Nucynta Vs. Oxycodone | Differences & Similarities

Nucynta (tapentadol) and oxycodone are opioid analgesics (painkillers) prescribed for moderate to severe pain. As opioids, they share many features, but there are a few differences between them, including ingredients, cost, and abuse potential. 

A doctor may prescribe one over the other based on your medical history and how your body responds to each drug.

Differences Between Nucynta & Oxycodone

Nucynta (tapentadol) differs from other opioids because it has two mechanisms of action. It is a mu-opioid receptor agonist, and it causes norepinephrine reuptake inhibition. 

It activates opioid receptors, so you feel pain relief, relaxation, and possibly euphoria. It also allows more serotonin and norepinephrine to be present in your brain. These hormones stabilize your mood and increase attention, focus, heart rate, and blood pressure.

Oxycodone only has one mechanism of action. It’s an opioid receptor agonist with an analgesic effect.

If you overdose on Nucynta or oxycodone, naloxone can reverse the symptoms of opioid overdose. But it can’t help with serotonin syndrome, a potentially life-threatening condition that occurs when you take too much tapentadol.

Other differences between Nucynta and oxycodone include:

• Dosage: The starting dosage of Nucynta is 50 mg, while oxycodone starts at 10 mg. 
• Side effects at low doses: At a dosage of 50 mg, Nucynta produces fewer gastrointestinal effects—such as constipation and nausea—than a 10 mg dose of oxycodone.
• What they treat: Nucynta is approved to treat diabetic neuropathy (neuropathic pain or nerve damage resulting from diabetes), while oxycodone doesn’t help with nerve pain.
• What’s in them: The only active ingredient in Nucynta is tapentadol hydrochloride. Oxycodone hydrochloride (OxyContin) is also available as a combination drug with acetaminophen (Percocet), aspirin (Percodan), or ibuprofen (Combunox). 
• Cost: Nucynta can cost almost five times as much as oxycodone.
• Abuse potential: Research shows that tapentadol is less likely to be abused than other Schedule II opioid pain medications. 

Similarities Between Nucynta & Oxycodone

Since both drugs are opioids, Nucynta and oxycodone have more similarities than differences.

Side Effects

At higher doses (75 to 100 mg), tapentadol can produce nausea, vomiting, and gastrointestinal distress at the same rate as oxycodone. 

At any dosage, Nucynta and oxycodone share many side effects, such as: 

• dizziness
• headaches
• fatigue
• sleepiness
• abdominal pain
• itching
• constipation

Pain Relief Effectiveness

Nucynta and oxycodone have a similar rate of pain relief effectiveness. Since they function a little differently, which one your doctor prescribes depends on your needs and history with opioids.

What They Treat

Both drugs treat moderate to severe chronic pain as well as acute pain. They may be used for injuries and post-operative pain, or pain management of issues like osteoarthritis (bone degeneration), cancer pain, and chronic low back pain.

When They’re Prescribed

The U.S. Food and Drug Administration (FDA) indicates that healthcare providers should only prescribe Nucynta or oxycodone when non-opioid painkillers are ineffective.

How They Work

Like all opioids, tapentadol and oxycodone are central nervous system (CNS) depressants. They slow your breathing and heart rate, relaxing your brain and body.

While Nucynta has the additional feature of being a norepinephrine reuptake inhibitor, it is primarily an opioid. It functions like oxycodone, decreasing pain intensity by changing how your brain perceives pain.

Formulations & Frequency Of Use

Nucynta and oxycodone are available in immediate-release (IR) and extended-release (ER) formulations. 

Tapentadol immediate release or oxycodone IR should be taken every four to six hours. 

You only need to take the Nucynta ER or oxycodone extended-release tablets every 12 hours (twice daily).

Drug Metabolism

Both drugs have a similar half-life (the time it takes for half of the drug to be processed and excreted by your body). That means your body will metabolize (break down) tapentadol at the same rate as oxycodone as long as the dose is comparable. 

Withdrawal Symptoms

Opioids usually produce physical dependence if you use them for a prolonged period. If you cut back your dosage or suddenly stop using them, you’ll likely experience opioid withdrawal symptoms.

Nucynta and oxycodone have similar withdrawal symptoms, which include:

• restlessness
• irritability
• anxiety
• runny nose
• watery eyes
• perspiration
• chills
• yawning
• weakness
• muscle or joint pain
• backache
• abdominal pain
• nausea and vomiting
• diarrhea

Other opioids, like hydrocodone (Vicodin), hydromorphone (Exalgo ER), and tramadol (Ultram), produce the same withdrawal symptoms.

Opioid Overdose Risk

Abusing drugs like tapentadol and oxycodone can cause severe respiratory depression—slow, shallow, or stopped breathing. Lack of oxygen to the brain and body may result in brain damage, loss of consciousness, coma, or death.

Mixing Nucynta and oxycodone or taking them with other opioids, sedatives, benzodiazepines, or alcohol can lead to an overdose. Using more oxycodone or Nucynta than prescribed also increases overdose risk.

Naloxone (Narcan) is widely available in the U.S. to combat opioid overdose death. It buys you time to seek medical help and may save your life or the life of a loved one.

Opioid Abuse

Most opioid overdoses occur because of opioid abuse. Opioids like oxycodone and Nucynta (tapentadol) are Schedule II controlled substances because they’re highly addictive and widely abused. 

If you or someone you know is misusing opioids, ask for help before it’s too late. 

At Ark Behavioral Health, we provide opioid rehab programs tailored to your unique needs. Through evidence-based treatment options, we’ll help you regain quality of life, rebuild relationships, and embrace recovery.

Contact an Ark Behavioral Health specialist today to learn more.