21 August 2022
Medically reviewed by
Kajal Jain
M. Pharm
Table of Contents

What is Tapentadol?

Tapentadol, sold under the brand name Nucynta, is a centrally acting opioid analgesic for relieving moderate to severe acute pain in patients 18 years of age and older. It was developed by the German pharmaceutical company Grünenthal in the late 1980s and approved by the US FDA in November 2008. 

Like tramadol, it acts by activating mu opioid receptors and inhibiting norepinephrine reuptake. Because Tapentadol is not a pro-drug and does not mediate its therapeutic effect via metabolism, it is a useful alternative for patients who do not respond quickly to commonly prescribed opioid analgesics. (Hartrick, C.T. and Rodríguez Hernandez, J.R., 2012)

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It is used for moderate to severe pain, and musculoskeletal pain, including neuropathic pain associated with diabetic peripheral neuropathy.

Nucynta Extended-release formulations are not indicated for use in managing acute pain. 

How does Tapentadol work?

Tapentadol is a benzenoid-class opioid prescribed to treat moderate to severe short-term pain. It combines two mechanisms, namely mu receptor agonism and noradrenaline reuptake inhibition. Unlike Tramadol, it has weaker effects on serotonin reuptake and is a significantly more potent opioid.

Tapentadol exhibits analgesia within 32 minutes of oral administration, and the action lasts for 4-6 hours. (Vadivelu, N., Huang, Y., Mirante, B., Jacoby, M., Braveman, F.R., Hines, R.L. and Sinatra, R., 2013.)

Alcohol: How does it work?

Ethyl alcohol is the main constituent of all kinds of alcoholic beverages and is generally obtained by the fermentation of sugar by yeast. The alcohol is separated by simple distillation. The alcohol concentrations of various beverages vary between 4- 55% by volume.
Alcohol is thought to work primarily by increasing the effects of a neurotransmitter γ-aminobutyric acid, or GABA and by facilitating its actions, alcohol suppresses the activity of the central nervous system. (Room, R., Babor, T. and Rehm, J., 2005)

Can you take Alcohol with Tapentadol?

Doing so may cause increased dizziness, difficulty in concentrating, and the most death. Some may also experience impairment in thinking and judgment. Therefore, avoid alcohol and anything containing alcohol while taking Tapentadol.

What Are the Effects of Mixing Tapentadol and Alcohol?

Concomitant use of alcohol and Tapentadol may result in serious effects, including death. Because of its mu-opioid agonist activity, additive effects should be expected when Tapentadol is taken with alcohol. So, avoid or limit your intake of alcohol while you are taking Tapentadol. Also, inform your doctor if you are taking similar medicines.

Effects of Alcohol

For healthy adults, moderate alcohol consumption means one drink per day for women and up to two drinks for men. But drinking an excess amount can potentially lead to unwanted health consequences.

At lower doses, alcohol can act as a stimulant, inducing feelings of euphoria, drowsiness, slurred speech, and talkativeness. A high amount of alcohol consumed at once can lead to drowsiness, respiratory depression, coma, and even death if the body cannot handle it. (Zakhari S)

Dosage of Tapentalol

The dosing regimen of Tapentadol should be individualized depending on the severity of pain and previous experience with other opioid analgesics. 

Tapentadol is available as immediate release (IR) and extended release (ER) tablets.
The doses available are 50 mg, 75 mg, or 100 mg every 4 to 6 hours depending upon pain intensity. Take the tablet with or without food every 4 to 6 hours as needed.

The second dose may be administered as early as one hour after the first dose if adequate pain relief was not achieved with the first dose. 

Subsequent dosing is 50 mg, 75 mg, or 100 mg every 4 to 6 hours and should be adjusted to maintain adequate analgesia with acceptable tolerability. (Singh, D.R., Nag, K., Shetti, A.N. and Krishnaveni, N., 2013)

Side effects

  • Headache
  • Stomach pain
  • Dry mouth
  • Fatigue
  • Anxiety
  • Drowsiness
  • Heartburn
  • Itchiness
  • Insomnia
  • Irritability

Treatment of Addiction to Alcohol

Treatment of alcohol dependence can be done in an outpatient or inpatient setting.
Alcohol withdrawal usually develops 6 to 8 hours after the cessation of alcohol consumption. 
Tremors are usually one of the first signs of alcohol withdrawal. Psychotic symptoms begin 8 to 12 hours after the cessation of alcohol use. Withdrawal symptoms peak on the second or third day and diminish significantly on the fourth or fifth day.
Cognitive behavioral therapy- If the patient is confused and disoriented or hallucinating, a supportive and reassuring approach should be used and the patient should not be confronted.
Use of sedatives- benzodiazepines
Maintenance of nutritional deficiency, particularly Thiamine
Disulfiram - Disulfiram is a deterrent drug used for the long-term treatment of alcohol dependence. It is an irreversible inhibitor that blocks aldehyde dehydrogenase, which leads to an accumulation of acetaldehyde when alcohol is consumed, known as the disulfiram-ethanol reaction (DER). The usual dose of disulfiram is 250 mg/day. The first dose of disulfiram should be administered at least 24 hours after the last alcohol dose. If a patient is unsuccessful with 250 mg/day (DER), the dose can be increased to 500 mg/day, which in turn can be increased to 750 mg/day. (Knight, R.P., 1938)


It is important to thoroughly review your medical history with your doctor at the beginning of any treatment. Inform your doctor about any drug allergies and avoid taking alcohol while taking Tapentadol. Discontinue the medication only after consulting with your doctor.

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