Comparative Pharmacology
Head-to-head clinical analysis: PROPOXYPHENE HYDROCHLORIDE 65 versus VICODIN.
Peer-Reviewed Evidence
Head-to-head clinical analysis: PROPOXYPHENE HYDROCHLORIDE 65 versus VICODIN.
PROPOXYPHENE HYDROCHLORIDE 65 vs VICODIN
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
Propoxyphene is a centrally acting opioid agonist that binds to mu-opioid receptors in the central nervous system, inhibiting pain signal transmission and altering pain perception. It also has local anesthetic effects.
VICODIN (hydrocodone/acetaminophen) is a combination opioid agonist and analgesic. Hydrocodone acts on mu-opioid receptors in the CNS to alter pain perception and response; acetaminophen inhibits cyclooxygenase (COX) activity, likely in the CNS, reducing prostaglandin synthesis and providing antipyretic effects.
65 mg orally every 4 hours as needed for pain; maximum 390 mg/day.
1-2 tablets (hydrocodone 5-10 mg and acetaminophen 300-325 mg) orally every 4-6 hours as needed for pain; maximum daily acetaminophen dose 4 g.
None Documented
None Documented
6-12 hours (mean ~8 hours); prolonged in hepatic impairment and elderly; accumulation possible with repeated dosing.
Hydrocodone: 3.8-6.4 hours (terminal); Acetaminophen: 2-3 hours (terminal). Clinically, steady-state achieved in 1-2 days.
Renal excretion of unchanged drug (approximately 20-30%) and metabolites; approximately 40-60% as conjugated metabolites; minor biliary/fecal elimination.
Hydrocodone: primarily renal (~60% as metabolites, 12% unchanged); minor biliary. Acetaminophen: renal (90-100% as metabolites, 2-4% unchanged).
Category C
Category C
Opioid Analgesic
Opioid Analgesic