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Phenylpiperidines (meperidine-like agonists) Fentanyl (Duragesic, Fentora, Lazanda) Synthetic 50–100 mcg *Varies 25–50 mcg IV q1–2h Transdermal: 25 mcg/h q72h 7–15 min (IV)1–2h 6h (transdermal) (IV) 72–96h (transdermal) Buccal film IV solution sublingual/buccal products patch intranasal solution tablet IV, transdermal, sublingual, buccal Meperidine (Demerol) Synthetic 75–100 mg 300 mg 50–100 mg IV/IM q2–3hRecommended Not 10–15 min 4–6h Tablet (IR) oral solution IV solution IV, PO Diphenylheptanes (methadone-like agonits) Methadone Synthetic *Varies *Varies 2.5–10 mg IV/IM q8–12h 2.5 mg q8–12h 30–60 min 4–8h Tablet (IR) oral concentrate IV solution IV, PO Agonist-antagonist derivatives Buprenorphine (Buprenex, Butrans) Synthetic *Varies *Varies 0.3 mg IM q6–8h 75 mg q12–24h Transdermal: 5 mcg/h q7d 10–20 min 6h Buccal film patch IV solution tablet implant IV, sublingual, buccal, transdermal, subcutaneous Central analgesics Tramadol Synthetic N/A N/A N/A 50–100 mg q4–6h (max 400 mg daily) 60 min 4h 10h (ER) Capsule (ER) tablet (ER, IR) oral suspension cream PO, transdermal IR = immediate release, ER = extended release, IV = intravenously, PO = by mouth, APAP = acetaminophen 9