Long COVID Patterns in the RECOVER-Adult Study
November 21, 2025
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Brand Name :
Nucynta, Nucynta ER
Synonyms :
tapentadol
Class :
Opioid analgesics
Brand Name :
Nucynta, Nucynta ER
Synonyms :
tapentadol
Class :
Opioid analgesics
Dosage Forms & StrengthsÂ
Immediate release tablet, Schedule IIÂ Â
50mgÂ
75mgÂ
100mgÂ
Extended-release tablet, schedule IIÂ
50mgÂ
100mgÂ
150mgÂ
200mgÂ
250mgÂ
Indicated for diabetic peripheral neuropathy:
Immediate release:
Initial dose:50to 100mg orally every 4-6 hours
First dose: may be given as soon as 1 hour after the initial dose
The subsequent doses should be given every 4 to 6 hours, with the option to adjust the dosage to achieve adequate pain relief while still being tolerable to the patient. The available dosages are 50mg, 75mg, and 100mg
Acute moderate to severe pain
Immediate release solution: 50-100mg orally every 4-6 hours when necessary
Chronic: 50-250mg orally every 12 hours when necessary
Do not exceed 500mg/day
Opioid naĂŻve patients:50mg orally every 12 hours when necessary. Do not exceed 500mg/day
Chronic severe pain
50-250mg orally every 12 hours when necessary
Do not exceed 500mg/day
Opioid naĂŻve patients:50mg orally every 12 hours when necessary. Do not exceed 500mg/day
Safety and efficacy not established
Refer adult dosingÂ
may increase the CNS depressant effects of CNS depressants
may increase the CNS depressant of opioid agonists
may increase the CNS depressant of opioid agonists
may increase the CNS depressant of opioid agonists
may increase the CNS depressant of opioid agonists
may increase the CNS depressant of opioid agonists
may increase the CNS depressant effects of CNS depressants
may increase the CNS depressant effects of CNS depressants
may increase the CNS depressant effects of CNS depressants
may increase the CNS depressant effects of CNS depressants
may increase the CNS depressant effects of CNS depressants
may decrease the therapeutic effect of opioid agonists
may increase the toxic effects of CNS depressants
may increase the CNS depressant effects of CNS depressants
may increase the hyponatremic effect of opioid agonists
may increase the toxic effects of CNS depressants
may increase the toxic effects of CNS depressants
may increase the toxic effects of CNS depressants
may increase the toxic effects of CNS depressants
may increase the toxic effects of CNS depressants
may increase the CNS depressant effects of CNS depressants
may increase the CNS depressant effects of CNS depressants
may increase the CNS depressant effects of CNS depressants
may increase the toxic effects of CNS depressants
may increase the CNS depressant effects of CNS depressants
may decrease the therapeutic effect of opioid agonists
may increase the CNS depressant effects of CNS depressants
may increase the toxic effects of CNS depressants
may increase the toxic effects of CNS depressants
may increase the toxic effects of CNS depressants
may increase the toxic effects of CNS depressants
may increase the toxic effects of CNS depressants
may increase the toxic effects of CNS depressants
may increase the toxic effects of CNS depressants
may increase the toxic effects of opioid agonists
may increase the toxic effects of opioid agonists
may increase the toxic effects of opioid agonists
may increase the toxic effects of opioid agonists
may increase the toxic effects of opioid agonists
may decrease the therapeutic effects of opioid agonists
may decrease the therapeutic effects of opioid agonists
may decrease the therapeutic effects of opioid agonists
may decrease the therapeutic effects of opioid agonists
may decrease the therapeutic effects of opioid agonists
may increase the CNS depressant of CNS depressants
may increase the CNS depressant of CNS depressants
may increase the CNS depressant of CNS depressants
It may enhance sedation when combined with a shepherd's purse
Mechanism of actionÂ
Mu-opioid agonists are a class of drugs that bind to mu-opioid receptors in the body. They treat pain by inhibiting the ascending pain pathways in the body, which alters the body’s response to pain. These drugs can produce analgesia, respiratory depression, and sedation. They also inhibit the reuptake of norepinephrine, which further affects the ascending pain pathways. Examples of mu-opioid agonists include morphine, fentanyl, and oxycodone.Â
SpectrumÂ
It is a centrally acting analgesic drug that has a unique mechanism of action. It is a dual-acting drug that acts as a mu-opioid receptor agonist and a norepinephrine reuptake inhibitor (NRI). The mu-opioid receptor agonist activity relieves pain by inhibiting the ascending pain pathways. In contrast, the NRI activity enhances the pain-relieving effects of the mu-opioid receptor agonist by increasing the levels of norepinephrine in the brain.
This dual mechanism of action results in a broad spectrum of activity for tapentadol, making it practical for treating acute and chronic pain. It is used to treat moderate to severe pain, including pain from osteoarthritis, lower back pain, and postoperative pain. It is available as an oral tablet and an extended-release oral tablet.Â
Frequency defined:Â Â
>10%Â
DizzinessÂ
SomnolenceÂ
NauseaÂ
vomitingÂ
1-10%Â
PruritisÂ
FatigueÂ
AnorexiaÂ
InsomniaÂ
ConstipationÂ
XerostomiaÂ
DyspepsiaÂ
Post-marketing reportsÂ
AngioedemaÂ
HeadacheÂ
PalpitationsÂ
Panic attackÂ
DiarrheaÂ
Black box warningÂ
ContraindicationsÂ
CautionÂ
Pregnancy consideration: Insufficient data availableÂ
Lactation: Excretion of the drug in human breast milk is knownÂ
Pregnancy category:Â
Category A: well-controlled and Satisfactory studies show no risk to the fetus in the first or later trimester.  Â
Category B: there was no evidence of risk to the fetus in animal studies, and there were not enough studies on pregnant women.Â
Category C: there was evidence of risk of adverse effects in animal reproduction studies, and no adequate evidence in human studies must take care of potential risks in pregnant women.   Â
Category D: adequate data available with sufficient evidence of human fetal risk from various platforms, but despite the potential risk, and used only in emergency cases for potential benefits.   Â
Category X: Drugs listed in this category outweigh the risks over benefits. Hence these categories of drugs need to be avoided by pregnant women.   Â
Category N: There is no data available for the drug under this categoryÂ
PharmacologyÂ
The mu-opioid receptor agonist activity of tapentadol provides pain relief by inhibiting the ascending pain pathways in the spinal cord and brain, reducing pain perception. This activity is similar to other opioid analgesics, such as morphine and fentanyl.Â
The NRI activity of tapentadol enhances the pain-relieving effects of the mu-opioid receptor agonist activity by increasing the levels of norepinephrine in the brain. Norepinephrine is a neurotransmitter that helps to modulate pain perception. It can also have a positive effect on mood, which may also contribute to the overall effectiveness of tapentadol in treating painÂ
PharmacodynamicsÂ
It is a centrally-acting analgesic drug that belongs to the class of opioid agonists. It acts on the mu-opioid receptor and the norepinephrine reuptake inhibitor (NRI) to produce its analgesic effect. The drug’s dual mechanism of action provides a balance between pain relief and reduced risk of side effects such as respiratory depression, compared to traditional opioid analgesics. It is indicated for the management of moderate to severe pain. It is available in both immediate-release and extended-release formulationsÂ
PharmacokineticsÂ
Absorption: Â
It is well absorbed from the gastrointestinal tract with peak plasma concentrations occurring within 2-3 hours of oral administration. The bioavailability of the immediate-release formulation is about 50-60%Â
Distribution: Â
It is highly protein bound (about 99%) and has a volume of distribution of about 3 L/kg Â
Metabolism: Â
It is metabolized primarily by the liver, primarily via the cytochrome P450 (CYP) enzyme, CYP2D6. The main metabolite is O-desmethyltapentadol (ODT), which is also an active compound Â
Elimination/Excretion: Â
tapentadol and its metabolites are primarily excreted in the urine, with a small portion excreted in the feces. The elimination half-life of the drug is about 3-4 hoursÂ
AdministrationÂ
Patient information leafletÂ
Generic Name: tapentadolÂ
Pronounced: (ta-PEN-ta-dol)Â
Why do we use tapentadol?Â
It is a centrally-acting analgesic drug that is used for the management of moderate to severe pain. It is approved for use in adults for the management of acute and chronic pain, including:Â
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