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Nucynta doses: Nucynta Dosage Guide – Drugs.com

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Nucynta Dosage Guide – Drugs.com

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Generic name: TAPENTADOL HYDROCHLORIDE 50mg
Dosage form: tablet, film coated
Drug class: Opioids (narcotic analgesics)

Medically reviewed by Drugs.com. Last updated on Mar 6, 2023.

Important Dosage and Administration Instructions

Use the lowest effective dosage for the shortest duration consistent with individual patient treatment goals [see Warnings and Precautions (5)].

Initiate the dosing regimen for each patient individually, taking into account the patient’s severity of pain, patient response, prior analgesic treatment experience, and risk factors for addiction, abuse, and misuse [see Warnings and Precautions (5.1)].

Monitor patients closely for respiratory depression, especially within the first 24-72 hours of initiating therapy and following dosage increases with NUCYNTA and adjust the dosage accordingly [see Warnings and Precautions (5.3)]

Patient Access to Naloxone for the Emergency Treatment of Opioid Overdose

​Discuss the availability of naloxone for the emergency treatment of opioid overdose with the patient and caregiver and assess the potential need for access to naloxone, both when initiating and renewing treatment with NUCYNTA tablets [see Warnings and Precautions (5. 3), Patient Counseling Information (17)].

Inform patients and caregivers about the various ways to obtain naloxone as permitted by individual state naloxone dispensing and prescribing requirements or guidelines (e.g., by prescription, directly from a pharmacist, or as part of a community-based program).

Consider prescribing naloxone, based on the patient’s risk factors for overdose, such as concomitant use of CNS depressants, a history of opioid use disorder, or prior opioid overdose. The presence of risk factors for overdose should not prevent the proper management of pain in any given patient [see Warnings and Precautions (5.1, 5.3, 5.5)].

Consider prescribing naloxone if the patient has household members (including children) or other close contacts at risk for accidental ingestion or overdose.

Initial Dosage

Initiating Treatment with NUCYNTA Tablets

Initiate treatment with NUCYNTA tablets in a dosing range of 50 mg to 100 mg every 4 to 6 hours as needed for pain.

On the first day of dosing, the second dose may be administered as soon as one hour after the first dose, if adequate pain relief is not attained with the first dose. Subsequent dosing is 50 mg, 75 mg, or 100 mg every 4 to 6 hours and should be adjusted to maintain adequate analgesia with acceptable tolerability.

Daily doses greater than 700 mg on the first day of therapy and 600 mg on subsequent days have not been studied and are not recommended.

NUCYNTA tablets may be given with or without food [see Clinical Pharmacology (12.3)].

Conversion from NUCYNTA Tablets to NUCYNTA ER

Patients can be converted from NUCYNTA tablets to NUCYNTA ER using the equivalent total daily dose of NUCYNTA tablets and dividing it into two equal doses of NUCYNTA ER separated by approximately 12-hour intervals. As an example, a patient receiving 50 mg of NUCYNTA tablets four times per day (200 mg/day) may be converted to 100 mg NUCYNTA ER twice a day.

Dosage Modifications in Patients with Hepatic Impairment

The safety and efficacy of NUCYNTA tablets has not been studied in patients with severe hepatic impairment (Child-Pugh Score 10-15) and use in this population is not recommended [see Warnings and Precautions (5. 16)].

Initiate treatment of patients with moderate hepatic impairment (Child-Pugh Score 7 to 9) with 50 mg no more frequently than once every 8 hours (maximum of three doses in 24 hours). Further treatment should reflect maintenance of analgesia with acceptable tolerability, to be achieved by either shortening or lengthening the dosing interval. Monitor closely for respiratory and central nervous system depression [see Clinical Pharmacology (12.3)].

No dosage adjustment is recommended in patients with mild hepatic impairment (Child-Pugh Score 5 to 6) [see Clinical Pharmacology (12.3)].

Titration and Maintenance of Therapy

Continually reevaluate patients receiving NUCYNTA tablets to assess the maintenance of pain control and the relative incidence of adverse reactions, as well as monitoring for the development of addiction, abuse, or misuse [see Warnings and Precautions (5.1)]. Frequent communication is important among the prescriber, other members of the healthcare team, the patient, and the caregiver/family during periods of changing analgesic requirements, including initial titration.

If the level of pain increases after dosage stabilization, attempt to identify the source of increased pain before increasing the NUCYNTA tablets dosage. If unacceptable opioid-related adverse reactions are observed, consider reducing the dosage. Adjust the dosage to obtain an appropriate balance between management of pain and opioid-related adverse reactions.

Safe Reduction or Discontinuation of NUCYNTA Tablets

Do not abruptly discontinue NUCYNTA Tablets in patients who may be physically dependent on opioids. Rapid discontinuation of opioid analgesics in patients who are physically dependent on opioids has resulted in serious withdrawal symptoms, uncontrolled pain, and suicide. Rapid discontinuation has also been associated with attempts to find other sources of opioid analgesics, which may be confused with drug-seeking for abuse. Patients may also attempt to treat their pain or withdrawal symptoms with illicit opioids, such as heroin, and other substances.

When a decision has been made to decrease the dose or discontinue therapy in an opioid-dependent patient taking NUCYNTA Tablets, there are a variety of factors that should be considered, including the dose of NUCYNTA Tablets the patient has been taking, the duration of treatment, the type of pain being treated, and the physical and psychological attributes of the patient. It is important to ensure ongoing care of the patient and to agree on an appropriate tapering schedule and follow-up plan so that patient and provider goals and expectations are clear and realistic. When opioid analgesics are being discontinued due to a suspected substance use disorder, evaluate and treat the patient, or refer for evaluation and treatment of the substance use disorder. Treatment should include evidence-based approaches, such as medication assisted treatment of opioid use disorder. Complex patients with co-morbid pain and substance use disorders may benefit from referral to a specialist.

There are no standard opioid tapering schedules that are suitable for all patients. Good clinical practice dictates a patient-specific plan to taper the dose of the opioid gradually. For patients on NUCYNTA Tablets who are physically opioid-dependent, initiate the taper by a small enough increment (e.g., no greater than 10% to 25% of the total daily dose) to avoid withdrawal symptoms, and proceed with dose-lowering at an interval of every 2 to 4 weeks. Patients who have been taking opioids for briefer periods of time may tolerate a more rapid taper.

It may be necessary to provide the patient with lower dosage strengths to accomplish a successful taper. Reassess the patient frequently to manage pain and withdrawal symptoms, should they emerge. Common withdrawal symptoms include restlessness, lacrimation, rhinorrhea, yawning, perspiration, chills, myalgia, and mydriasis. Other signs and symptoms also may develop, including irritability, anxiety, backache, joint pain, weakness, abdominal cramps, insomnia, nausea, anorexia, vomiting, diarrhea, or increased blood pressure, respiratory rate, or heart rate. If withdrawal symptoms arise, it may be necessary to pause the taper for a period of time or raise the dose of the opioid analgesic to the previous dose, and then proceed with a slower taper. In addition, monitor patients for any changes in mood, emergence of suicidal thoughts, or use of other substances.

When managing patients taking opioid analgesics, particularly those who have been treated for a long duration and/or with high doses for chronic pain, ensure that a multimodal approach to pain management, including mental health support (if needed), is in place prior to initiating an opioid analgesic taper. A multimodal approach to pain management may optimize the treatment of chronic pain, as well as assist with the successful tapering of the opioid analgesic [see Warnings and Precautions (5.13), Drug Abuse and Dependence (9.3)].

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Nucynta ER Dosage Guide – Drugs.com

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Generic name: TAPENTADOL HYDROCHLORIDE 50mg
Dosage form: tablet, film coated, extended release
Drug class: Opioids (narcotic analgesics)

Medically reviewed by Drugs.com. Last updated on Mar 2, 2023.

Important Dosage and Administration Instructions

NUCYNTA ER should be prescribed only by healthcare professionals who are knowledgeable in the use of potent opioids for the management of chronic pain.

  • Use the lowest effective dosage for the shortest duration consistent with individual patient treatment goals [see Warnings and Precautions (5)].
  • Initiate the dosing regimen for each patient individually, taking into account the patient’s severity of pain, patient response, prior analgesic treatment experience, and risk factors for addiction, abuse, and misuse [see Warnings and Precautions (5.1)]
  • Monitor patients closely for respiratory depression, especially within the first 24-72 hours of initiating therapy and following dosage increases with NUCYNTA ER and adjust the dosage accordingly [see Warnings and Precautions (5. 3)].

Instruct patients to swallow NUCYNTA ER tablets whole, one tablet at a time, with enough water to ensure complete swallowing immediately after placing in the mouth [see Patient Counseling Information (17)]. Crushing, chewing, or dissolving NUCYNTA ER tablets will result in uncontrolled delivery of tapentadol and can lead to overdose or death [see Warnings and Precautions (5.1)].

Discontinue all other tapentadol and tramadol products when beginning and while taking NUCYNTA ER [see Warnings and Precautions (5.7)]. Although the maximum approved total daily dose of NUCYNTA immediate-release formulation is 600 mg per day, the maximum total daily dose of NUCYNTA ER is 500 mg. Do not exceed a total daily dose of NUCYNTA ER of 500 mg.

Patient Access to Naloxone for the Emergency Treatment of Opioid Overdose

​Discuss the availability of naloxone for the emergency treatment of opioid overdose with the patient and caregiver and assess the potential need for access to naloxone, both when initiating and renewing treatment with NUCYNTA ER [see Warnings and Precautions (5. 3), Patient Counseling Information (17)].

Inform patients and caregivers about the various ways to obtain naloxone as permitted by individual state naloxone dispensing and prescribing requirements or guidelines (e.g., by prescription, directly from a pharmacist, or as part of a community-based program).

Consider prescribing naloxone, based on the patient’s risk factors for overdose, such as concomitant use of CNS depressants, a history of opioid use disorder, or prior opioid overdose. The presence of risk factors for overdose should not prevent the proper management of pain in any given patient [see Warnings and Precautions (5.1, 5.3, 5.5)].

Consider prescribing naloxone if the patient has household members (including children) or other close contacts at risk for accidental ingestion or overdose.

Initial Dosage

Use of NUCYNTA ER as the First Opioid Analgesic (opioid-naïve patients)

Initiate treatment with NUCYNTA ER with the 50 mg tablet orally twice daily (approximately every 12 hours).

Use of NUCYNTA ER in Patients who are not Opioid Tolerant

The starting dose for patients who are not opioid tolerant is NUCYNTA ER 50 mg orally twice daily (approximately every 12 hours). Use of higher starting doses in patients who are not opioid tolerant may cause fatal respiratory depression.

Conversion from NUCYNTA to NUCYNTA ER

Patients can be converted from NUCYNTA to NUCYNTA ER using the equivalent total daily dose of NUCYNTA and dividing it into two equal doses of NUCYNTA ER separated by approximately 12-hour intervals. As an example, a patient receiving 50 mg of NUCYNTA four times per day (200 mg/day) may be converted to 100 mg NUCYNTA ER twice a day.

Conversion from Other Opioids to NUCYNTA ER

There are no established conversion ratios for conversion from other opioids to NUCYNTA ER defined by clinical trials. Initiate dosing using NUCYNTA ER 50 mg orally every 12 hours.

It is safer to underestimate a patient’s 24-hour oral tapentadol dosage and provide rescue medication (e. g., immediate-release opioid) than to overestimate the 24-hour oral tapentadol requirements which could result in an adverse reaction due to an overdose. While useful tables of opioid equivalents are readily available, there is inter-patient variability in the potency of opioid drugs and opioid formulations.

Close observation and frequent titration are warranted until pain management is stable on the new opioid. Monitor patients for signs and symptoms of opioid withdrawal and for signs of oversedation/toxicity after converting patients to NUCYNTA ER.

Conversion from Methadone to NUCYNTA ER

Close monitoring is of particular importance when converting from methadone to other opioid agonists. The ratio between methadone and other opioid agonists may vary widely as a function of previous dose exposure. Methadone has a long half-life and can accumulate in the plasma.

Titration and Maintenance of Therapy

Individually titrate NUCYNTA ER to a dose that provides adequate analgesia and minimizes adverse reactions. Continually reevaluate patients receiving NUCYNTA ER to assess the maintenance of pain control and the relative incidence of adverse reactions, as well as monitoring for the development of addiction, abuse, or misuse [see Warnings and Precautions (5.1)]. Frequent communication is important among the prescriber, other members of the healthcare team, the patient, and the caregiver/family during periods of changing analgesic requirements, including initial titration. During chronic therapy, periodically reassess the continued need for opioid analgesics.

Patients who experience breakthrough pain may require a dosage adjustment of NUCYNTA ER, or may need rescue medication with an appropriate dose of an immediate-release analgesic. If the level of pain increases after dose stabilization, attempt to identify the source of increased pain before increasing the NUCYNTA ER dosage. Titrate patients to adequate analgesia with dose increases of 50 mg no more than twice daily every three days. In clinical studies, efficacy with NUCYNTA ER was demonstrated relative to placebo in the dosage range of 100 mg to 250 mg twice daily [see Clinical Studies (14)].

If unacceptable opioid-related adverse reactions are observed, consider reducing the dosage. Adjust the dosage to obtain an appropriate balance between management of pain and opioid-related adverse reactions.

Dosage Modification in Patients with Hepatic Impairment

The use of NUCYNTA ER in patients with severe hepatic impairment (Child-Pugh Score 10-15) is not recommended [see Warnings and Precautions (5.15)].

In patients with moderate hepatic impairment (Child-Pugh Score 7 to 9), initiate treatment using 50 mg NUCYNTA ER, administer no more frequently than once every 24 hours, and monitor closely for respiratory and central nervous system depression, particularly during initiation and titration of NUCYNTA ER. The maximum recommended dose for patients with moderate hepatic impairment is 100 mg of NUCYNTA ER per day. Monitor closely for respiratory and central nervous system depression [see Clinical Pharmacology (12.2)].

No dosage adjustment is recommended in patients with mild hepatic impairment (Child-Pugh Score 5 to 6) [see Warnings and Precautions (5. 15), Use in Specific Populations (8.6), Clinical Pharmacology (12.3)].

Safe Reduction or Discontinuation of NUCYNTA ER

Do not abruptly discontinue NUCYNTA ER in patients who may be physically dependent on opioids. Rapid discontinuation of opioid analgesics in patients who are physically dependent on opioids has resulted in serious withdrawal symptoms, uncontrolled pain, and suicide. Rapid discontinuation has also been associated with attempts to find other sources of opioid analgesics, which may be confused with drug-seeking for abuse. Patients may also attempt to treat their pain or withdrawal symptoms with illicit opioids, such as heroin, and other substances.

When a decision has been made to decrease the dose or discontinue therapy in an opioid-dependent patient taking NUCYNTA ER, there are a variety of factors that should be considered, including the dose of NUCYNTA ER the patient has been taking, the duration of treatment, the type of pain being treated, and the physical and psychological attributes of the patient. It is important to ensure ongoing care of the patient and to agree on an appropriate tapering schedule and follow-up plan so that patient and provider goals and expectations are clear and realistic. When opioid analgesics are being discontinued due to a suspected substance use disorder, evaluate and treat the patient, or refer for evaluation and treatment of the substance use disorder. Treatment should include evidence-based approaches, such as medication assisted treatment of opioid use disorder. Complex patients with comorbid pain and substance use disorders may benefit from referral to a specialist.

There are no standard opioid tapering schedules that are suitable for all patients. Good clinical practice dictates a patient-specific plan to taper the dose of the opioid gradually. For patients on NUCYNTA ER who are physically opioid-dependent, initiate the taper by a small enough increment (e.g., no greater than 10% to 25% of the total daily dose) to avoid withdrawal symptoms, and proceed with dose-lowering at an interval of every 2 to 4 weeks. Patients who have been taking opioids for briefer periods of time may tolerate a more rapid taper.

It may be necessary to provide the patient with lower dosage strengths to accomplish a successful taper. Reassess the patient frequently to manage pain and withdrawal symptoms, should they emerge. Common withdrawal symptoms include restlessness, lacrimation, rhinorrhea, yawning, perspiration, chills, myalgia, and mydriasis. Other signs and symptoms also may develop, including irritability, anxiety, backache, joint pain, weakness, abdominal cramps, insomnia, nausea, anorexia, vomiting, diarrhea, or increased blood pressure, respiratory rate, or heart rate. If withdrawal symptoms arise, it may be necessary to pause the taper for a period of time or raise the dose of the opioid analgesic to the previous dose, and then proceed with a slower taper. In addition, monitor patients for any changes in mood, emergence of suicidal thoughts, or use of other substances.

When managing patients taking opioid analgesics, particularly those who have been treated for a long duration and/or with high doses for chronic pain, ensure that a multimodal approach to pain management, including mental health support (if needed), is in place prior to initiating an opioid analgesic taper. A multimodal approach to pain management may optimize the treatment of chronic pain, as well as assist with the successful tapering of the opioid analgesic [see Warnings and Precautions (5.13), Drug Abuse and Dependence (9.3)].

Frequently asked questions

  • What does XR or ER mean after a drug name?

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Nucynta Solution / Nucynta Solution in English – Product

Nucynta Solution / Nucynta Solution in English – Product – Medicine.net

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  • Interactions
  • Contraindications

Overview

Nucynta Solution is used for moderate to severe acute pain, severe neuropathic pain and other conditions.

Nucynta Solution contains the following active ingredients: Tapentadol Hydrochloride. Available in solution form.

Detailed information regarding the use, composition, dosage, side effects of Nucynta Solution / Nucynta Solution, as well as user reviews are provided below:

Uses

Nucynta Solution / Nucynta Solution is used for the treatment, control, prevention, & improvement of the following diseases, conditions and symptoms:

  • Moderate to severe acute pain
  • Severe neuropathic pain

Learn more: Uses

Side Effects

The following is a list of possible side effects that may be caused by the constituents of Nucynta Solution. This list is not final. These side effects have been recorded previously, but are not always recorded when using the drug. Some of these side effects may be extremely rare, but have incredibly severe consequences. If you notice any side effects, contact your doctor immediately. Especially in the case of observing side effects for a long time.

  • Nausea
  • Vomiting
  • Loss of appetite
  • Headache
  • Heartburn
  • Diarrhea
  • Abdominal pain
  • Dry mouth
  • Dizziness
  • Excessive fatigue
  • Anxiety
  • Drowsiness

with side effects not listed above, contact your healthcare provider for advice. In addition, you can report side effects to your local Food and Drug Administration.

Precautions

Before starting this drug, tell your doctor about any medications you are taking, dietary supplements (such as vitamins, natural supplements, etc.), allergies, existing medical conditions, and current health conditions (such as pregnancy, upcoming surgery, and etc. ). The side effects of the drug may be more pronounced depending on the state of your body. Take this medicine as directed by your doctor, or follow the directions for use that come with your medicine. The dosage of the drug depends on your condition. Tell your doctor if there is no change or if your condition worsens. Important points to discuss with your healthcare provider are listed below.

  • Liver disease
  • Kidney disease
  • Breastfeeding
  • Blockage in the stomach or intestines
  • Difficulty urinating
  • Having surgery
  • gallbladder disease
  • pancreatic disease
  • thyroid disease

If if you use other drugs or over the counter products at the same time, the effects of Nucinta Solution may change. Tell your healthcare provider about all medications, vitamins, and supplements you use. Your doctor will be able to make the right plan for taking the drug, which will avoid negative interactions. Nucinta Solution / Nucynta Solution may interact with the following drugs and products:

  • Almotriptan
  • Buprenorphine
  • Butorphanol
  • Citalopram \ Escitalopram
  • Doxepin
  • Eletriptan
  • Fluoxetine
  • Fluvoxamine
  • Frovatriptan
  • Imipramine

Composition and active ingredients ingredients (salts)

  • Tapentadol Hydrochloride

Please note that this preparation is available in different strengths for each of the active ingredients listed above.

Packing options and strengths

Nucynta Solution is available in the following pack strengths

Nucynta Solution / Nucynta Solution packs are available: EQ 20MG BASE/ML

FAQ

  • Is it safe to drive or operate heavy machinery while using this product?

    If you experience drowsiness, dizziness, hypotension or a headache as side-effects when using Nucynta Solution medicine then it may not be safe to drive a vehicle or operate heavy machinery. You should stop driving if taking this medicine makes you drowsy, dizzy, or hypotensive. Doctors recommend that you stop drinking alcohol with such drugs, because. alcohol greatly increases the side effects and drowsiness. Please check for these effects on your body when using Nucynta Solution. Be sure to consult your doctor for advice based on the characteristics of your body and general health.

  • Is this drug (product) addictive or addictive?

    Most drugs are not habit-forming or addictive. In most cases, the state classifies drugs that can be addictive as controlled dispensing drugs. For example, schedule H or X in India and schedule II-V in the USA. Please check the information on the drug packaging to make sure that this drug is not in the controlled category. Also, do not self-medicate or accustom your body to medications without consulting your doctor.

  • Can I stop using this product immediately or do I need to slowly stop using it?

    Some medications need to be stopped gradually due to a rebound effect. Be sure to consult your healthcare provider for advice based on your body, general health, and other medications you may be taking.

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Last update date

This page was updated on 9/27/2020.

This page provides information for Nucynta Solution Product in English .

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Nucynta vs. Oxycodone: Differences, Similarities & What’s Best for You – Drug Vs. Friend

Home >> Drug Vs. Friend >> Nucynta vs Oxycodone: Differences, Similarities & Which is Best for You

Drug Vs. Friend

Drug Overview and Key Differences | Conditions of treatment | Efficiency | Insurance coverage and cost comparison | Side effects | Drug Interactions | Warnings | FAQ

Nucynta and oxycodone are FDA approved. opioid prescription medications indicated for the treatment of severe, acute pain. They are typically used for pain that cannot be controlled with non-opioid medications or when the patient is intolerant of other alternatives. Both painkillers are classified as narcotic (Appendix II), which means they have a high potential for abuse or dependence.

How Nucynta works is not fully understood. Some studies have shown that Nucynta is a mu-receptor (nociceptor) agonist and norepinephrine reuptake inhibitor, resulting in pain relief. Oxycodone works by binding to mu receptors in the brain, which dampens or blocks pain signals, resulting in pain relief.

Since both drugs are very strong, they are usually used in situations where pain relief is required when lighter (non-narcotic) pain medications would not be effective or would not be tolerated. Although both drugs are used for severe pain, they have many differences, which we will discuss below.

What is the main difference between ‌Nucynta and oxycodone?

Nucinta (tapentadol) is an opioid or narcotic pain reliever (painkiller). It is available branded as both immediate-release and extended-release tablets. The extended release tablet is called Nucynta ER. The starting dose is 50 to 100 mg every four to six hours as needed for pain. The dose may be changed by your doctor and the maximum dose is 600 mg per day.

Oxycodone is also a general opioid analgesic (and immediate release oxycodone IR) and is available in branded form as OxyContin, an extended release tablet. Dosage varies, but a typical dose for immediate release oxycodone tablets is 5 to 15 mg every four to six hours depending on the pain.

Main differences between ‌Nucynta and oxycodone
Nucynta Oxycodone
Drug class Opioid (narcotic) analgesic Opioid (narcotic) analgesic
Brand/generic status Brand Brand and generic
What is a generic/trademark? Generic: Tapentadol Brand: OxyIR (immediate release), Oxycontin (long acting)
What form(s) does the drug come in? Immediate-release tablet
Extended-release tablet
Immediate-release tablet
Immediate-release capsule
Extended-release tablet
Oral solution
What is the standard dosage? Initial:
50 to 100 mg every 4 to 6 hours as needed. If necessary, the dose can be adjusted by the doctor. Maximum 700 mg per day on the first day of treatment, then the maximum dose is 600 mg per day after the first day.
Immediate release tablet:
5-15 mg every 4-6 hours as needed
Extended-release tablet:
20 mg every 12 hours
How long does a typical treatment last? Short-term, may be used longer depending on condition treated (eg chronic pain) and response Short-term, may be used longer depending on condition treated (eg chronic pain) and response
Who usually takes this medicine? Adults Adults

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Conditions treated by ‌Nucynta and oxycodone

Both Nucynta and oxycodone have the same indication for treatment, which is to treat acute adult pain that is severe enough to require an opioid analgesic, and when alternative therapies are inadequate or intolerable.

902 83 Treatment of acute pain in adults that is severe enough to require an opioid analgesic and when alternative treatments are inadequate
Condition Nucynta Oxycodone
yes yes

‌Nucynta or oxycodone more effective?

In a study comparing immediate release Nucynta with immediate release oxycodone in patients with moderate to severe acute back pain, both drugs were equally safe and effective in treating back pain as well as associated leg pain. Nucynta patients had fewer stomach-related side effects.

In a study comparing the potential for abuse in patients taking Nucynta or oxycodone, Nucynta was found to have less potential for abuse.

The most effective medicine for you should only be determined by your doctor, who will review your condition(s), medical history and other medicines you are taking.

Coverage and cost comparison of ‌Nucynta and oxycodone

State law states that if you are taking an opioid pain reliever for the first time, it is likely that you will receive a small amount.

Insurance coverage varies by Nucynta. Because it is more expensive and only available under brand names, your copay may be higher or the drug may need prior authorization from your insurance company. Nucynta is generally not covered by Medicare Part D. Nucynta 50mg, 30 tablets usually cost around $250, but you can get it for as little as $211 with the SingleCare discount.

Oxycodone is usually covered by insurance and Part D. Medicare. The cash price of 30.5mg tablets can be around $100, but you can use a single coupon at participating pharmacies and get it from $36.

Nucynta Oxycodone
Usually covered by insurance? Varies yes
Usually covered by Medicare Part D? No yes
Standard dosage0283 5 mg #30 tablets
Typical Medicare Part D copay $95-482 $2-56
SingleCare Cost $211+ 36-62 US$

Common side effects of ‌Nucynta versus oxycodone

The most common side effects of Nucynta are nausea, vomiting, drowsiness, dizziness, constipation, dry mouth and itching. Severe respiratory depression (slowed breathing, lack of oxygen) may occur, which can be life-threatening or fatal.

Exact percentages of oxycodone not reported, except that side effects were observed in more than or equal to 3% of patients. The most common side effects are nausea, constipation, vomiting, headache, itching (itching), insomnia, dizziness, weakness, and drowsiness. Serious adverse reactions may include respiratory depression, respiratory arrest (breathing arrest), cardiac arrest (sudden loss of heart, breathing, and consciousness function), low blood pressure, and/or shock.

Because of the serious risks, it is very important that if you are taking Nucynta or oxycodone, you take the drug exactly as prescribed and do not take extra doses. You should also monitor respiratory depression, especially when you start taking one of these drugs or during a dose change.

Other side effects may occur. Check with your healthcare provider for a complete list of side effects.

9027 9

90 283 yes

Nucynta Oxycodone
Side effect 90 055 Applicable? Frequency Applicable? Frequency
6
Vomiting yes 18% 9 ≥3%
Constipation yes 8% yes ≥3%
Dry mouth yes 4% yes% not reported
Drowsiness yes fifteen% yes ≥3%
Dizziness 24% yes ≥3%
Itching yes 5% yes ≥3%

Source: DailyMed (Nucynta), DailyMed (oxycodone )

‌Nucynta drug interaction with oxycodone

Use of benzodiazepines or other CNS depressants, including other opioid drugs when combined with Nucynta or oxycodone may result in low blood pressure, respiratory depression, severe sedation, coma and/or death. Combinations should be avoided. However, if no other option is available, the lowest dose of each drug should be used for the shortest period of time, and the patient should be closely monitored, especially at the start of treatment and any dose changes.

Taking Nucynta or oxycodone with drugs that increase serotonin levels may also increase the risk of serotonin syndrome, a life-threatening condition caused by the accumulation of too much serotonin. These drugs include antidepressants such as serotonin reuptake inhibitors, muscle relaxants, MAO inhibitors (MAO inhibitors should not be used within 14 days of taking Nucynta or oxycodone), and triptans for migraine.

Taking oxycodone with certain drugs that are metabolized by CYP3A4 or CYP2D6 may lead to drug interactions. These drugs are known as enzyme inhibitors and include macrolide antibiotics, azole antifungals, and protease inhibitors. Using them along with oxycodone can lead to high levels of the opioid, which can be very dangerous. These drugs interact with oxycodone but not with Nucynta.

Other drugs, known as enzyme inducers, work in the opposite way to inhibitors, lowering opioid levels so that they are not as effective or may even cause withdrawal symptoms. Inducers may affect Nucynta or oxycodone.

Consult your healthcare professional for a complete list of drug interactions.

9028 3 Amitriptyline
Citalopram
Desipramine
Desvenlafaxine
Duloxetine
Escitalopram
Fluoxetine

9 0279

9 0276

9028 3 No

903 71

‌Nucynta and Oxycodone Warnings

Both Nucynta and oxycodone have a boxed warning, which is the most stringent warning required by the FDA.

  • Opioids are associated with a risk of dependence, abuse and misuse. This can lead to overdose and death. Patients should be assessed for risk and closely monitored before taking opioids.
  • Opioids can cause serious, life-threatening or fatal respiratory depression. Patients should be closely monitored, especially at the start of treatment and after dose changes.
  • Accidental ingestion, especially by children, may result in fatal overdose. Patients should keep opioids out of the reach of children and, if possible, locked up.
  • Long-term use of opioids during pregnancy can cause neonatal opioid withdrawal, which can be life-threatening if not recognized and treated.
  • Use of benzodiazepines such as Xanax or other CNS depressants such as other opioids (or alcohol) may result in severe sedation, respiratory depression, coma and death. Whenever possible, the combination of opioids and benzodiazepines should be avoided. Patients who must take this combination because other alternatives do not work should be given the lowest effective dose for the shortest possible time and under close supervision.

Other warnings:

  • Patients with significant respiratory depression, acute/severe uncontrolled asthma, gastrointestinal obstruction, or hypersensitivity to any of the ingredients should not use Nucynta or oxycodone.
  • Nucynta or oxycodone should not be used in patients with chronic lung disease, elderly or debilitated patients.
  • Serotonin syndrome may occur, especially when taking drugs that increase serotonin levels, such as antidepressants. Patients should be monitored for changes in mental status (agitation, hallucinations), changes in blood pressure, incoordination, and/or stomach symptoms such as nausea, vomiting, or diarrhea. The patient should immediately seek medical attention if any of these symptoms appear because serotonin syndrome is very dangerous and can be fatal.
  • Adrenal insufficiency can usually occur after a month. Patients should seek treatment if they experience nausea, vomiting, loss of appetite, fatigue, weakness, dizziness, and/or low blood pressure.
  • Nucynta or oxycodone may cause low blood pressure.
  • Nucynta or oxycodone should not be used in patients who are unconscious or comatose.
  • Nucynta or oxycodone may increase the risk of seizures in patients with seizure disorders.
  • Nucynta or oxycodone should not be stopped abruptly, but should be tapered off instead.
  • Nucynta should not be used in patients with severe liver or kidney disease.
  • Do not drive or operate machinery until you know how the medicine is affecting you.
  • Unprotected opioids can be a deadly risk for everyone in the home, including visitors. Store in a safe place out of the reach of children and out of the reach of strangers. Ask your healthcare provider how to dispose of unused opioids in your area.
  • When taking any opioid, talk to your doctor about a prescription for naloxone, a drug that can help treat an emergency opioid overdose.

Because there are no well-controlled studies in women, Nucynta or oxycodone should not be used during pregnancy. The use of opioids during pregnancy, for both medical and non-medical purposes, can cause physical dependence in the baby and can lead to opioid withdrawal in the newborn shortly after birth.

Frequently Asked Questions about ‌Nucynta vs Oxycodone

What is Nucynta?

Nucynta is a narcotic or opioid pain reliever used in the treatment of severe pain. It is available under brand name as immediate release tablets (Nucynta) or extended release tablets (Nucynta ER).

What is oxycodone?

Oxycodone is a narcotic pain reliever used to treat severe pain. It is available in generic form as immediate release tablets or capsules and under the brand name OxyContin long acting.

Are Nucynta and oxycodone the same thing?

No, but they are similar. Nucynta contains tapentadol. Oxycodone and tapentadol are both opioid analgesics (pain relievers) but they have some differences such as dosage, price and side effects described above.

Which is better Nucynta or Oxycodone?

In a study comparing two drugs, Nucynta and oxycodone were equally safe and effective in treating low back pain. Nucynta may have a lower abuse potential. Talk to your doctor if Nucynta or oxycodone is right for you, if other pain medications haven’t worked or you can’t tolerate them.

Can I use ‌Nucynta or oxycodone while pregnant?

No. Nucynta or oxycodone (or any opioid, such as Percocet) can cause neonatal withdrawal syndrome, which can be dangerous or life-threatening for the baby.

Can I use ‌Nucynta or oxycodone with alcohol?

No. Taking Nucynta or Oxycodone with alcohol may increase your risk of serious side effects such as respiratory depression (lack of oxygen and slow breathing) and may even lead to coma or death.

What is stronger than Nucynta?

According to researchers, higher doses of opioids are associated with a higher risk of overdose and death. CDC. It is important to look at the total daily dose of opioids and convert it to MME (milligram morphine equivalents) to calculate the risk of overdose and the need for closer monitoring.

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Drug Drug class Nucynta Oxycodone
Alprazolam
Clonazepam
Diazepam
Lorazepam
Benzodiazepines yes yes
Alcohol Alcohol yes yes
Codeine
Fentanyl 9026 0 Hydrocodone
Hydromorphone
Methadone
Morphine
Tramadol
Opioids yes yes
Baclofen
Carisoprodol
Cyclobenzaprine
Metaxalone
Tizanidine
Muscle relaxants yes yes
Antidepressants yes yes
Phenelzine
Rasagiline
Selegiline
Tranylcypromine
MAO inhibitors yes yes
Furosemide
Hydrochlorothiazide
Diuretics yes yes
Benztropine
Diphenhydramine
Oxybutynin
Tolterodine
Anticholinergics yes yes
Almotriptan 902 60 Eletriptan
Rizatriptan
Sumatriptan
Zolmitriptan
Triptans for migraine yes yes
Clarithromycin
Erythromycin
Fluconazole
Ketoconazole
Ritonavir
CYP3A4 or CYP2D6 inhibitors yes
Carbamazepine
Phenytoin
CYP3A4 inducers yes yes