Comparative Pharmacology
Head-to-head clinical analysis: VICODIN ES versus XTAMPZA ER.
Peer-Reviewed Evidence
Head-to-head clinical analysis: VICODIN ES versus XTAMPZA ER.
VICODIN ES vs XTAMPZA ER
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
Hydrocodone is a mu-opioid receptor agonist; acetaminophen inhibits cyclooxygenase (COX) and modulates descending serotonergic pathways.
Oxycodone is a full mu-opioid receptor agonist, producing analgesia, euphoria, and sedation. Xtampza ER utilizes DETERx technology to provide extended-release properties and resist tampering.
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.
Initial: 9 mg orally every 12 hours with food; titrate by 9 mg every 3-7 days as needed; maximum dose: 36 mg every 12 hours.
None Documented
None Documented
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.
3-4 hours for immediate-release morphine; 8-12 hours for extended-release formulation (XTAMPZA ER), allowing twice-daily dosing
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.
Primarily renal (70-90% as morphine-3-glucuronide, morphine-6-glucuronide, and free morphine); biliary/fecal (10-20%)
Category C
Category C
Opioid Analgesic
Opioid Analgesic