UMEM Educational Pearls

Category: Toxicology

Title: Tapentadol: A new opioid analgesic

Keywords: tapentadol, nucynta, opioid (PubMed Search)

Posted: 5/12/2011 by Bryan Hayes, PharmD (Updated: 2/4/2023)
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Several patients have recently presented with a medication history including tapentadol (Nucynta), the newest opioid formulation.  It is approved for treatment of acute moderate-severe pain.  Here are some key points:

  • Mechanism similar to tramadol: mu-receptor agonist, also inhibits norepinephrine reuptake
  • Potency stronger than tramadol, but less then morphine
  • Usual dose is same as tramadol 50-100 mg every 4-6 hours prn pain
  • Schedule II controlled substance, similar to morphine/oxycodone (tramadol is not a controlled substance)
  • Overdose should present like other opioids, but potentially also including tachycardia, serotonergic effects, and seizures (similar to tramadol)