What Is Tapentadol? | Uses & Abuse Potential

Tapentadol (or tapentadol hydrochloride) is a prescription opioid analgesic that is primarily used to treat moderate to severe pain. The medication can be found in immediate-release (IR) and extended-release (ER) formulations under the brand names Nucynta and Nucynta ER. 

As an opioid, tapentadol has a high potential for drug abuse and can be habit-forming and addictive. And the more it’s abused, the higher the risk of dependence and addiction as well as serious health issues.

Tapentadol Uses

Tapentadol is typically used to treat severe pain and should only be used when other non-opioid pain meds have not worked for pain management. Tapentadol can also be used for neuropathic pain (pain due to nerve damage) associated with diabetes.

Tapentadol is also likely only used for the short-term treatment of pain. Using it long-term or for chronic pain can increase the risk of dependence and addiction. 

How Tapentadol Works

Tapentadol has two mechanisms of action. The first is as a mu-opioid receptor/μ-opioid receptor agonist. This means the drug binds to that specific opioid receptor in the central nervous system (CNS).

The second mechanism is norepinephrine reuptake inhibition. This means the drug stops the reuptake of norepinephrine. This increases the amount of norepinephrine in the brain.

Together, these mechanisms cause an interruption of the pain signals that would normally travel to the nerves throughout the body. This, ultimately, leads to pain relief.

Abuse Potential Of Tapentadol

The U.S. Food and Drug Administration (FDA) classifies tapentadol as a Schedule II controlled substance. This means that it has a high potential for abuse and can lead to psychological and physical dependence as well as substance use disorder.

The opioid is also said to be as potent as tramadol and morphine and its effects are very similar to oxycodone, all of which are also Schedule II controlled substances. 

Side Effects Of Tapentadol

As with most medications, tapentadol comes with some side effects. It doesn’t matter if you’re taking tapentadol IR or tapentadol ER, you’ll likely feel some side effects. 

Some of the most common side effects of tapentadol may include:

• nausea
• constipation
• vomiting
• dizziness
• drowsiness
• headache
• stomach pain
• dry mouth
• anxiety
• difficulty falling asleep or staying asleep

While not as common, tapentadol can also lead to serious side effects. The risk for serious side effects, such as chest pain and difficulty breathing, is higher if you just started the medication, just had the dose increased, are older, or abuse the drug in high doses.

Drug Interactions

Some prescription drugs don’t mix well with tapentadol. Combining the opioid with certain substances can lead to serious adverse reactions that can be life-threatening:

• monoamine oxidase inhibitors (MAOIs) like isocarboxazid (Marplan) and linezolid (Zyvox)
• buprenorphine (Buprenex)
• selective serotonin reuptake inhibitors (SSRIs) like citalopram (Celexa) and fluoxetine (Prozac)
• selective serotonin/norepinephrine reuptake inhibitors (SNRIs) like duloxetine (Cymbalta) and venlafaxine (Effexor)
• tramadol (Conzip and Ultram)
• other opioids like hydrocodone, hydromorphone, fentanyl, and oxymorphone
• trazodone
• tricyclic antidepressants like amitriptyline and clomipramine (Anafranil)
  

Tapentadol Overdose

If you take too high a dose of this pain medicine or mix it with other substances, you increase your risk of opioid overdose.

Some of the signs and symptoms of overdose may include:

• narrowing or widening of pupils
• unconsciousness
• muscle weakness
• cold, clammy skin
• slow or shallow breathing
• slowed heartbeat
• severe drowsiness
• problems with speech
• problems with coordination and balance

If you know how to administer naloxone (Narcan), now is the time to do that. It can reverse the effects of opioid overdose.

Tapentadol Withdrawal Symptoms

If you abuse tapentadol on a regular basis or take a higher dose of the drug than prescribed over a long period of time, you’re likely to develop physical dependence. 

With physical dependence, your body becomes unable to function without the drug. And when you do try and quit, unpleasant withdrawal symptoms can occur which can make abstinence difficult.

Tapentadol withdrawal symptoms may include:

• restlessness
• anxiety
• trouble sleeping
• thoughts of suicide
• runny nose
• nausea
• vomiting
• loss of appetite
• diarrhea
• muscle aches
• tremors
  

If you or a loved one are struggling with opioid abuse or opioid use disorder, Ark Behavioral offers a wide-range of inpatient and outpatient substance abuse treatment options. To learn more, please contact us today.

FAQ

How Are Oxycodone & Nucynta Different?

Oxycodone and Nucynta are both opioid agonists (drugs that target opioid receptors). But Nucynta (tapentadol) also affects the hormones serotonin and norepinephrine. 

Other differences between Nucynta and oxycodone are:

• Nucynta dosage starts at 50 mg. The starting dose of oxycodone is 10 mg.
• At low doses, Nucynta produces less nausea than oxycodone.
• Nucynta treats nerve pain, while oxycodone does not.
• The only painkiller Nucynta contains is tapentadol. Oxycodone often comes in combination with acetaminophen, aspirin, or ibuprofen.
• Nucynta can cost almost five times what oxycodone costs.
• Some research shows that Nucynta is less likely to be abused than oxycodone. 

Learn more about Nucynta Vs. Oxycodone