Comparative Pharmacology
Head-to-head clinical analysis: IONSYS versus VICOPRIN.
Peer-Reviewed Evidence
Head-to-head clinical analysis: IONSYS versus VICOPRIN.
IONSYS vs VICOPRIN
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.
VICOPRIN (hydrocodone/acetaminophen) combines a mu-opioid receptor agonist (hydrocodone) that inhibits ascending pain pathways and alters pain perception, with an analgesic and antipyretic (acetaminophen) that inhibits cyclooxygenase (COX) and central prostaglandin synthesis.
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.
1 to 2 tablets (each containing 7.5 mg hydrocodone bitartrate and 200 mg ibuprofen) orally every 4 to 6 hours as needed for pain; maximum 5 tablets 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).
Hydrocodone: 3.8-6.0 hours in adults; acetaminophen: 2.0-4.0 hours. Clinically, Vicoprofen (hydrocodone/ibuprofen) has an effective half-life of ~4-6 hours for hydrocodone; ibuprofen half-life is 2-4 hours.
Renal: approximately 90% as fentanyl metabolites (mainly norfentanyl) and less than 10% as unchanged drug; fecal: less than 10%.
Renal excretion of metabolites (hydrocodone: ~60% as conjugates; acetaminophen: ~85-90% as glucuronide and sulfate conjugates). Biliary/fecal elimination accounts for <5%.
Category C
Category C
Opioid Analgesic
Opioid Analgesic