Comparative Pharmacology
Head-to-head clinical analysis: OPANA ER versus ULTRAM.
Peer-Reviewed Evidence
Head-to-head clinical analysis: OPANA ER versus ULTRAM.
OPANA ER vs ULTRAM
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.
Tramadol is a centrally acting synthetic opioid analgesic that binds to μ-opioid receptors and inhibits norepinephrine and serotonin reuptake.
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.
50-100 mg orally every 4-6 hours as needed for pain; maximum 400 mg/day (for extended-release: 100 mg once daily, titrated up to 300 mg once daily).
None Documented
None Documented
Terminal elimination half-life: 11.1–13.8 hours; clinically relevant as steady-state achieved in 2–3 days
Tramadol: ~6 hours; M1 metabolite (O-desmethyltramadol): ~7 hours; prolonged in renal/hepatic impairment
Renal (primarily as glucuronide conjugates and unchanged drug): 85-90%; Fecal: <10%
Renal: ~90% (tramadol and metabolites; conjugated metabolites are major), Fecal: ~10%
Category C
Category C
Opioid Analgesic
Opioid Analgesic