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Generic name: tapentadol [ta-PEN-ta-dol]
The brand names are Nucynta and Nucynta ER.
Dosage formats: oral tablet (100 mg, 50 mg, 75 mg) Oral tablet extended release (100 mg, 150 mg, 200 mg, 250 mg, 50 mg)
Drug class: opiates (narcotic analgesics)

What is Tapentadol?

Tapentadol is an opioid painkiller. Sometimes, opioids are referred to as narcotics. Tapentadol is a prescribed medicine that is used in the treatment of moderate or severe discomfort. Tapentadol extended-release version (Nucynta in the ER) is a round-the-clock treatment for pain that isn't managed by other medications. The extended-release version of tapentadol is not to be used on a limited basis to treat pain.


Do not take tapentadol if you've taken a MAO antagonist within the last 14 days. A potentially dangerous interaction with a drug could occur. MAO inhibitors include isocarboxazid, linezolid, methylene blue injection, phenelzine, rasagiline, selegiline, or tranylcypromine. This medication is prescribed if you suffer from severe breathing problems and a condition of the bowel referred to as paralytic ileus. Tapentadol can cause a slowing or stopping of your breathing, especially if you first start taking this medication or when your dose is altered. Do not take this medication in greater quantities or for a longer duration than prescribed. Don't crush, break, or break an extended-release tablet. Inhale it completely to avoid exposure to a possibly fatal dose.

Tapentadol may be habit-forming, even at regular doses. Follow the exact dosage recommended by your physician. Don't share this medication with anyone else. The misuse of narcotic pain medications can lead to the development of addiction, a high dose, or the death of a child or another person who is taking the medication without having a prescription. Make sure to keep the medication in a location where other people are not able to access it. Consult your physician when you're pregnant. Tapentadol could cause severe withdrawal symptoms in babies in the event that the mother took this medication during the course of pregnancy. Side effects that are fatal can be experienced if you take opioids in conjunction with alcohol or other substances that can cause drowsiness or a slowing of breathing.

Similar or related drugs

Aspirin, acetaminophen, tramadol, duloxetine, naproxen, oxycodone, and tylenol

Before taking this medication

You shouldn't use tapentadol when you are allergic to it or are suffering from

  • Serious asthma or breathing issues;
  • Stomach or obstruction of the bowel (including paralytic ileus), as well as
  • If you've used an MAO inhibitor within the last 14 days, like linezolid, isocarboxazid, phenelzine, methylene blue injection, or tranylcypromine,

To ensure that tapentadol is suitable for you, inform your physician if you've ever experienced:

  • Breathing difficulties; sleep apnea (breathing that ceases during sleep);
  • A head injury, brain tumour, or seizures
  • Addiction or addiction to drugs or mental illness;
  • Urination issues,
  • Kidney disease, liver failure, or
  • Issues with your gallbladder, thyroid gland, pancreas, or adrenal gland.

If you take tapentadol during pregnancy, your baby may become dependent on the medication. This can cause dangerous withdrawal symptoms in the newborn after it's born. Babies who become dependent on habit-forming drugs might require medical attention for a period of time. Talk to a doctor before taking opioids if you are nursing. Tell your doctor when you experience severe fatigue or a slow breathing rate in your baby. Do not give tapeentadol to children.

How to take Tapentadol?

Follow the exact dosage of tapentadol as recommended by your physician. Follow the instructions on your prescription label and review all medication guidelines. Do not take tapentadol in greater quantities or for a longer period than what is prescribed. Consult your physician if you notice an increase in your desire to take more tapentadol.

Don't share opioids with anyone else, particularly those who have an addiction history. A MISUSE OF OPIOIDS can cause addiction, overdose, or death. Place the medication in a place where no one else can access it. Giving away or selling this medication is against the law. Stop taking any other medications that contain tapentadol or tramadol as soon as you start taking tablets that contain tapentadol. Drink four full glasses of fluid at regular intervals every day, whether or not you eat. Avoid crushing, breaking, or breaking the extended-release tablet. Inhale it completely to avoid exposure to a possibly fatal dose.

Tapentadol can cause constipation. Consult your physician prior to taking a laxative or stool softener to prevent or treat this adverse result. Do not crush pills to inhale them or inject the powder into a vein. This could lead to his death. You could experience withdrawal symptoms if you stop using tapentadol suddenly. Consult your physician before removing the medication. Keep at room temperature, free of heat and moisture. Make a note of the medicine you have purchased. You must be aware if someone is taking it incorrectly or without a prescription. Don't store any leftover medication for opioids. A single dose could cause death for someone who is using this medication improperly or in a dangerous way. Ask your pharmacist where you can find a drug disposal program. If there isn't a take-back plan, dispose of the remaining medicine down the drain.

Details on dosage

Usual Adult Dose for Pain:

Therapy that is individualised, taking into account the severity of pain, the treatment response, previous treatment with analgesics, as well as the risk factors for addiction, misuse, and abuse

The first dose is 50–100 mg taken orally every 4–6 hours, as required for discomfort.
Day 1: A second dose can be administered within 1 hour following the first dose, if necessary.
Subsequent doses are 50, 75, or 100 mg orally within 4–6 hours. modify the dose to provide sufficient analgesia and acceptable tolerability.
Maximum dosage for 1 day: 700 mg; 600 mg/day on the days following.

Use the dose that is most effective for the least amount of time and is in line with the specific treatment goals of the patient.
Monitor closely for any signs of respiratory depression, particularly during the initial 24 to 72 hours after starting therapy and after each dosage increase.
Due to the risks of abuse, addiction, and misuse even at recommended doses, limit use to patients who require alternative treatments (e.g., opioid analgesics that are not opioids or opioid-based combinations) that are not being well tolerated,  aren't anticipated to be tolerated, do not provide sufficient analgesia, or are not likely to provide sufficient analgesia.

Usual Adult Dose for Chronic Pain:

Individualise your therapy based on the intensity of pain, reaction to therapy, previous experiences with analgesics, and potential risk factors for addiction, misuse, and abuse.
Discontinue all other tapentadol or tramadol medications prior to introducing tapentadol tablets with extended release.

The first dose is 50 mg, taken orally twice every day.
Individually titrate the dose until it gives adequate analgesia and reduces the risk of adverse reactions. Dose increases shouldn't exceed 50 mg two times per day for three days.
Dosage for maintenance ranges from 100 mg to 250 mg, taken orally twice daily.
Maximum dose: 500 mg/day

Provide the same daily dose of tapentadol, divided into two equal doses. The doses are taken orally two times a day, at least 12 hours apart.

Conversion from Other Opioids:
As there aren't any established conversion rates from other opioids, begin at 50 mg daily orally for 12 hours.
Close observation and regular titrations are recommended until pain is under control. Be aware of the indications and symptoms of withdrawal.
Provide emergency medication that contains the appropriate dosage of an analgesic that is immediate-release as appropriate.

For patients who experience breakthrough pain, it is recommended to use a first-aid medication that includes the right dose of an immediate-release analgesic.
If the intensity of pain rises following stabilisation of the dose, attempt to pinpoint the source of the pain before increasing the dose.
Because of the dangers of abuse, addiction, and misuse, even at recommended doses, usage is recommended only for patients whose alternatives to treatment (e.g., non-opioid analgesics or immediately-released opioids) are not effective, cannot be well tolerated, or are otherwise insufficient for treatment for pain.
This medicine is not intended to be used as an analgesic as needed.

What happens If I miss a dose?

Because tapentadol is a medication used to treat pain, you're less likely to skip a dose. Do not miss any doses in the event that it's time to take your next dose. Don't take any extra medication to make up for the missed dose.

Don't take additional medication to make up for a missed dose. Do not exceed the dose you are prescribed within 24 hours.

What happens if I overdose?

Get medical attention immediately, make a call to emergency medical attention, or call the Poison Help line at 1-800-222-1222. A fatal overdose could be fatal, particularly in the case of a child or someone who is taking opioids without a prescription. Overdose symptoms may include extreme drowsiness, a sharpening of the pupils, slow breathing, or the inability to breathe.

The doctor might suggest that you purchase Naloxone (a medication to treat an overdose of opioids) and carry it on hand throughout the day. The person who is caring for you could administer Naloxone in the event that you lose your breath or are unable to wake up. The carer should still seek emergency medical attention and might need to administer CPR (cardiopulmonary resuscitation) on you as they wait for assistance to arrive.

Naloxone can be purchased from the local pharmacy or health department. It is important that everyone who cares for you is aware of the location where you store your naloxone and how to utilise it.

What should be avoided?

Don't drink alcohol. Dangerous side effects or even death could happen. Avoid driving or engaging in hazardous activities until you are aware of how the effects of tapeentadol affect you. Difficulty or drowsiness could result in accidents, falls, or even serious injuries.

Side effects of Tapentadol

Take immediate medical attention in the event that you exhibit symptoms of an allergy reaction with tapeentadol: hives and chest pains; rapid heartbeats; difficulty breathing; swelling of your lips, face, and throat. Opioid medication may slow or stop breathing, and it is even possible to die. The person who is caring for you should administer Naloxone or seek medical attention if you experience prolonged breathing, pauses in your breathing, blue-coloured lips, or if you find it difficult to get up.

See your doctor right away. If you are suffering from:

  • Loud breathing, sighing, deep breathing, and breathing that ceases;
  • A feeling of lightheadedness, as if you're passing out;
  • Arousal: a hot, hot sensation;
  • Dizziness or severe drowsiness; trouble with balance or speech;
  • A seizure;
  • Serotonin Syndrome: hallucinations, agitation, or fever; rapid heartbeat; muscle stiffness; loss of coordination; twitching; nausea, diarrhoea, or
  • Low levels of cortisol, nausea, vomiting, fatigue, loss of appetite, and fatigue that gets worse.

The presence of serious breathing issues is more common in older adults and those who are weak or suffer from the syndrome of wasting as well as chronic respiratory problems.

Common tapentadol side effects may include:

  • Constipation, nausea, vomiting, and stomach pain;
  • Headache, feeling tired, or
  • Drowsiness, dizziness.

This isn't a complete list of all the side effects. Others could happen. Consult your physician for advice regarding medical adverse effects. You may report any adverse reactions to the FDA at 1-800-FDA-1088.

Interaction with other drugs

A variety of other medications can be hazardous when combined with opioid medications. Tell your doctor when you are using:

  • Medicine to treat allergy asthma, allergies, high blood pressure, motion sickness, and irritable bowel syndrome, as well as an overactive bladder;
  • Other opioid medications;
  • Benzodiazepine sedatives such as Valium, Klonopin, and Xanax
  • Sleep aids such as muscle relaxers, sleep medicine, and other medications that can make you sleepy or
  • Medications that alter serotonin levels medications that affect serotonin, like antidepressants and stimulants. They also include medications that treat headaches or Parkinson's disease.

This list isn't comprehensive. Numerous drugs can interact with the drug, including prescription and over-the-counter medicines, vitamins, and herbal products. There are many possible interactions that are not mentioned here.