IRFANA PARVEEN
By Irfana Parveen

B.Sc (Psychiatry Ward)

18 August 2022
Medically reviewed by
Sumayya Salam
Pharm D
tapentadol-for-neuropathic-pain
Table of Contents

Widespread in the U.S., pain associated with adverse clinical, economic, and quality-of-life outcomes ranges from 15% to 20% of patients. Up to 75% of patients experience pain after surgery, and 10% million have chronic pain yearly. Neuropathic pain is a common problem encountered in palliative care. Patients with chronic neuropathic pain report a higher degree of impairment in quality of life, Anxiety, and depression than patients with chronic non-neuropathic pain. 

Tapentadol is an effective opioid analgesic but does it help relieve neuropathic pain?

What Is Tapentadol?

Tapentadol (Nucynta) is an opioid medicament for alleviating severe acute pain. It belongs to the class called opiate analgesics. Nucynta ER is the first and only opioid medication for neuropathic pain associated with diabetic peripheral neuropathy (DPN) in adults approved by FDA. 

Tapentadol alters how the nervous system and brain respond to pain. It reduces pain perception by inhibiting the pain signals to the brain.

Why Does Neuropathic Pain Occur?

Neuropathic pain occurs if the nervous system is not working correctly or is damaged. This pain is felt at different levels of the nervous system, i.e., the brain, spinal cord, and peripheral nerves. The healthcare provider can diagnose it through medical history and physical examination.

What Is The Cause Of Neuropathic Pain?

Neuropathic pain may be caused due to side effects of certain medicines or nerve damage after trauma or surgery.   It may also be caused due to diseases such as alcoholism, vascular malformations, HIV infection or AIDs, shingles, facial nerve problems, viral infections, cancer, neurological conditions such as multiple sclerosis, and metabolic conditions such as diabetes.

Other causes include radiation therapy, spinal nerve compression or inflammation, amputation, chemotherapy drugs (cisplatin, vincristine, etc.), and tumor nerve compression or infiltration.

Why Is Nerve Pain So Painful?

Nerve pain feels different in different ways. It often feels like a stabbing, shooting, or burning sensation or can be as sharp as an electric shock. Uncontrolled pain is hard to bear, but it can be controlled with treatment. 

Any damage to body tissues such as tendons, muscles, ligaments, or capsules around the joints causes unpleasant, i.e., nociceptive pain. The nerve receptors (i.e., nociceptors) transmit pain signals to the brain, usually achy, sharp, dull, or throbbing.

Is Tapentadol Good For Neuropathic Pain?

Tapentadol is a central-acting oral analgesic with combined opioid and noradrenergic properties, making it potentially suitable for many pain conditions. 

In randomized controlled trials, Tapentadoltapentadol has proven effective in relieving neuropathic pain in chronic low back pain and diabetic peripheral neuropathy. In observational studies, Tapentadoltapentadol reduced blood and solid cancers, neuropathic pain in chemotherapy-induced peripheral neuropathies, and the pain component in neck pain and Parkinson’s disease. 

Side Effects of Tapentadol?

Tapentadol might have some side effects, which may also vary by individual individuals. Seek immediate medical attention if you develop symptoms such as extreme conditions.

Common Side Effects Severe Side Effects
Headache sleepiness
Drowsiness, dizziness seizure
Constipation unresponsiveness
Nausea, vomiting agitation
Abdominal pain slowed or difficulty breathing

Note: Serious breathing problems are more common in senior citizens.

Tapentadol Dosages For Neuropathic Pain

This drug is available in 50mg, 75mg, 100mg as immediate-release and 50, 100 and, 150, 200, and 250mg as extended-release tablets.

It is usually administered with or without a meal, with plenty of water every 4-6 hrs as per the requirement. Extended-release tablets are taken once in 12 hours or as directed by the physician. Never crush this pill to inhale as a powder or inject it into your vein, as it may be fatal. Immediate-release tablets are used for acute pain, whereas extended-release tablets are used in chronic neuropathic pain in people with diabetes.

Acute moderate-to-severe pain

  • Immediate-release: 50-100mg oral every 4-6hrs; maximum dose for the day1 is 700mg and 600mg after that.

Chronic pain

  • Extended-release: 50-250mg oral every 12hrs; maximum dose is 500mg/day. Tapentadol For diabetic peripheral neuropathy, the recommended dosage for extended-release tablets is 50mg oral every 12hrs initially and 100-250mg oral every 12hrs.

Are There Natural Ways To Treat Neuropathic Pain?

Chronic pain is joint and affects up to 60% of older people, usually a nociceptive musculoskeletal pain from a common degenerative disease. Neuropathic pain is also expected and needs to be managed adequately, which may lead to depression and cognitive and functional impairment.   

Apart from pharmacotherapy, there are other treatment measures for neuropathic pain, which depend on its cause. Some standard therapy includes surgery, physical therapy, and injections for increased nerve pressure. These treatments focus on reducing discomfort with OTC analgesics such as aspirin. 

Bottom Line From Practical Anxiety Solutions

Tapentadol is a centrally-acting analgesic, classified as schedule II of the controlled substance act. It is a more efficacious and tolerable drug than classical opioids in many populations for managing moderate to severe chronic and neuropathic pain in adults.

It is challenging to eradicate Neuropathic pain, but it is usually not life-threatening. This drug may cause some or other side effects, but it shows its more significant impact if taken in the prescribed manner. However, natural measures are also available to treat neuropathic pain, reducing discomfort from the analgesics.

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