Comparative Pharmacology
Head-to-head clinical analysis: LAZANDA versus OPANA ER.
Peer-Reviewed Evidence
Head-to-head clinical analysis: LAZANDA versus OPANA ER.
LAZANDA vs OPANA ER
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.
Opana ER (oxymorphone hydrochloride) is a full opioid agonist with relative selectivity for the mu-opioid receptor, although it can interact with other opioid receptors at higher doses. The principal therapeutic action is analgesia via activation of mu-opioid receptors in the central nervous system, leading to altered perception and response to pain.
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.
Initial: 5 mg orally every 12 hours; titrate by 5-10 mg every 12 hours every 3-7 days; maximum 40 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: 11.1–13.8 hours; clinically relevant as steady-state achieved in 2–3 days
Renal excretion of metabolites (mostly fentanyl metabolites, primarily norfentanyl): approximately 75%; fecal excretion: approximately 9%; less than 10% excreted as unchanged fentanyl in urine.
Renal (primarily as glucuronide conjugates and unchanged drug): 85-90%; Fecal: <10%
Category C
Category C
Opioid Analgesic
Opioid Analgesic