a semi-synthetic opioid agonist that binds to mu-opioid receptors in the central nervous system, inhibiting ascending pain pathways and altering pain perception and response. It also has affinity for kappa and delta opioid receptors.
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.
Initial: 1 mg IV/IM every 3-4 hours as needed for moderate to severe pain; titrate to effect. For patient-controlled analgesia (PCA), 0.5 mg IV loading dose, then 0.25-0.5 mg every 6-15 minutes with lockout. Rectal suppository: 5 mg every 4-6 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: 7-9 hours (range 4-12 h in elderly/renal impairment). Clinically, steady-state achieved within 24-36 hours.
Renal: approximately 90% as fentanyl metabolites (mainly norfentanyl) and less than 10% as unchanged drug; fecal: less than 10%.
Primarily renal (90% as parent drug and metabolites); <1% fecal. Unchanged oxymorphone accounts for ~30% of urinary recovery.
Category C
Category C
Opioid Analgesic
Opioid Analgesic