Comparative Pharmacology
Head-to-head clinical analysis: OPANA ER versus PROPOXYPHENE HYDROCHLORIDE.
Peer-Reviewed Evidence
Head-to-head clinical analysis: OPANA ER versus PROPOXYPHENE HYDROCHLORIDE.
OPANA ER vs PROPOXYPHENE HYDROCHLORIDE
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.
Propoxyphene hydrochloride is a centrally acting opioid analgesic that binds to mu-opioid receptors in the central nervous system, inhibiting ascending pain pathways and altering perception of and response to pain.
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.
65 mg orally every 4 hours as needed for pain; maximum 390 mg per day.
None Documented
None Documented
Terminal elimination half-life: 11.1–13.8 hours; clinically relevant as steady-state achieved in 2–3 days
6–12 hours (parent drug); norpropoxyphene metabolite half-life 30–36 hours, accumulates with repeated dosing, increasing risk of toxicity, especially in elderly or renal impairment.
Renal (primarily as glucuronide conjugates and unchanged drug): 85-90%; Fecal: <10%
Primarily renal (70-90% as unchanged drug and metabolites, including norpropoxyphene); biliary/fecal excretion accounts for less than 10%.
Category C
Category C
Opioid Analgesic
Opioid Analgesic