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What Is Nucynta (Tapentadol)?

If you develop moderate-to-severe pain, your doctor may prescribe a medication called Nucynta. This opioid analgesic (painkiller) is recommended mainly for people who have not responded well to non-opioid pain medications. Here’s what you should know about it.

What Is Nucynta (Tapentadol)?

Nucynta is the brand name for a prescription drug called tapentadol.

As an opioid agonist, it provides analgesia (pain relief) by attaching to opioid receptors throughout your body. It also increases the amount of norepinephrine in your brain. Norepinephrine is a hormone and neurotransmitter (chemical messenger) that affects how your body reacts to pain.

The United States Food and Drug Administration (FDA) has approved two formulations of Nucynta: an immediate-release tablet and an extended-release tablet.

The immediate-release tablet treats acute pain (short-term pain), while the extended-release tablet treats chronic pain (long-term pain) as well as nerve pain caused by diabetic peripheral neuropathy.

Risks Of Nucynta

Like other prescription drugs, Nucynta may cause adverse reactions, including side effects, negative drug interactions, worsened health conditions, pregnancy and breastfeeding problems, overdose, and addiction.

Side Effects

The most common side effects of Nucynta include:

  • nausea and vomiting
  • dizziness
  • drowsiness
  • constipation
  • dry mouth
  • headache
  • trouble falling or staying asleep
  • strange dreams

Some people also experience more serious side effects, such as:

  • anxiety
  • irritability
  • somnolence (extreme drowsiness)
  • confusion
  • hallucinations (seeing, hearing, or feeling things that aren’t really there)
  • fast heartbeat
  • chest pain
  • trouble breathing or swallowing
  • sleep apnea (a condition that causes your breathing to repeatedly stop and start while you sleep)

If you experience these more serious side effects, contact your doctor right away.

Negative Drug Interactions

Before starting Nucynta, you should tell your prescribing physician about any medications and supplements you take. That’s because some substances interact negatively with Nucynta.

For example, you should not use Nucynta alongside substances that increase levels of the neurotransmitter serotonin. These substances include:

  • certain antidepressants, including selective serotonin reuptake inhibitors (SSRIs), serotonin–norepinephrine reuptake inhibitors (SNRIs), and monoamine oxidase inhibitors (MAOIs)
  • triptans, such as almotriptan (Axert), eletriptan (Relpax), and lasmiditan (Reyvow)
  • St. John’s Wort, an over-the-counter supplement
  • MDMA, a street drug also known as ecstasy or molly

Using Nucynta alongside these substances can lead to a life-threatening condition called serotonin syndrome. Common symptoms include fever, confusion, fast heartbeat, and muscle stiffness or spasms.

You should also avoid combining Nucynta with central nervous system depressants. Central nervous system depressants are substances that slow down your brain activity, breathing, and heart rate. They include:

  • alcohol
  • benzodiazepines, such as alprazolam (Xanax), clonazepam (Klonopin), and diazepam (Valium)
  • muscle relaxants, such as carisoprodol (Soma), cyclobenzaprine (Flexeril), and methocarbamol (Robaxin)
  • other opioids, such as tramadol (Ultram), oxycodone (OxyContin), and hydromorphone (Dilaudid)
    general anesthetics

Because Nucynta is also a central nervous system depressant, mixing it with the above drugs can cause extreme sedation that slows your breathing and heart rate to a life-threatening degree.

Worsened Health Conditions

Nucynta can worsen the symptoms of certain health conditions, including:

  • hypotension (low blood pressure)
  • head injuries
  • seizure disorders
  • adrenal insufficiency
  • pancreatitis
  • hepatic impairment (liver disease)
  • renal impairment (kidney disease)
  • gastrointestinal obstructions, including paralytic ileus

Make sure your prescribing physician knows about all of your health conditions before you start taking Nucynta. If they think the drug could worsen your conditions, they will prescribe a different medication instead.

Pregnancy & Breastfeeding Problems

Using Nucynta on a regular basis while pregnant can lead to neonatal opioid withdrawal syndrome. That means your baby may experience withdrawal symptoms such as irritability, uncontrollable shaking, and failure to gain weight.

Also, Nucynta can pass into your breast milk and cause side effects in your baby.


Nucynta can cause an overdose, particularly if you take a higher dose than prescribed or mix it with other CNS depressants. Common symptoms of Nucynta overdose include:

  • drowsiness
  • change in pupil size
  • cold, clammy skin
  • muscle weakness
  • slow heartbeat
  • respiratory depression (slow breathing)
  • loss of consciousness

If you or someone you know experiences these symptoms, call 911 right away. Also, administer naloxone if you have it. Naloxone (brand name Narcan) is a medication that can rapidly reverse the effects of an opioid overdose. You can get it at most pharmacies without a prescription.

You face a higher risk of overdose if you illegally buy Nucynta on the street. That’s because many drug dealers lace their products with fentanyl. Fentanyl is an opioid that’s up to 50 times stronger than heroin. It has caused numerous fatal overdoses.


Nucynta is a Schedule II controlled substance. That means it poses a risk of addiction, especially if you use it for a long time or abuse it. Abusing Nucynta means using the drug in a manner not prescribed (such as taking higher doses than prescribed or mixing it with alcohol).

The most common symptoms of Nucynta addiction include:

  • strong cravings for Nucynta
  • tolerance (needing increasingly larger or more frequent doses to feel the desired effects)
  • physical dependence (experiencing withdrawal symptoms, such as nausea and irritability, upon discontinuation of the drug)

If you or a loved one experiences these symptoms, please contact a Recovering Champions specialist. Our board-certified healthcare providers offer behavioral therapy, medication-assisted treatment, and other evidence-based treatment options to help you recover from drug abuse and addiction.

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