Comparative Pharmacology
Head-to-head clinical analysis: OXYMORPHONE HYDROCHLORIDE versus VICODIN ES.
Peer-Reviewed Evidence
Head-to-head clinical analysis: OXYMORPHONE HYDROCHLORIDE versus VICODIN ES.
OXYMORPHONE HYDROCHLORIDE vs VICODIN ES
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
Oxymorphone is a semi-synthetic opioid agonist that binds to mu-opioid receptors in the central nervous system, inhibiting ascending pain pathways and altering pain perception and response. It also has affinity for kappa and delta opioid receptors.
Hydrocodone is a mu-opioid receptor agonist; acetaminophen inhibits cyclooxygenase (COX) and modulates descending serotonergic pathways.
Initial: 1 mg IV/IM every 3-4 hours as needed for moderate to severe pain; titrate to effect. For patient-controlled analgesia (PCA), 0.5 mg IV loading dose, then 0.25-0.5 mg every 6-15 minutes with lockout. Rectal suppository: 5 mg every 4-6 hours.
Oral: 1 tablet (7.5 mg hydrocodone/300 mg acetaminophen) every 4-6 hours as needed for pain; maximum 6 tablets per day due to acetaminophen limit.
None Documented
None Documented
Terminal elimination half-life: 7-9 hours (range 4-12 h in elderly/renal impairment). Clinically, steady-state achieved within 24-36 hours.
Hydrocodone: terminal half-life approximately 3.3-4.5 hours in adults, extended in hepatic or renal impairment. Acetaminophen: terminal half-life about 2-3 hours.
Primarily renal (90% as parent drug and metabolites); <1% fecal. Unchanged oxymorphone accounts for ~30% of urinary recovery.
Hydrocodone: primarily renal (urine) as unchanged drug and metabolites (O-demethylation and 6-keto-reduction products); ~26% excreted unchanged. Acetaminophen: renal (urine), ~85% as glucuronide and sulfate conjugates, ~2% unchanged.
Category C
Category C
Opioid Analgesic
Opioid Analgesic