Comparative Pharmacology
Head-to-head clinical analysis: ONSOLIS versus OXAYDO.
Peer-Reviewed Evidence
Head-to-head clinical analysis: ONSOLIS versus OXAYDO.
ONSOLIS vs OXAYDO
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.
Oxycodone is a full opioid agonist with relative selectivity for mu-opioid receptors, although it can bind to kappa-opioid receptors at higher doses. The principal therapeutic action of oxycodone is analgesia. Like all full opioid agonists, there is no ceiling effect to analgesia for oxycodone.
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.
Oral, 5-10 mg every 4-6 hours as needed for pain; maximum 60 mg per day.
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 3.5-5.5 hours for immediate-release oxycodone; clinically dose every 4-6 hours for sustained analgesia.
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 as unchanged drug and metabolites; ~90% excreted in urine (approx 10% unchanged oxycodone, rest as noroxycodone and oxymorphone conjugates) and <10% in feces via biliary elimination.
Category C
Category C
Opioid Analgesic
Opioid Analgesic