Tapentadol immediate release: a review of its use in the treatment of moderate to severe acute pain.
Summary of "Tapentadol immediate release: a review of its use in the treatment of moderate to severe acute pain."
Tapentadol (Nucynta) is an orally active, centrally acting synthetic analgesic that is thought to exert its analgesic effects via two mechanisms of action (mu-opioid receptor agonism and norepinephrine reuptake inhibition). In the US, the immediate-release (IR) formulation of the drug is approved for the relief of moderate to severe acute pain in patients aged > or =18 years. In the EU, the drug is currently in the marketing authorization process. In clinical trials in patients with moderate to severe acute (postorthopaedic surgical or musculoskeletal) pain, recommended regimens of tapentadol IR (50-100 mg every 4-6 hours) provided an analgesic effect that was superior to that of placebo, and noninferior or similar to that of oxycodone IR (10 or 15 mg every 4-6 hours). Tapentadol IR therapy was generally well tolerated; it was associated with significant reductions in the incidences of nausea, vomiting and constipation compared with oxycodone IR therapy. Thus, tapentadol IR is an effective treatment option for the management of moderate to severe acute pain. However, further studies evaluating its clinical utility in relation to that of tramadol and opioids other than oxycodone are warranted. Because tapentadol IR offers the prospect of reduced opioid-related gastrointestinal adverse events while maintaining adequate analgesia, it is a potentially valuable addition to the analgesic armamentarium.
Affiliation
Adis, a Wolters Kluwer Business, Auckland, New Zealand. demail@adis.co.nz
Journal Details
This article was published in the following journal.
Name: Drugs
ISSN: 0012-6667
Pages: 1719-43
Links
- PubMed Source: http://www.ncbi.nlm.nih.gov/pubmed/20731478
- DOI: http://dx.doi.org/10.2165/11204470-000000000-00000
Medical and Biotech [MESH] Definitions
Concurrent Review
Review of the medical necessity of hospital or other health facility admissions, upon or within a short time following an admission, and periodic review of services provided during the course of treatment.
Crush Syndrome
Severe systemic manifestation of trauma and ischemia involving soft tissues, principally skeletal muscle, due to prolonged severe crushing. It leads to increased permeability of the cell membrane and to the release of potassium, enzymes, and myoglobin from within cells. Ischemic renal dysfunction secondary to hypotension and diminished renal perfusion results in acute tubular necrosis and uremia.
Oxymorphone
An opioid analgesic with actions and uses similar to those of MORPHINE, apart from an absence of cough suppressant activity. It is used in the treatment of moderate to severe pain, including pain in obstetrics. It may also be used as an adjunct to anesthesia. (From Martindale, The Extra Pharmacopoeia, 30th ed, p1092)
Abdomen, Acute
A clinical syndrome with acute abdominal pain that is severe, localized, and rapid onset. Acute abdomen may be caused by a variety of disorders, injuries, or diseases.
Drug Utilization Review
Formal programs for assessing drug prescription against some standard. Drug utilization review may consider clinical appropriateness, cost effectiveness, and, in some cases, outcomes. Review is usually retrospective, but some analysis may be done before drugs are dispensed (as in computer systems which advise physicians when prescriptions are entered). Drug utilization review is mandated for Medicaid programs beginning in 1993.
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