Comparative Pharmacology
Head-to-head clinical analysis: LAZANDA versus OPANA.
Peer-Reviewed Evidence
Head-to-head clinical analysis: LAZANDA versus OPANA.
LAZANDA vs OPANA
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
Fentanyl is a μ-opioid receptor agonist. It binds to μ-opioid receptors in the central nervous system, activating G-protein-coupled receptors to inhibit adenylate cyclase, reduce cAMP production, and modulate ion channels, leading to decreased neurotransmitter release (e.g., substance P, glutamate) and hyperpolarization of neurons, resulting in analgesia and sedation.
Mu-opioid receptor agonist; produces analgesia by binding to opioid receptors in the CNS, inhibiting ascending pain pathways and altering pain perception.
100 mcg (one spray) intranasally as needed for breakthrough pain; may repeat once after 15-30 minutes if needed; do not exceed 2 doses per episode and 4 doses per day.
5-20 mg orally every 4-6 hours as needed for pain; extended-release tablets: 5 mg orally every 12 hours, titrated up to 20 mg every 12 hours.
None Documented
None Documented
Terminal elimination half-life: 6–10 hours (mean approximately 7 hours) following nasal administration; prolonged in hepatic impairment.
Terminal elimination half-life is 11-16 hours (mean 14 hours) in adults; prolonged in hepatic impairment (up to 30 hours) and elderly.
Renal excretion of metabolites (mostly fentanyl metabolites, primarily norfentanyl): approximately 75%; fecal excretion: approximately 9%; less than 10% excreted as unchanged fentanyl in urine.
Primarily renal (approximately 90% as conjugated metabolites, 10% unchanged); biliary/fecal elimination accounts for <10%.
Category C
Category C
Opioid Analgesic
Opioid Analgesic