Tapentadol is a new pain relieving medication that combines the actions of an opioid (like morphine) and a noradrenaline reuptake inhibitor (booster of the body’s pain suppressing ability). It is designed for the management of moderate to severe intensity pain and is currently available in a slow release formulation.
Tapentadol relieves pain by altering perception of signals coming from the body into the central nervous system (brain) for processing.
Studies have shown it is effective in comparison with traditional opioid medications (such as morphine and oxycodone) and may have a better side effect profile. Of note, it causes less drowsiness, constipation and depression of breathing compared to traditional opioids.
Potential side effects include:
The most commonly experience side effects with Tapentadol are:
- Nausea and vomiting
- Hyperhidrosis (excessive sweating)
- Dysphoria (feeling strange)
- Sedation (drowsiness)
As with other opioid medications there is potential for tolerance, dependence/addiction and abuse. This agent should not be stopped suddenly and the dose not altered without medical supervision.
Potential drug interactions include:
- Excess drowsiness
- Respiratory depression (slowing of breathing) – especially when combined with other sedative agents including opioids, alcohol, benzodiazepines, other drugs with sedative side effects
- Serotonin toxicity; there remains a theoretical risk with combined use of Tapentadol and other serotonergic agents (SSRI’s, SNRI’s, TCA’s, MAOI’s, St Johns Wort and triptans) may result in Serotonin Syndrome – check with your doctor
Because of the potential side effect of drowsiness, tapentadol may effect the ability of patients to drive and use heavy machinery. This effect is most prominent at beginning of treatment or in changing doses, or particularly when combined with other sedative medicines and alcohol.
Use in pregnancy not studied (Category c), should not be used whilst breastfeeding and not approved for use in children under 18 years.