Nucynta vs. Tramadol for Pain: Important Differences and Potential Risks.

Nucynta

(tapentadol)

Tramadol

Summary for Nucynta

Prescription only

Nucynta (tapentadol) is an opioid that's used to treat pain that isn't relieved by non-opioid pain medications. It's available as an immediate-release tablet that's taken by mouth every 4 to 6 hours as needed for pain. There's also an extended-release version that's taken every 12 hours. Side effects include nausea, constipation, and dizziness. This medication is a controlled substance because of its high risk of misuse and dependence. Nucynta (tapentadol) is available as a brand-name medication only.

Indications for Nucynta

Pain that isn't relieved by non-opioid pain medications, including:

Short-term pain - immediate-release tablet only
Severe long-term pain - extended-release tablet only
Severe nerve pain from diabetes (diabetic neuropathy) - extended-release tablet only

Pros and Cons for Nucynta

Pros

Can take with or without food
Available as both immediate-release and extended-release tablets

Cons

Has many safety warnings, including a high risk for addiction and dependence
Not a good choice for people who have trouble swallowing pills because the tablet can't be crushed and there isn't a liquid version available

Common Side Effects for Nucynta

Immediate-release:

Nausea (30%)
Dizziness (24%)
Vomiting (18%)
Sleepiness (15%)
Constipation (8%)

Extended-release:

Nausea (21%)
Constipation (17%)
Dizziness (17%)
Headache (15%)
Sleepiness (12%)
Fatigue (9%)
Vomiting (8%)

Warnings for Nucynta

Potential for addiction and misuse
Dangerously slow breathing (respiratory depression)
Risk for opioid overdose
Difficulty concentrating and extreme sleepiness
Harm to newborn babies
Physical dependence and withdrawal
Low blood pressure
Low adrenal hormone levels
Seizures

Summary for Tramadol

Prescription only

Tramadol is an opioid pain medication used when non-opioid medications aren't working well enough to control pain. Compared to other opioids, tramadol might have a lower risk of misuse and dependency. But tramadol is a controlled substance and has a lot of potentially serious risks, so it must be used with caution.

Indications for Tramadol

Pain that isn't relieved by non-opioid pain medications alone

Pros and Cons for Tramadol

Pros

Extended-release tablets and ConZip capsules are taken once per day and last throughout the day.
Immediate-release tablets are available as a lower-cost generic.
Possible lower risk of misuse and dependency compared to other opioids

Cons

A controlled medication, so there are special requirements to get a prescription filled
Must slowly lower the dose to stop the medication after long-term use to avoid withdrawal symptoms
Can't use in some children due to higher risk of potentially severe and life-threatening side effects
Not recommended while breastfeeding