Comparative Pharmacology
Head-to-head clinical analysis: IONSYS versus PROPOXYPHENE HYDROCHLORIDE 65.
Peer-Reviewed Evidence
Head-to-head clinical analysis: IONSYS versus PROPOXYPHENE HYDROCHLORIDE 65.
IONSYS vs PROPOXYPHENE HYDROCHLORIDE 65
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.
Propoxyphene is a centrally acting opioid agonist that binds to mu-opioid receptors in the central nervous system, inhibiting pain signal transmission and altering pain perception. It also has local anesthetic effects.
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.
65 mg orally every 4 hours as needed for pain; maximum 390 mg/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).
6-12 hours (mean ~8 hours); prolonged in hepatic impairment and elderly; accumulation possible with repeated dosing.
Renal: approximately 90% as fentanyl metabolites (mainly norfentanyl) and less than 10% as unchanged drug; fecal: less than 10%.
Renal excretion of unchanged drug (approximately 20-30%) and metabolites; approximately 40-60% as conjugated metabolites; minor biliary/fecal elimination.
Category C
Category C
Opioid Analgesic
Opioid Analgesic