II. Mechanism
- Mu-Opioid receptor Agonist
- Norepinephrine reuptake inhibitor
III. Indications
- Moderate to severe acute pain
IV. Contraindications
- Severe renal Impairment
- Severe hepatic Impairment
V. Efficacy
- As effective as Oxycodone
- Less Nausea, Vomiting and Constipation than Oxycodone
VI. Drug Interactions
- Serotonin Syndrome risk
VII. Adverse Reactions
- Seizures
- Anaphylactoid Reaction
- Respiratory Depression
VIII. Preparations
- Schedule II Controlled Substance
- Immediate release
- Tapentadol 50-100 mg orally every 4-6 hours as needed (up to 600 mg/day)
- Decrease dose to 50 mg every 8 hours if moderate hepatic Impairment
- Extended release
- Tapentadol XR 50 mg orally twice daily (and titrate up to 250 mg twice daily)
- May start higher if transitioning from other Opioids
IX. References
- Tarascon pharmacopeia (2013)
- Hartrick (2011) CNS Drugs 25(5): 359-70 [PubMed]
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