Tapentadol

Aka: Tapentadol, Nucynta

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II. Mechanism

  1. Mu-Opioid receptor Agonist
  2. Norepinephrine reuptake inhibitor

III. Indications

  1. Moderate to severe acute pain

IV. Contraindications

  1. Severe renal Impairment
  2. Severe hepatic Impairment

V. Efficacy

  1. As effective as Oxycodone
  2. Less Nausea, Vomiting and Constipation than Oxycodone

VI. Drug Interactions

  1. Serotonin Syndrome risk

VII. Adverse Reactions

  1. Seizures
  2. Anaphylactoid Reaction
  3. Respiratory Depression

VIII. Preparations

  1. Schedule II Controlled Substance
  2. Immediate release
    1. Tapentadol 50-100 mg orally every 4-6 hours as needed (up to 600 mg/day)
    2. Decrease dose to 50 mg every 8 hours if moderate hepatic Impairment
  3. Extended release
    1. Tapentadol XR 50 mg orally twice daily (and titrate up to 250 mg twice daily)
    2. May start higher if transitioning from other Opioids

IX. References

  1. Tarascon pharmacopeia (2013)
  2. Hartrick (2011) CNS Drugs 25(5): 359-70 [PubMed]

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