Abstract
Tapentadol is a novel pain reliever with apparently synergistic dual mechanisms of action, capable of addressing both nociceptive and neuropathic components of chronic pain. As an effective analgesic with good tolerability, tapentadol may be appropriate for patients suffering from severe chronic pain associated with low back pain (LBP) or osteoarthritis (OA). Efficacy studies of tapentadol in populations of patients with severe chronic LBP or OA pain suggest that tapentadol is non-inferior to oxycodone. Its tolerability, especially with respect to gastrointestinal (GI) side effects, may be better than that of other strong opioids in clinical trials and analyses of multiple trials. Patient satisfaction with tapentadol extended release for chronic noncancer pain syndromes is good. Although tapentadol has an opioid component with abuse liability, it appears to be a difficult opioid for tampering with less appeal to abusers than other opioids. For patients with severe LBP and OA pain, tapentadol appears to hold promise as a safe, effective therapeutic option.
Highlights
More people in the US suffer from chronic pain than have diabetes, all cancers, and acquired immune deficiency syndrome (AIDS) combined
As the role of opioid analgesics in the treatment of severe chronic noncancer pain remains controversial, chronic pain patients may become resigned to their suffering out of their inability to deal with an unhelpful healthcare system
The purpose of our review is to consider tapentadol as an analgesic that can help to manage patients who present with severe chronic pain associated with either low back pain (LBP) or osteoarthritis (OA), the two most common chronic pain syndromes in the US [11]
Summary
More people in the US suffer from chronic pain than have diabetes, all cancers, and acquired immune deficiency syndrome (AIDS) combined. The Centers for Disease Control and Prevention (CDC) recently issued guidelines regarding opioid prescribing that advocated conservative use of opioid analgesics for chronic noncancer pain; there is concern among some clinicians that these guidelines may limit noncancer pain patients’ access to opioid analgesia [8, 9]. The national media seems more interested in raising awareness about opioid addiction than the undertreatment of chronic pain in millions of Americans [10]. This creates a conundrum for the clinicians on the frontlines who treat patients with chronic, severe noncancer pain
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