FRENY MENEZES
By Freny Menezes

Pharm. D

26 August 2022
Medically reviewed by
Kajal Jain
M. Pharm
TAPENTADOL DOSE AND OVERDOSE THINGS YOU SHOULD KNOW
Table of Contents

Tapentadol is an opioid analgesic recommended for patients experiencing short-term moderate to severe chronic pain. This medication comes in immediate-release, extended-release tablets, and oral solution forms. Like other opioids, Tapentadol has a high potential for addiction.

About 25% of persons who are prescribed opioid painkillers for chronic pain abuse them, and overdose deaths from opioids like Tapentadol increased by 30% between July 2016 and September 2017. 

It is beneficial to be aware of these symptoms if you know someone undergoing Tapentadol treatment encounters an overdose. Let us see the typical overdose symptoms, treatment details, and the required dosage of tapentadol.

What Is Tapentadol (Nucynta)?

Tapentadol (Nucynta) is a prescription drug for treating short-term moderate to severe acute pain, such as pain after surgery. This medication belongs to opioid analgesics, which work to directly affect how your brain recognizes and responds to pain. 

It is quite uncertain how Tapentadol works in the treatment of pain. It's thought to bind to mu-opioid receptors and affect norepinephrine levels in the brain, which help change how your body recognizes pain.

Pros Of Taking Tapentadol

  1.  Available in short and long-acting forms
  2.  Can be taken with or without food
  3.  The extended-release tablet has greater efficacy for chronic as well as diabetic nerve pain
  4.  Its extended-release form provides around-the-clock pain relief

Cons Of Taking Tapentadol

  1.  Is expensive as it is available only in the brand formulation   
  2.  It might increase the chance of seizures and breathing disorders in case of similar case history
  3. Tapentadol cannot be stopped immediately because of the probability of getting withdrawal symptoms
  4. Its immediate-release formulation shall be taken multiple times a day, which can be inconvenient.
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Dosage of Tapentadol

Tapentadol is available in three doses i.e. 50, 75 and 100 mg. Take the lowest possible amount for short-term pain. The healthcare practitioner can gradually increase its quantity as per the requirements. (Zajączkowska, R., Przewłocka, B., Kocot-Kępska, M., Mika, J., Leppert, W. and Wordliczek, J., 2018)

Tapentadol is available in three forms-

  1. For Acute pain (short-term)- Immediate-release tablets
  2. For Chronic pain (long-term)- Extended-release tablets
  3. For Nerve pain from diabetes- Extended-release tablets

In general:

The two forms of tapentadol now on the market are IR (50, 75, and 100 mg) and ER (50, 100, 150, 200, and 250 mg). It costs more than what is accessible in generic form

Immediate-release tablet for acute pain:

The initial dose is 50 to 100 mg oral every 4 to 6 hours as per the requirement.

 Extended-release tablet for chronic pain:

·         For a patient with diabetic nerve pain:
The initial dose is 50mg oral every 12 hours (twice a day)
·         For patients switching from Nucynta to Nucynta ER or switching from other narcotics:
Take the tablet every 12 hours. The total dose is the same as regular tapentadol
 
For children, dose and use of this drug shall be determined by the concerned healthcare practitioner.

After a single oral dose of Tapentadol immediate-release, serum concentrations peak at 1.25 hours.
Initially, take 50 mg twice daily (every 12 hours). If necessary, your doctor might change your dose. The dose, though, is often limited to 500 mg per day.
Do not crush, break, dissolve, or chew Tapentadol pills as this could result in the uncontrolled release and quick absorption of a potentially fatal amount of the medication.

Drug Overdose

Drug overdose is when you take more than the recommended dose, which might result in severe or harmful symptoms or even death.

When a person takes an excess drug on purpose, it is called an intentional overdose; when it is taken unintentionally, it is called an accidental overdose.

An overdose is not similar to poisoning, although the effects can be the same.
A large overdose can interfere with normal breathing or even stop breathing and may result in death if not treated immediately. Depending on the drug taken, multiple organs may be affected, affecting the person's outcome and probability of survival.

On receiving medical attention on time, before the occurrence of any serious problem, the person might have lesser long-term consequences.

An estimated 25% of people misuse the prescription analgesic taken for chronic pain, and between July 2016 and September 2017, a 30% rise in overdoses has been observed in opioids like Tapentadol.

Signs Of Overdose

Unfortunately, opioid overdoses continue to rise. Below we have outlined typical signs of an overdose:

  • Problems with vital signs (Pulse rate, temperature, blood pressure, respiratory rate) are possible and can be life-threatening. These signs can either be increased, decreased or completely absent. 
  • Confusion, sleepiness and coma are common. 
  • Skin can be cool, hot and dry or sweaty.
  • Shortness of breath might occur.
  • Pain in the chest can also be caused by lung or heart damage. 
  • Abdominal pain, vomiting, nausea, and diarrhea are possible. Blood in bowel movements or Vomiting blood can be life threatening.
  • Some drugs can damage specific organs too.

Symptoms of Tapentadol Overdose

The signs and symptoms of Tapentadol overdose differ for every individual as numerous factors can affect drug overdose. Typically, potential Tapentadol overdose symptoms include confusion, sweating, extreme drowsiness, blurred vision, slowed breathing, clammy skin, and muscle weakness.

Some of these symptoms might occur as side effects, making it difficult to notice an overdose. It is recommended to talk to a healthcare practitioner or seek medical attention as a precautionary measure to prevent adverse reactions.

One of the most visible symptoms of a tapentadol overdose is respiratory depression. When taking more Tapentadol, respiratory depression may be lethal if left untreated.

Other signs of tapentadol overdose include:

  • Limp or stiff muscles
  •  Bradycardia (prolonged heart rate)
  •  Low blood pressure
  •  Coma
  •  Cardiac arrest
  •  Snoring caused by shallow breathing

How Much Tapentadol Consumption Cause Overdose?

The amount of drugs that can cause an overdose from Tapentadol differs for every individual. Even in small doses, this substance can cause an overdose if combined with other drugs or alcohol

A person with a higher tolerance for opioid medications is unlikely to overdose at levels that could cause an overdose for inexperienced people. The maximum dose of Tapentadol for every patient is 600 mg daily. 

Tapentadol Overdose Treatment

Before taking any drug, certain measures should be taken to prevent any side effects before they are treated by a medical professional. Once the overdose symptoms are observed, seek immediate help from the concerned doctor.

  1. Tapentadol overdose does not always cause loss of consciousness. In this case, it is crucial to keep the person calm and prevent them from making unwanted movements to prevent them from falling.
  2. It should also be ensured that the overdose victim is hydrated and head elevated, as profuse sweating occurs during a Tapentadol overdose.
  3. If a Tapentadol overdose causes shallow breathing and loss of consciousness, seek immediate medical attention.
  4. If a victim goes into cardiac arrest or respiratory depression, perform cardiopulmonary resuscitation if possible
  5. In case of respiratory depression, a breathing tube shall also be used to keep the airway open and prevent CO2 from building up in the body. In some cases, Naloxone, an opioid antagonist, also works as an antidote to respiratory depression.
  6. Activated charcoal may also be administered in hospitals to clear the stomach of Tapentadol, which lowers the absorption rate. 
  7. Regularly check the victim's blood pressure, pulse rate, and withdrawal symptoms. In addition, this could be harmful because an overdose puts a strain on vital organs.
  8. If any person has recently suffered from a Tapentadol overdose, ensure a rehabilitation facility so that another overdose does not happen.

Bottom Line From Practical Anxiety Solutions

Tapentadol (Nucynta) is an opioid medication used to treat acute, chronic, or neuropathic pain. This medicine is effective for short-term use or when other drugs become intolerant. Tapentadol is a Schedule II controlled substance with a potential for abuse similar to other potent opioid analgesics. However, it causes severe side effects when taken in excess or other than prescribed.

A person can also overdose on the lower levels of Tapentadol if you mix it with other recreational or illicit drugs or alcohol. If you know someone who has overdosed on Tapentadol, seek emergency medical treatment to avoid complications.

  • Zajączkowska, R., Przewłocka, B., Kocot-Kępska, M. et al. Tapentadol — A representative of a new class of MOR-NRI analgesics. Pharmacol. Rep 70, 812–820 (2018). From https://doi.org/10.1016/j.pharep.2018.01.005 Obtain on 24/08/2022

  • Kleinert, Regina, et al. "Single dose analgesic efficacy of tapentadol in postsurgical dental pain: the results of a randomized, double-blind, placebo-controlled study." Anesthesia & Analgesia 107.6 (2008): 2048-2055. From https://doi.org/10.1213/ane.0b013e31818881ca Obtain on 24/08/2022

  • Vadivelu, N., Timchenko, A., Huang, Y., & Sinatra, R. (2011). Tapentadol extended-release for treatment of chronic pain: a review. Journal of Pain Research, 4, 211-218. From https://doi.org/10.2147/JPR.S14842 Obtain on 24/08/2022

  • Channell, J.S. and Schug, S., 2018 From https://doi.org/10.2217/pmt-2018-0027 Obtain on 24/08/2022

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