FRENY MENEZES
By Freny Menezes

Pharm. D

26 August 2022
Medically reviewed by
Kajal Jain
M. Pharm
tapentadol-vs-tramadol
Table of Contents

Tapentadol and tramadol are  opioid medications used for similar ailments. Both drugs are analgesic agents with multiple mechanisms of action, i.e., both are norepinephrine reuptake inhibitors with weak opioid agonist activity. Tapentadol is not a prodrug as it does not depend on metabolism to get it working. Contrary, tramadol is a prodrug as it does not do anything on its own and gets metabolized in the liver by the cyp450 enzyme into active chemicals. (Hartrick, C.T. and Rozek, R.J., 2011

Tramadol and Tapentadol share a mixed mechanism of action, including monoaminergic and µ-agonist properties. Tramadol also has serotonin reuptake inhibiting properties associated with prominent side effects, including nausea and seizures. (Lee, C., McTavish, D. and Sorkin, E.M., 1993)

Tapentadol is nearly two to three times more potent than tramadol and two to three times less potent than morphine. 

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Tapentadol and Tramadol Similarities and Comparison Assessment

The similarities and differences between Tapentadol and Tramadol are further examined below-

1. Similarity Assessment 

 

Tapentadol

Tramadol

1. Indications

-      Moderate-to-severe pain

-      It is used for short-term and max. for 3 weeks of continuous use

-      Moderate-to-severe pain

-      It is used for short-term and max. for 3 weeks of continuous use

2. Legal Status

-      Australia (controlled drug)

-      Canada (Schedule I)

-      UK (Schedule II)

-      USA (Schedule II)

-      Australia (Prescription only)

-      Canada (Prescription only)

-      UK (Schedule III)

-      USA (Schedule IV)

3. Efficacy

-      30 min from administration

-      30 min from administration

Use in Pregnancy

-  Not advised

-  Not advised

 

2. Comparative Assessment

 

 

Tapentadol

Tramadol

4. Brand Name

-      Nucynta

-      Ultram

5. FDA Approval

-      Yes, in year 2005

-      Yes, in year 2008

6. Class of drug

-      Strong opioid

-      Weak opioid

7. Legal Status

-      Australia (controlled drug)

-      Canada (Schedule I)

-      UK (Schedule II)

-      USA (Schedule II)

-      Australia (Prescription only)

-      Canada (Prescription only)

-      UK (Schedule III)

-      USA (Schedule IV)

8. Dosage

-      Recommended daily dose is 600 to 700 mg without significant contraindications

-      10 to 15mg every 4-6 hrs for moderate to severe acute pain

-      Recommended daily dose is 25 to 100mg every 4-6 hrs

-      Max. daily dose is 400 mg (adults)

Dosage Form

-      Are produced as oral tablets only

-      Produced as oral, IV solution and rectal suppository

-      Available as immediate and delayed-release formulations

Elimination half-life

-      4-6 hrs

-      Drug eliminated through urine and feces

-      2-6 hrs

-      Drug eliminated through urine and faeces

 

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Price Comparision

Tapentadol

Tapentadol comes in IR (50, 75, and 100 mg) and ER (50, 100, 150, 200, and 250 mg) dosage forms.
Nucynta ER oral tablet extended-release 50 mg costs roughly $611 for a supply of 60 pills, depending on the drugstore. These prices apply only to cash customers and are not valid for those with insurance plans.

Tramadol

Tramadol comes in 100 mg, 150 mg, 200 mg, and 300 mg strengths. Tramadol Hcl is typically sold at about $31.30 every 30, 50MG Tablet. This pricing of Tramadol is solely applicable to cash clients and does not apply to individuals with insurance coverage.

Common side effects of Tapentadol and Tramadol

Tapentadol is a highly tolerant pain medication making it a safer option. However, improper administration and abuse can result in developing adverse signs in users. Some side effects one may experience from these opioid analgesics are-

Common Side effects of Tapentadol-

1.      Headache
2.      Heartburn
3.      Drowsiness
4.      Irritability
5.      Difficulty sleeping
6.      Excessive tiredness
7.      Dry mouth
8.      Abdominal pain
9.      Anxiety

 Common Side effects of Tramadol-

1.      Headache
2.      Heartburn
3.      Nervousness
4.      Sleepiness
5.      Dry mouth
6.      Muscle tightness
7.      Uncontrollable shaking of body part
 
Some side effects can be severe or life-threatening. If you experience any of the below-mentioned symptoms, contact a healthcare doctor immediately or get emergency medical help:

In case of Tapentadol, serious side effects which can be observed are-

1.      Seizures
2.      Difficulty breathing
3.      Irregular menstruation
4.      Agitation, hallucination
5.      Chest pain
6.      Loss of consciousness
7.      Excess sweating
8.      Nausea, vomiting, loss of appetite, weakness, dizziness
9.      Hoarseness
10.  Reduces sexual desire

Some severe side effects which can be observed after administration of Tramadol are-

1.      Seizures
2.      Difficulty breathing or swallowing
3.      Swelling of eyes, throat, hand, feet, lips, lower leg
4.      Agitation, hallucination
5.      Change in heartbeat
6.      Loss of consciousness
7.      Excess sweating
8.      Nausea, vomiting, loss of appetite, weakness, dizziness
9.      Hoarseness
10.  Blisters, hives, rash

Interactions of Tapentadol and Tramadol

The interaction of drugs may change how a drug would work or increase the risk of severe side effects. It is recommended to talk to the concerned doctor before the start, stop or alter any medication.

A list of drugs that interact with Tapentadol includes-

1.      Alcohol
2.      Benzodiazepines and other CNS depressants
3.      Serotonergic drugs (SSRIs, SNRIs, TCAs)
4.      Monoamine Oxidase Inhibitors (MAOIs) (such as phenelzine, tranylcypromine, linezolid)
5.      Mixed Agonist/Antagonist (butorphanol, nalbuphine, pentazocine, buprenorphine)
6.      Muscle relaxants (such as cyclobenzaprine, metaxalone)
7.      Certain Anticholinergic Drugs

A list of drugs that interact with tramadol includes-

1.      Celebrex (celecoxib)
2.      Flexeril (cyclobenzaprine)
3.      Cymbalta (duloxetine)
4.      Lexapro (escitalopram)
5.      Tylenol (acetaminophen)
6.      Lyrica (pregabalin)
7.      Xanax (alprazolam)

When Not To Take Tapentadol or Tramadol?

The following conditions are contraindicated with these drugs:

A.     Tapentadol

  •   Alcohol intoxication
  •   Low blood pressure
  •   Reduced function of the adrenal gland
  •   Decreased lung function
  •   Seizures
  •   Coma
  •   Sleep apnea
  •   Liver problems
  •   Severe renal impairment
  •   Weakness and wasting of the body
  •   Asthma attack
  •   Drug abuse
  •   Reduced level of thyroid hormones


B.      Tramadol

  •   Low blood sugar  
  • Alcohol intoxication
  •   Suicidal behavior, depression
  •   Reduced function of the adrenal gland
  •   Asthma
  •   Decreased lung function
  •   Drug abuse
  •   Serotonin syndrome
  •   Breastfeeding
  •   Benzodiazepine overdose
  •   Blockage of the stomach or intestine
  •   Opioid overdose

Look for clinical counsel from your doctor if you have any of the above-mentioned conditions.

User Review

Evaluating the opioid pain medication from trusted medical and health sites indicates its effectiveness and user experience. Several reviews on the prestigious website Drugs show the use of Tramadol and Tapentadol in treating pain.

The reviews of Tramadol and Tapentadol offer a close insight into these opioid drugs. It also allows people to decide on a suitable analgesic for treating their body pain.

Tramadol Review

Tramadol has an average rating of 5.9 out of 10 from a total of 625 ratings for the treatment of Pain. 48% of reviewers reported a positive experience, while 34% reported a negative experience.

Tapentadol Review

Tapentadol has an average rating of 6.2 out of 10 from a total of 374 ratings for the treatment of Pain. 51% of reviewers reported a positive experience, while 29% reported a negative experience.

Conclusion

From the above comparative study of Tapentadol and Tramadol, both opioid analgesics portray similar potency in treating body pain. However, we can conclude from all evidence that Tapentadol is a more tolerant drug than Tramadol, making it a safer choice of opioid medication. 

It is best to consult a physician before buying Tapentadol or Tramadol for body pain to avoid any side effects or abuse of the drug.

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