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Nucynta cr, Tapentadol Hydrochloride --Anyone tried it?--

Posted: Sun Jan 01, 2012 7:06 am
by rthom
I'm supposed to decide whether to give this one a try, I know nothing about it and have never heard the name before. I certainly don't feel qualified to make this decision. Has anyone had experience with this drug, and what outcomes?

Re: Nucynta cr, Tapentadol Hydrochloride --Anyone tried it?-

Posted: Mon Jan 02, 2012 9:06 am
by badnights
It's fairly new, in the opioid class. This from Wikipedia:
Tapentadol (trade name Nucynta, Palexia, In India - ZYNTAP)[2] is a centrally acting analgesic with a dual mode of action as an agonist at the ╬╝-opioid receptor and as a norepinephrine reuptake inhibitor.[3] While its analgesic actions have been compared to tramadol and oxycodone,[4] its general potency is somewhere between tramadol and morphine in effectiveness.[5] Tapentadol is a new molecular entity that is structurally similar to Tramadol (Tramal). It has opioid and nonopioid acitivity in a single compound.

In the US, Tapentadol is FDA approved for the treatment of moderate to severe acute pain. Due to the dual mechanism of action as an opioid agonist and norepinephrine reuptake inhibitor, there is potential for off label use in chronic pain.

Doctors use serotonin and norepinephrine reuptake inhibitors in chronic pain management to increase the effectiveness of opioids and, to a lesser extent, NSAIDs (along with other analgesics) against neuropathic pain and from certain specific contributing causes such as fibromyalgia and diabetic neuropathy. One selective serotonin and norepinephrine reuptake inhibitor (SNRI) often used as an adjunct, atypical & potentiator is duloxetine (Cymbalta). Another opioid with selective norepinephrine reuptake inhibitor effects is levorphanol (Levo-Dromoran).

Its dual mode of action provides analgesia at similar levels of more potent narcotic analgesics such as hydrocodone, oxycodone, and pethidine (meperidine) with a more tolerable side effect profile.

What are you on now, and how is it controlling your symptoms? From your post in the New forum, I'd say not too well... Opiods are very commonly used to treat RLS. I'm on opioids; here's the 2-year search for meds: DAs I moved off fairly quickly as one caused me to augment horribly and the other put me to sleep all day, I tried anti-convulsants with some relief but much more needed, added codeine (up to 150 mg/day) to the mix for some improvement but worsening spiralled it all out of control, finally tried 10 mg oxycodone not enough, moved to 12 mg hydromorph contin plus a sleeping aid (zopiclone) and this is where I'm happy (gradually increaseing the HM - I'm 15-18 now, after not quite 2 years on it). I also have pramipexole (the sleepy DA) in my stash for emergencies, and Sinemet for occasional times when I need relief NOW not 2 hours from now.

So - your current meds are ineffective. The prescribed drug is new, but side effect profile seems smaller than many of the older opioids. Opioids are known to kill RLS. I would think it's worth a try?? Has anyone else out there used this drug?

Nausea, dizziness, constipation, and CNS sedation are common side effects of opioid pain medications. In phase II trials, tapentadol has been shown to provide equianalgesic effect with a lower incidence of side effects compared to oxycodone and morphine. One trial, sponsored by Gr├╝nenthal, comparing tapentadol to morphine and ibuprofen for relief of postoperative pain found tapentadol to cause less nausea and dizziness than morphine, with no significant difference in the incidence of vomiting or drowsiness.[14]

Clinical studies cite there is less incidence of select adverse gastrointestinal effects tapentadol compared to oxycodone.

May cause hallucinations and short term memory loss to patients on anti-depressants.

You mentioned anti-depressants in another post. In some people, SSRIs and tricyclics worsen RLS. Wellbutrin is RLS-friendly. (It made my RLS worse, wihch must be the exception that proves the rule)

Re: Nucynta cr, Tapentadol Hydrochloride --Anyone tried it?-

Posted: Thu Jan 05, 2012 4:09 am
by Chipmunk
Beth, Wellbutrin made my WED worse as well. It is known to cause seizures in higher doses, and my WED responds to anti-convulsants, so perhaps that is why?

Anyway, I would stay away from newer meds until you've tried the time-tested ones. I hear about so many drugs lately with "surprise" side effects that aren't discovered until ten or twenty years after the drug is approved. However, I wouldn't hesitate to go on something new if I'd already burned through the other stuff.

Re: Nucynta cr, Tapentadol Hydrochloride --Anyone tried it?-

Posted: Thu Jan 05, 2012 6:32 am
by rthom
Thanks for the ideas. I have also tried welbutrin in the past and did not fair well at all (every pun intended). I have done well on morphine along with other drugs, one to sleep, ibuprofen, and oxycontin, along with gabapentin or mirapex. Two problems but mostly, I was so hazy I couldn't function and my memory was vertually non-existent. I was asleep on my feet and yet still hyper as h... My body was at rest more during the day when I was on my feet then at night when I wasn't,--by far. I actually would allow myself to sleep standing so I could get some more. But my legs didn't hurt nearly as much and I felt far less physically exhausted. Nowadays I have a hard time holding my shoulders off my chest, I'm so spent. My muscles are way over-taxed.
So the meds gave me better health but took the life to use it for. Make sense?
I'm so gratefull for this forum, I did my research about 20 years ago and this sort of thing was not there. It has taught me by the experiences of others that everything I have done and didn't quite know why (drugs) was helping the rls in some way. I usually just tell my docs, everything seems to make a difference, I just don't know what ones are doing what. (mine become in-effective quite quickly).
My family is the center of my life and wife goes through everything with me. It's important to me that my rls doesn't affect them any more than is absolutely necessary. She is getting a lot from this info as well.

Re: Nucynta cr, Tapentadol Hydrochloride --Anyone tried it?-

Posted: Mon Jan 09, 2012 2:20 pm
by Chipmunk
I know what you mean about the meds giving you nights but taking the days away.

I am on Lamictal right now. It's a drug similar to gabapentin, but must be titrated extremely cautiously, which is why it's usually not prescribed as a first-line drug. I'm very happy with it, and you might consider it if your WED/RLS responded to gabapentin.

Re: Nucynta cr, Tapentadol Hydrochloride --Anyone tried it?-

Posted: Mon Jan 09, 2012 3:06 pm
by rthom
thanks that's good to know

Re: Nucynta cr, Tapentadol Hydrochloride --Anyone tried it?-

Posted: Fri Jun 27, 2014 1:33 am
by Polar Bear
I have just today been given, from a friend, a leaflet with regard to Palexia SR/ Oral Solution and Tablets. It has only recently been started to be used over here (I understand) and not all areas and are as ready to use it as others. Not sure if this is because it is relatively new, or expensive, or just that docs stick with what they are familiar with.
I've heard it's nickname is 'Granny's Tramadol' ??

Re: Nucynta cr, Tapentadol Hydrochloride --Anyone tried it?-

Posted: Sat Jul 12, 2014 2:51 am
by JustKeepWalking82
I have been on the Nucynta- both the regular and the extended release. The extended release helped me for almost nine months.