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Several patients have recently presented with a medication history including tapentadol (Nucynta), the newest opioid formulation. It is approved for treatment of acute moderate-severe pain. Here are some key points:
- Mechanism similar to tramadol: mu-receptor agonist, also inhibits norepinephrine reuptake
- Potency stronger than tramadol, but less then morphine
- Usual dose is same as tramadol 50-100 mg every 4-6 hours prn pain
- Schedule II controlled substance, similar to morphine/oxycodone (tramadol is not a controlled substance)
- Overdose should present like other opioids, but potentially also including tachycardia, serotonergic effects, and seizures (similar to tramadol)