What is Tapentadol? Tapentadol is an opioid pain medication. An opioid is sometimes called a narcotic. Tapentadol is used to treat moderate to severe pain. The extended-release form of tapentadol (Nucynta ER) is for around-the-clock treatment of pain that is not controlled by other medicines. Nucynta ER is not for use on an as-needed basis for pain. Before taking this medicine You should not use this medicine if you are allergic to tapentadol, or if you have: severe asthma or breathing problems; or a blockage in your digestive tract (stomach or intestines). Do not use tapentadol if you have taken an MAO inhibitor in the past 14 days. A dangerous drug interaction could occur. MAO inhibitors include isocarboxazid, linezolid, methylene blue injection, phenelzine, rasagiline, selegiline, and tranylcypromine. To make sure tapentadol is safe for you, tell your doctor if you have ever had: any type of breathing problem or lung disease; a head injury, brain tumor, or seizures; drug or alcohol addiction, or mental illness; urination problems; liver or kidney disease; or problems with your gallbladder, pancreas, or thyroid. How should I take tapentadol? Take this medicine with a full glass of water. Tapentadol can be taken with or without food. Stop taking all other around-the-clock narcotic pain medications when you start taking tapentadol extended-release tablets. Do not crush, break, or open an extended-release pill. Swallow it whole to avoid exposure to a potentially fatal dose. Tapentadol can cause constipation. Talk to your doctor before using a laxative or stool softener to treat or prevent this side effect. Do not stop using tapentadol suddenly, or you could have unpleasant withdrawal symptoms. Ask your doctor how to safely stop using this medicine. Never crush or break a tablet to inhale the powder or mix it into a liquid to inject the drug into your vein. This practice has resulted in death with the misuse of tapentadol and similar prescription drugs. Store at room temperature away from moisture and heat. Keep track of your medicine. You should be aware if anyone is using it improperly or without a prescription. Usual Adult Dose for Pain IMMEDIATE RELEASE TABLETS AND SOLUTION: Initial dose: 50, 75, or 100 mg orally every 4 to 6 hours depending on pain intensity Maximum dose: 600 mg/day Comments: -Adjust the dosing regimen for each patient individually, taking into account the patient’s prior analgesic experience, general condition, other medications, and risk factors for abuse. -On the first day of dosing, the second dose may be administered as soon as one hour later if adequate pain relief is not attained. -May be taken with or without food. -Consider starting elderly patients at the lower end of the recommended dose range. -When the patient no longer requires therapy with this drug, gradually taper to prevent withdrawal symptoms in the physically dependent patient. Use: Moderate to severe acute pain in adults EXTENDED RELEASE TABLETS: Initial dose: 50 mg orally twice a day Maximum dose: 500 mg/day