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What is Tapentadol?

By Sheri Cyprus
Updated May 17, 2024
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Tapentadol is a synthetic, narcotic analgesic, or pain reliever. It's unique from similar drugs for two reasons. First, it has dual activity, which means that to block pain it binds to mu-opioid receptors in the body as well as inhibits the hormone and neurotransmitter norepinephrine. Second, immediate-release tapentadol is the first centrally acting synthetic analgesic approved by the United States Food and Drug Administration (USFDA) in more than 25 years.

The FDA approved this analgesic, produced by Johnson & Johnson Pharmaceutical Research and Development (J&JPRD), in November of 2008. Before being approved by the FDA, clinical studies testing the drug against a placebo that involved at least 2,100 patients were conducted. Tapentadol is sold under the name Nucynta, and is prescribed for moderate to severe pain relief.

This analgesic is sold in tablets of 50 mg, 75 mg and 100 mg. Patients may be advised to take one tablet every four to six hours for pain relief. Like other narcotic pain relievers, Nucynta is designed to be taken short term to relieve acute pain, as it does have at least some potential to be abused as a habit-forming drug.

Tapentadol has a molecular structure similar to tramadol, brand name Ultram, another centrally acting analgesic. Its potency is said to be stronger than tramadol but not as strong as morphine. Alcohol should be avoided when taking these drugs, as it may interfere with potency levels and/or worsen the side effects. Nucynta's side effects can include nausea, poor sleep, itchy rash, increased sweating and painful joints. Other possible side effects are runny nose, coughing, sneezing, drowsiness, constipation and dizziness.

Patients taking monoamine ovidase inhibitors (MAO) antidepressant drugs should not take tapentadol because these medications tend to affect the body's norepinephrine levels. Typically, doctors want patients to have at least two weeks without any MAO being taken before starting tapentadol. The analgesic is prescribed for moderate to severe, rather than mild, acute pain. Before it was approved by the FDA, tapentadol studies indicated it to be effective in managing osteoarthritis-related knee pain.

Osteoarthritis, diabetic neuropathy and lower back pain are conditions for which tapentadol may be prescribed. It is typically not recommended for patients with a respiratory disorder such as asthma. In some cases, doctors may prescribe asthmatics the drug, but dosages may be changed or further testing of the patient may be done first. Nucynta is not recommended for patients with severe kidney or liver disease.

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