Tapentadol

Ask A Pharmacist

Self medication is not recommended. Always discuss medication changes with your physician and pharmacist.

Name: Tapentadol (ta PEN ta dol), Nucynta™CR

Uses:

Tapentadol is officially approved in Canada for the management of moderate to moderately- severe pain in adults who require continuous treatment for several days or more.

How It Works:

Tapentadol works in two different ways that work together. It works on the opioid receptor and by increasing norepinephrine, a chemical in the brain that helps to decrease pain perception. Tapentadol provides pain relief somewhere between that of tramadol and morphine. 

Precautions:

Discuss with your physician about whether tapentadol may be an option for you. Medical conditions including kidney or liver disease are important considerations. It should be used with caution in patients with a history of alcohol or drug abuse.

Discuss with your physician and pharmacist other prescription medications, non-prescription medications and natural products you are taking to make sure there are no adverse effects when taken with tapentadol.

Tapentadol may cause dizziness and drowsiness therefore don’t drive until you know how it affects you.

Avoidance of alcohol is recommended.

Dosing:

Tapentadol CR is a long-acting medication that must be swallowed whole. Do not split, crush or chew the tablet. These actions can result in overdose because the drug will be released suddenly and in excessive amounts rather than a slow release over 12 hours.

Take with or without food, twice daily (about 12 hours apart) to maintain a constant level in your system. 

Doses in patients not already taking opioids are started at 50mg twice daily. The usual maintenance dose is 100mg to 250mg twice daily. Doses in patients switching from another opioid are individualized.

If you forget to take a dose, take it as soon as you remember. If it is close to your next dose then skip the missed dose (do NOT take double the dose).

If stopping tapentadol do not stop suddenly to avoid withdrawal reactions. Always discuss this with your physician.

Side Effects:

All medications that have positive effects (usefulness) also have negative effects (side effects). A balance between the two is necessary. Starting at a low dose and increasing the dose gradually decreases the chance of side effects.

The most common side effects are nausea, dizziness, constipation, headache and drowsiness.

Summary:

Tapentadol is a unique medication because of its two modes of action that work together to decrease pain. It has been found effective in decreasing pain caused by tissue damage (nociceptive pain) and pain caused by damage to the nerve itself (neuropathic pain).

Always discuss medication with your physician and pharmacist to see if this medication is appropriate for you.

Janice Sumpton RPh, BScPhm.              July 20, 2011