Comparative Pharmacology
Head-to-head clinical analysis: ONSOLIS versus OPANA ER.
Peer-Reviewed Evidence
Head-to-head clinical analysis: ONSOLIS versus OPANA ER.
ONSOLIS vs OPANA ER
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.
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.
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.
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 is approximately 3-5 hours in adults, providing sustained analgesic effect with multiple daily dosing.
Terminal elimination half-life: 11.1–13.8 hours; clinically relevant as steady-state achieved in 2–3 days
Primarily hepatic metabolism via glucuronidation, with approximately 70% of the dose excreted in urine as metabolites and 10-15% in feces as unchanged drug.
Renal (primarily as glucuronide conjugates and unchanged drug): 85-90%; Fecal: <10%
Category C
Category C
Opioid Analgesic
Opioid Analgesic