Comparative Pharmacology
Head-to-head clinical analysis: LEVORPHANOL TARTRATE versus XTAMPZA ER.
Peer-Reviewed Evidence
Head-to-head clinical analysis: LEVORPHANOL TARTRATE versus XTAMPZA ER.
LEVORPHANOL TARTRATE vs XTAMPZA ER
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.
Oxycodone is a full mu-opioid receptor agonist, producing analgesia, euphoria, and sedation. Xtampza ER utilizes DETERx technology to provide extended-release properties and resist tampering.
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.
Initial: 9 mg orally every 12 hours with food; titrate by 9 mg every 3-7 days as needed; maximum dose: 36 mg every 12 hours.
None Documented
None Documented
11-16 hours; extended in hepatic impairment (up to 30 hours).
3-4 hours for immediate-release morphine; 8-12 hours for extended-release formulation (XTAMPZA ER), allowing twice-daily dosing
Renal: approximately 30% as unchanged drug and 50% as glucuronide conjugates; fecal: 20% via biliary excretion.
Primarily renal (70-90% as morphine-3-glucuronide, morphine-6-glucuronide, and free morphine); biliary/fecal (10-20%)
Category C
Category C
Opioid Analgesic
Opioid Analgesic