Tapentadol is an opioid analgesic prescribed to treat moderate to severe pain. Tapentadol works by changing the way the nervous system and brain respond to pain. It is available in both immediate-release and extended-release oral tablets. Tapentadol extended-release can also be prescribed to treat severe neuropathic pain associated with diabetic peripheral neuropathy. Tapentadol may be prescribed when alternative pain treatments fail to provide any relief.
Immediate-release tapentadol tablets are used to treat acute pain. Extended-release tapentadol tablets are prescribed to provide 24-hour chronic pain relief and should not be used on an as-needed basis for pain. Tapentadol works best if taken at the onset of pain; it may not work as well if pain levels are already high. Tapentadol should only be taken as prescribed.
Tapentadol is typically started at a low dose and gradually increased until pain is under control. Dosage should be individualized based on pain severity, therapy response, prior treatment experience and risk factors of addiction, abuse and misuse.
- Immediate-release tapentadol tablets are typically prescribed with an initial dosage of 50 to 100 mg taken orally every four to six hours as needed for pain relief. Additional doses may be prescribed for the first day of use to achieve optimum pain relief. The maximum dosage for immediate-release tapentadol tablets is 700 mg on the first day and 600 mg on subsequent days.
- Extended-release tapentadol tablets are typically prescribed with an initial dosage of 50 mg taken twice per day. The maximum dosage of extended-release tapentadol tablets is 500 mg per day.
- Dosage should be individualized to provide adequate pain relief yet minimize adverse reactions.
- If changing from immediate-release to extended-release tapentadol, the current daily dosage of immediate-release should be divided into two equal doses of extended-release and taken orally twice per day, 12 hours apart.
If a dose of immediate-release tapentadol is missed, it should be taken as soon as possible; however, a double dose should not be taken. If a dose of extended-release tapentadol is missed, the missed dose should be skipped, and the regular schedule continued; a double dose should not be taken.
Tapentadol should not be taken by individuals with the following:
- Tapentadol allergy
- Severe asthma
- Breathing complications
- Digestive tract obstruction (stomach or intestines)
- An MAOI (monoamine oxidase inhibitor) has been taken in the past 14 days (A dangerous drug interaction may occur.)
Prior to taking tapentadol
Before taking tapentadol, the prescribing physician and pharmacist must be informed of any other prescription medications, over-the-counter medications, vitamins, nutritional supplements and herbal products (especially St. John’s Wort or tryptophan) that are currently being taken or may be taken prior to taking tapentadol. All health care professionals, including dentists, should be informed of tapentadol treatment prior to any surgery, including dental work.
Before taking tapentadol, the prescribing health care professional should be informed about any previous or current health conditions, including, but not limited to, the following:
- Sleep apnea or breathing problems
- Seizures, head injury or brain tumor
- Urinary problems
- Kidney or liver disease
- Drug or alcohol addiction
- Mental illness
- Gallbladder, pancreas or thyroid problems
Common side effects
- Drowsiness (Driving, operating machinery or participating in potentially dangerous activities should be avoided until the effects of the medication are known.)
- Dizziness, lightheadedness, or faintness, especially when standing from a reclined position.
- Constipation (A health care professional should be consulted before taking a laxative or stool softener while on tapentadol.)
- Heartburn or indigestion
- Muscle pain or stiffness
Important general information
- Tapentadol should never be given to children.
- Tapentadol can slow breathing, especially when first started.
- Extended-release tablets should not be crushed, broken or opened. They must be swallowed whole.
- Tapentadol should not be taken for longer than prescribed or in higher doses than prescribed.
- Tapentadol may be habit-forming.
- This medication should never be shared with another person.
- Misuse of tapentadol can cause addiction, overdose or death.
- Alcohol should be avoided while taking tapentadol as fatal side effects can occur.
- Tapentadol should be taken with a full glass of water and with or without food. If nausea occurs, it should be taken with food.
- When first starting tapentadol, other extended-release narcotic pain medications should not be taken.
- Tapentadol should not be suddenly stopped, as unpleasant withdrawal symptoms may occur.
- Tapentadol should be stored at room temperature and away from moisture.
- A health care professional should be consulted if pain worsens or does not improve.
- Tapentadol may lose some of its effectiveness if taken for extended periods.
- Use of tapentadol can decrease fertility in both males and females.