Comparative Pharmacology
Head-to-head clinical analysis: OPANA ER versus VICODIN HP.
Peer-Reviewed Evidence
Head-to-head clinical analysis: OPANA ER versus VICODIN HP.
OPANA ER vs VICODIN HP
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.
Hydrocodone is a mu-opioid receptor agonist that inhibits ascending pain pathways; acetaminophen inhibits cyclooxygenase and has antipyretic effects.
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.
One tablet (hydrocodone bitartrate 10 mg/acetaminophen 660 mg) orally every 4-6 hours as needed for pain; maximum 6 tablets 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
Hydrocodone: 3.8-5.5 hours (mean 4.5 h). Acetaminophen: 2-3 hours. Clinical context: dosing interval every 4-6 hours for acute pain.
Renal (primarily as glucuronide conjugates and unchanged drug): 85-90%; Fecal: <10%
Primarily renal: hydrocodone is eliminated as conjugated metabolites (glucuronides) ~80%; unchanged drug ~5%. Biliary/fecal: minor, <10%.
Category C
Category C
Opioid Analgesic
Opioid Analgesic