Comparative Pharmacology
Head-to-head clinical analysis: ONSOLIS versus OPANA.
Peer-Reviewed Evidence
Head-to-head clinical analysis: ONSOLIS versus OPANA.
ONSOLIS vs OPANA
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
Onsolis (fentanyl buccal soluble film) is an opioid agonist that binds to mu-opioid receptors in the central nervous system, producing analgesia by increasing potassium conductance and inhibiting calcium channels, leading to reduced neurotransmitter release and hyperpolarization of neurons.
Mu-opioid receptor agonist; produces analgesia by binding to opioid receptors in the CNS, inhibiting ascending pain pathways and altering pain perception.
Onsolis (fentanyl buccal soluble film) is indicated for breakthrough pain in opioid-tolerant patients. The initial dose is 200 mcg placed on the buccal mucosa; titrate to effective dose in 200 mcg increments across subsequent episodes. Maximum frequency: 4 doses per day. Allow at least 2 hours between doses.
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 is approximately 3-5 hours in adults, providing sustained analgesic effect with multiple daily dosing.
Terminal elimination half-life is 11-16 hours (mean 14 hours) in adults; prolonged in hepatic impairment (up to 30 hours) and elderly.
Primarily hepatic metabolism via glucuronidation, with approximately 70% of the dose excreted in urine as metabolites and 10-15% in feces as unchanged drug.
Primarily renal (approximately 90% as conjugated metabolites, 10% unchanged); biliary/fecal elimination accounts for <10%.
Category C
Category C
Opioid Analgesic
Opioid Analgesic