Comparative Pharmacology
Head-to-head clinical analysis: OPANA ER versus ORAMORPH SR.
Peer-Reviewed Evidence
Head-to-head clinical analysis: OPANA ER versus ORAMORPH SR.
OPANA ER vs ORAMORPH SR
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
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.
Morphine is a full opioid agonist with relative selectivity for the mu-opioid receptor, although it can interact with other opioid receptors at higher doses. Binding to mu-opioid receptors in the central nervous system (CNS) and peripheral tissues results in analgesia, euphoria, sedation, respiratory depression, and physical dependence. Morphine also activates descending inhibitory pathways and inhibits ascending nociceptive transmission.
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.
10-30 mg orally every 8-12 hours, sustained-release; titrate as needed for pain.
None Documented
None Documented
Terminal elimination half-life: 11.1–13.8 hours; clinically relevant as steady-state achieved in 2–3 days
2–4 hours in adults; in controlled-release formulation, effective half-life is prolonged due to sustained absorption. Clinically, steady-state is achieved in 1–2 days.
Renal (primarily as glucuronide conjugates and unchanged drug): 85-90%; Fecal: <10%
Renal (approximately 90% as morphine-3-glucuronide and morphine-6-glucuronide, minor amounts of unchanged morphine, and other conjugates); biliary/fecal (approximately 10%).
Category C
Category C
Opioid Analgesic
Opioid Analgesic