I am glad to hear you are getting relief from the Nucynta (tapentadol). I've been on it since 2010 (occasionally switched out with Vicodin for 1 month) and its worked better than hydrocodone and tramadol and with similiar efficiency to roughly 10mgs of oxycodone with a longer duration (at the 75mg level) and less side effects. Also, it builds tolerance MUCH slower than Oxycodone. RADAR actually put out a report in Feb 2012 that used an 18 month study and found misuse and abuse of tapentadol has actually decreased since it came out. I personally feel this is partially due to its slow building tolerance and the fact that it doesn't cause as much sedation. It causes LESS mental fogginess than oxycodone too. Of the C-IIs, it seems (in my opinion) to have the least abuse potential and least opioid related side effects.
As for Nucynta concerning seratonin syndrome seems to be less of a risk than with tramadol. Tramadol has stronger SSRI properties than Nucynta. However, Nucynta does have mild seratonin effects but unlike tramadol, the increase in Seratonin isn't considered clinically significant to its pain relief properties. Nucynta CAN still cause Seratonin syndrome. This is partially because Nucynta has moderately potent Norephedrine Reuptake Inhibitation (NRI) properties. The NRI properties have an indirect effect on Seratonin levels. However, as I understand, the risk is still less than tramadol as well as anti depressants.
The fairly potent NRI properties of Nuncynta is also key to its comparable pain relief to moderate doses of other C-IIs, as its Mu opioid receptor binding affinity is 18x weaker than morphine, yet its about
1/3rd the stregnth of oral morphine in terms of pain relief. It is important to note that Nucynta IS more potent than tramadol in its Mu opioid receptor agonism and while similiar to tramadol has some differences. Older studies showed that 200mgs of Nucynta was superior in pain relief to 60mgs of oral morphine.
Sorry that this is practically a repeat discussion on my part as I've posted to answer Nucynta questions a few times now. It's still a relatively new medication so I'm happy to provide my personal insight on both the benefits and risks of the medication.
Be sure you drink plenty of water with it as it WILL dehydrate you. Also, at doses of 75 mgs, it had mild but noticable and tolerable mental effects. It seems to have a mild anti like depressant effect on mood. However, because the medication is mildly stimulating, you might find you need to take your last dose of the day about
2 hours before bedtime instead of right at bedtime. Also, if your doctor allows for a breakthrough dosing for flare ups (mine allows me to use 150 instead of 75 for flare-ups), the side effects increase substantially. For this reason, I'll try to get by with just an extra half one if I have a flare-up, which does cause some increase in side effects, but its tolerable. At 150mgs, it will literally drop my pain from an 8 to 0 but while shorted lives (about
90 minutes to 2 hours) the breakthrough dose causes a feeling of losing touch with reality as far as body effects go, as well as anxiety and naseua. Mentally (only at the 150 dose) it causes mild auditory hallucinations and closed eye visuals and "corner of eye" peripheral effects. These can be unpleasant but if they do happen, they usually improve within 2 hours.
Also, it seems that the effectiveness of the medication increases a little with repeated dosings (by this I mean if you take a second one 6 hours after the first dose, it seems to have better pain killing effects than if you didn't take it till the next day.
All in all its a great medication, ESPECIALLY for nueropathic pain! Again, at the 50-100mg dosings, low level of side effects compared to most narcotics. With less stomach related effects, its also easier to take asprin. Its effects on cognition are noticable but less than oxycodone or morphine so it has little impact on my "living life" and being outgoing. Please only take my advice with a grain of salt as I'm not a medical professional, just someone who has kept himself well informed concerning the medication since its a daily regiment.
I hope this helps and best of wishes. Remember to stay well hydrated :)
MRI revealed disc bulge and test injections revealed RA. Radio Freq procedures helped for months, but pain is up and im having the procedure done again. Currently on 75 mgs of Nucynta (tapentadol - A MOR + NRI) 2 to 3 time per day and Soma 350 as needed.
Post Edited (grainofsalt) : 3/27/2012 3:41:14 AM (GMT-6)