Comparative Pharmacology
Head-to-head clinical analysis: IONSYS versus XARTEMIS XR.
Peer-Reviewed Evidence
Head-to-head clinical analysis: IONSYS versus XARTEMIS XR.
IONSYS vs XARTEMIS XR
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.
XARTEMIS XR is a combination of oxycodone (a full mu-opioid receptor agonist) and acetaminophen (a centrally acting analgesic with antipyretic properties via cyclooxygenase inhibition).
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 tablet (oxycodone 7.5 mg / acetaminophen 325 mg) orally every 12 hours; maximum 2 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).
Oxycodone: 5.3-6.6 hours (immediate-release), extended-release formulation shows prolonged absorption with apparent half-life ~7.2-9.6 hours; naloxone: 2-3 hours.
Renal: approximately 90% as fentanyl metabolites (mainly norfentanyl) and less than 10% as unchanged drug; fecal: less than 10%.
Renal: oxycodone and metabolites ~8.8% free oxycodone, ~8.8% noroxycodone, ~33% conjugated metabolites; naloxone: extensive hepatic metabolism, <1% excreted unchanged in urine. Fecal: naloxone metabolites ~17%.
Category C
Category C
Opioid Analgesic
Opioid Analgesic