An integrated fuse element is capable of being programmed to high resistance in low voltage process technology. The fuse includes a stack of an undoped polysilicon layer and a silicide layer. A voltage applied across the stack is increases until a first agglomeration event occurs, whereby a discontinuity is formed in the silicide layer. The current is further increased to cause a second agglomeration event whereby the size of the discontinuity is increased. Each agglomeration event increases the resistance of the fuse. An extended-drain MOS transistor, capable of sustaining high voltage, is connected in series with the fuse for programming the fuse. The transistor includes: a well region in a substrate, the well region forming the drain of the transistor; an insulating trench in the well; and a polysilicon gate extending over a portion of the substrate, a portion of the well and a portion of the trench, wherein upon reverse-biasing the junction between the well and the substrate a depletion region is formed which encompasses at least the entire portion of the surface region of the well over which the polysilicon extends.