Comparative Pharmacology
Head-to-head clinical analysis: LEVORPHANOL TARTRATE versus XARTEMIS XR.
Peer-Reviewed Evidence
Head-to-head clinical analysis: LEVORPHANOL TARTRATE versus XARTEMIS XR.
LEVORPHANOL TARTRATE vs XARTEMIS XR
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
Levorphanol is a potent opioid analgesic that acts as a mu-opioid receptor agonist. It also has NMDA receptor antagonist activity, inhibits norepinephrine and serotonin reuptake, and acts as a sigma receptor agonist, contributing to its analgesic effects and reduced tolerance development.
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).
2 mg orally every 6-8 hours as needed for pain; for opioid-tolerant patients, doses up to 4 mg orally every 6-8 hours may be used. Parenterally: 1-2 mg subcutaneously or intramuscularly every 6-8 hours; may be given intravenously at 0.5-1 mg every 6-8 hours.
1 tablet (oxycodone 7.5 mg / acetaminophen 325 mg) orally every 12 hours; maximum 2 tablets per day.
None Documented
None Documented
11-16 hours; extended in hepatic impairment (up to 30 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 30% as unchanged drug and 50% as glucuronide conjugates; fecal: 20% via biliary excretion.
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