Comparative Pharmacology
Head-to-head clinical analysis: IONSYS versus ROXILOX.
Peer-Reviewed Evidence
Head-to-head clinical analysis: IONSYS versus ROXILOX.
IONSYS vs ROXILOX
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.
Roxilox is a nonsteroidal anti-inflammatory drug (NSAID) that inhibits cyclooxygenase (COX-1 and COX-2) enzymes, reducing prostaglandin synthesis and thereby alleviating pain and inflammation.
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.
10 mg orally once daily, with or without food.
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 4.5 hours; prolonged to 18-24 hours in severe renal impairment (CrCl <30 mL/min)
Renal: approximately 90% as fentanyl metabolites (mainly norfentanyl) and less than 10% as unchanged drug; fecal: less than 10%.
Renal (70-80% unchanged), biliary/fecal (15-20%), remainder metabolized
Category C
Category C
Opioid Analgesic
Opioid Analgesic