Published on 16 August 2022

Tapentadol For Treatment Of Fibromyalgia

Table of Contents

Opioids are commonly provided to fibromyalgia patients worldwide. In a nationally representative US dataset of commercially insured persons (245,758  patients), 11.3% received chronic daily opioid medication.
In patients with fibromyalgia, tapentadol has been shown to reduce pain. The drug works by interfering with the opioid receptors and noradrenaline hormone in the body. Its particular mode of action is dependent on enhancing descending pain inhibition. They are more effective in treating symptoms of fibromyalgia.

What Is Tapentadol (Aspadol)?

Tapentadol is generally well tolerated and is effective in various disorders, including chronic pain. This section addresses the current status of Tapentadol therapy for fibromyalgia.

Tapentadol, also known as Nucynta, is a benzenoid-class centrally-acting opioid analgesic. It  has a dual mechanism of action as an agonist of the -opioid receptor and a norepinephrine reuptake inhibitor (NRI) 

Tapentadol is a kind of opioid pain reliever. Tapentadol is a pain reliever that is available only by prescription. It treats moderate to severe acute pain (such as pain from an injury or after surgery).

Fibromyalgia is a condition marked by widespread musculoskeletal pain and tiredness, sleep, cognitive, and mood problems. Fibromyalgia, according to researchers, increases painful feelings by altering how your brain and spinal cord receive painful and non-painful impulses.

What Is The Root Cause Of Fibromyalgia?

It is still unknown why some people develop Fibromyalgia. The precise explanation is strange, although several factors are involved.

Signs often appear with a traumatic event, such as physical trauma, surgery, illness, or considerable psychological stress. In other situations, symptoms develop moderately over time with no specific triggering event.

The following are some of the major elements contributing to the disorder.

  • Genetics: Fibromyalgia might affect you from generations due to genetics, making you more prone to developing the illness.
  • Sleep issues. Disrupted sleep patterns may cause Fibromyalgia rather than merely a symptom.
  • Unbalanced chemical reactions. Studies show that persons with fibromyalgia have abnormally low amounts of the brain chemicals serotonin, noradrenaline, and dopamine.

Frequently Asked Questions

The US Food and Drug Administration (FDA) has approved duloxetine, milnacipran, and pregabalin to treat FM. Opioid analgesics are still often employed in the management of FM.
Tapentadol is a centrally-acting analgesic with demonstrated efficacy in the treatment of neuropathic pain, chronic pain, acute pain, and pain with an inflammatory origin.
The abuse potential of tapentadol was found to be significantly higher than that of tramadol, but equivalent to that of hydrocodone and lower than that of other strong opioids.

Can Tapentadol Treat Fibromyalgia?

Tapentadol should relieve pain for people that are suffering from Fibromyalgia. Standard cornea nerve fibers are affected highly during this condition, but after the use of Tapentadol, there was a slight relief from pain. In the case of the condition of aberrant fibers, individuals did not respond to this medication.

To understand this in a better way, let us elaborate on it with a study. We have provided you with the exact findings of the study.  

Please click on the shared link in the paragraph below to know in detail

In a study, 15 participants received Tapentadol, and 19 received a placebo. The observation was for three months. They were evaluated every month while in therapy and every month following. The approach used to assess CPM involved giving a person cold pain in their foot and observing how this overrode hot pain in their arm. A questionnaire was used to assess patients' levels of spontaneous pain.

Tapentadol treatment boosted patients' CPM scores by 20.5% on average. On average, there was no significant difference from baseline in those given a placebo. Although the score climbed, this indicates less pain - it might be interpreted as "greater suppression of the initial suffering."


On average, there was no difference in spontaneous absolute pain across the groups. However, the researchers saw that individuals given Tapentadol were more likely to have any reaction, no matter how large or tiny.

In further detail, the researchers examined the patients who got Tapentadol to identify who did or did not have significant pain alleviation, which they defined as a CPM score rise of at least 30%.

The scientists studied the nerve fibers in patients' corneas (part of the eye) using a method called cornea confocal microscopy (CCM), which can indicate more general nerve injury or absence of damage. Surprisingly, individuals who reacted well to Tapentadol tended to have normal CCM pictures (8/9), but those with aberrant CCM images (1/6 persons) were substantially less likely to respond to the therapy.

Findings suggest that this medication may be for use in people with fibromyalgia, but only a small subset of individuals would benefit from this treatment

"In summary," the researchers said, "we found that Tapentadol dramatically enhanced the effectiveness of the descending inhibitory pain pathway as evaluated by CPM when compared to placebo."

During Tapentadol therapy, patients with normal cornea fiber states reported increased CPM and pain relief. On the other hand, patients with an aberrant corneal nerve condition had no pain alleviation by Tapentadol despite an increase in CPM." 

Is Tapentadol Recommended In Treating Fibromyalgia?

Because of the overlap between opioid side effects, many co-occurring Fibromyalgia symptoms, and the potential for addictive behaviours when taking opioids, current guidelines do not recommend opioids for the treatment of Fibromyalgia, a widespread chronic pain condition.

What Is The Best Fibromyalgia Treatment?

The FDA has authorised three medications for the treatment of Fibromyalgia: pregabalin (Lyrica), duloxetine (Cymbalta), and milnacipran (Savella). Other drugs, such as amitriptyline (Elavil), cyclobenzaprine (Flexeril), or gabapentin (Neurontin), are commonly used as first-line therapy. Each of these medications is used to treat various illnesses, such as depression or nerve pain. The best treatment you can get is with the help of a doctor.

Finding support for individuals in need can be challenging at times. Seeking a doctor that understands Fibromyalgia, knows how to treat it, and helps you understand and manage this illness is the greatest approach to discovering an effective treatment strategy. Although rheumatologists and pain specialists are the authorities in this field, many general care physicians also diagnose and treat it. You may take steps to increase your chances of finding the correct doctor to treat your problem.

Start with your primary care physician to identify the proper healthcare practitioner to treat your Fibromyalgia. He or she could have a lot of expertise in treating persons with this illness. If this is not the case, ask for a referral to a specialist (such as a rheumatologist or pain expert) to confirm the diagnosis and guide therapy. 

It may be beneficial to seek advice from individuals with the same diagnosis. Support groups can be a valuable resource in this situation. The website of the National Fibromyalgia Association includes support groups in each state that might assist you in making these early contacts. In addition, the association may give a list of "fibro-friendly" doctors in your area.

Can You Be Hospitalised For Fibromyalgia?

Adults in the USA have many complications in Fibromyalgia that cause pain, disability, and lower quality of life. If you have Fibromyalgia, you are most likely to get hospitalized. Patients with Fibromyalgia are more than three times more likely to get into depression. 

Bottom Line From Practical Anxiety Solutions

Fibromyalgia is a serious condition, and you should not take it lightly. People with this condition are more likely to get hospitalized and have depression. 

In the study, Tapentadol has shown pain relief in the patients. Still, not everyone with Normal cornea nerve fibers showed an analgesic response, and people with abnormal fibers had no response.

  • Tzschentke, Thomas M., et al. "Tapentadol hydrochloride: a next-generation, centrally acting analgesic with two mechanisms of action in a single molecule." Drugs of today (Barcelona, Spain: 1998) 45.7 (2009): 483-496. From Obtain on 16/08/2022
  • Häuser, W., Ablin, J., Fitzcharles, MA. et al. Fibromyalgia. Nat Rev Dis Primers 1, 15022 (2015). From Obtain on 16/08/2022

  • Donk, T., et al. "Cornea nerve fiber state determines analgesic response to tapentadol in fibromyalgia patients without effective endogenous pain modulation." European Journal of Pain (2019): 1-10. From Obtain on 16/08/2022
  • de Donk, T. V., Velzen, M. V., Dahan, A., & Niesters, M. (2019). Cornea nerve fibre state determines analgesic response to tapentadol in fibromyalgia patients without effective endogenous pain modulation. European Journal of Pain (London, England), 23(9), 1586-1595. From Obtain on 16/08/2022