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Tapentadol (By mouth)

Tapentadol (ta-PEN-ta-dol)

Treats moderate to severe pain. Also treats nerve pain caused by diabetes. This medicine is a narcotic pain reliever.

Brand Name(s):

Nucynta, Nucynta ER

There may be other brand names for this medicine.

When This Medicine Should Not Be Used:

Do not use this medicine if you have had an allergic reaction to tapentadol, or if you have used an MAO inhibitor (MAOI) such as isocarboxazid, phenelzine, selegiline, tranylcypromine, Eldepryl®, Marplan®, Nardil®, or Parnate® within the past 14 days. Do not use this medicine if you have breathing problems, such as severe asthma, or if you have paralytic ileus.

How to Use This Medicine:

Liquid, Tablet, Long Acting Tablet

  • Take your medicine as directed. Your dose may need to be changed several times to find what works best for you.
  • Measure the oral liquid medicine with a marked measuring spoon, oral syringe, or medicine cup.
  • Swallow the extended-release tablet whole. Do not crush, break, or chew it.Take the tablets one at a time, if your doctor has told you to take more than one. Take the tablet with enough water to make sure you swallow it completely.
  • This medicine should come with a Medication Guide. Ask your pharmacist for a copy if you do not have one.

If a dose is missed:

  • Take a dose as soon as you remember. If it is almost time for your next dose, wait until then and take a regular dose. Do not take extra medicine to make up for a missed dose.

How to Store and Dispose of This Medicine:

  • Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep the oral liquid bottle upright after you open it.
  • Ask your pharmacist, doctor, or health caregiver about the best way to dispose of any outdated medicine or medicine no longer needed.Flush all medicine you do not need down the toilet.
  • Keep all medicine out of the reach of children. Never share your medicine with anyone.

Drugs and Foods to Avoid:

Ask your doctor or pharmacist before using any other medicine, including over-the-counter medicines, vitamins, and herbal products.

  • Make sure your doctor knows if you also use other narcotic pain medicine (such as buprenorphine, butorphanol, nalbuphine, pentazocine, tramadol, Ultram®), medicine for depression (such as amitriptyline, citalopram, fluoxetine, mirtazapine, nortriptyline, sertraline, trazodone, Cymbalta®, Effexor®, Elavil®, Lexapro®, Pristiq®), or medicine to treat migraine headaches (such as eletriptan, frovatriptan, rizatriptan, sumatriptan, zolmitriptan, Frova®, Maxalt®, Relpax®, Zomig®).
  • Tell your doctor if you use a phenothiazine medicine, such as prochlorperazine, promethazine, Compazine®, Mellaril®, Phenergan®, Thorazine®, or Trilafon®. These medicines may be used to treat severe vomiting, coughing, psychiatric problems, or other conditions.
  • Tell your doctor if you also use other medicines that can cause dry mouth or constipation such as atropine, dicyclomine, glycopyrrolate, scopolamine, Bentyl®, Robinul®, or Transderm Scop®.
  • Do not drink alcohol while you are using this medicine.
  • Tell your doctor if you drink alcohol or if you are using any medicine that makes you sleepy, such as allergy medicine or narcotic pain medicine.

Warnings While Using This Medicine:

  • Make sure your doctor knows if you are pregnant or breastfeeding, or if you have kidney disease, liver disease, gallbladder problems, pancreas problems, or problems with urination. Tell your doctor if you have a history of head injury, brain tumor, seizures, depression, or mental illness. Also tell your doctor if you have a history of alcohol or drug abuse.
  • This medicine may slow your breathing and cause you to not get enough oxygen. This is more likely to happen when you first start this medicine or when your dose is increased. Make sure your doctor knows if you already have a breathing or lung problem, such as chronic obstructive pulmonary disease (COPD) or asthma. Tell your doctor if you have trouble breathing, slow or shallow breathing, or any other changes in your breathing while you are taking this medicine.
  • Do not take more of this medicine or take it more often than your doctor tells you to. This can be life-threatening, especially in children. Symptoms of an overdose include extreme dizziness or weakness, trouble breathing, slow heartbeat, seizure, and cold, clammy skin.
  • This medicine can be habit-forming. Do not use more than your prescribed dose. Call your doctor if you think your medicine is not working.
  • This medicine may make you dizzy, drowsy, or lightheaded. Do not drive, use machines, or do anything else that could be dangerous until you know how this medicine affects you. Stand or sit up slowly if you feel lightheaded or dizzy.
  • Do not stop using this medicine suddenly. Your doctor will need to slowly decrease your dose before you stop it completely.
  • This medicine may cause constipation, especially with long-term use. Ask your doctor if you should use a laxative to prevent and treat constipation.
  • Your doctor will check your progress and the effects of this medicine at regular visits. Keep all appointments.

Possible Side Effects While Using This Medicine:

Call your doctor right away if you notice any of these side effects:

  • Allergic reaction: Itching or hives, swelling in your face or hands, swelling or tingling in your mouth or throat, chest tightness, trouble breathing
  • Anxiety, restlessness, muscle spasms, twitching, diarrhea, seeing or hearing things that are not there
  • Extreme weakness or sleepiness, cold or clammy skin
  • Fainting, lightheadedness, dizziness
  • Fast, slow, or uneven heartbeat
  • Seizures
  • Trouble breathing, shallow breathing

If you notice these less serious side effects, talk with your doctor:

  • Dry mouth
  • Headache
  • Mild sleepiness or tiredness
  • Nausea, vomiting, constipation

If you notice other side effects that you think are caused by this medicine, tell your doctor

Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088

Last Updated: 4/4/2014

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