Drug - Nucynta ER (tapentadol extended release) [Janssen]
June 2016
Therapeutic area - Pain - Long Acting Opioids
The starting dose of Nucynta ER for all patients is 50 mg twice daily. Patients should be titrated to adequate pain control with increases of 50 mg at a minimum of twice daily every three days. The dose should be titrated within the therapeutic range of 100 mg to 250 mg twice daily. The maximum daily dosage of Nucynta ER is 500 mg daily.
Conversion from Nucynta IR to Nucynta ER: Divide the equivalent total daily dose of Nucynta IR into two equal doses of Nucynta ER separated by 12 hours (e.g. 50 mg of Nucynta IT four times daily converts to 100 mg Nucynta ER twice daily).
Tapentadol extended-release (Nucynta ER) is an opioid analgesic indicated for the management of moderate to severe chronic pain in adults when a continuous, around-the clock opioid analgesic is needed for an extended period of time and the treatment of neuropathic pain associated with diabetic peripheral neuropathy.
Nucynta ER should not be taken by patients who have received a monoamine oxidase inhibitor (MAOI) in the last 14 days. Nucynta ER should also be used with caution with selective serotonin receptor inhibitors (SSRIs), selective norepinephrine receptor inhibitors (SNRIs), triptans and any other drugs that may affect serotonergic neurotransmitter systems due to the risk of serotonin syndrome.
Expected Equivalent Dosing
Dosing | Oxycodone total daily dose | Morphine daily dose range | Nucynta ER dose range |
Strengths available | 10, 15, 20, 30, 40, 60, 80 mg | 15, 30, 60, 100 mg | 50, 100, 150, 200, 250 mg |
Dosing frequency | Twice daily | Twice daily | Twice daily |
Expected equianalgesic dosing
Represents total daily dose. |
20 mg
30 mg 40 mg 60 mg 80 mg 100 mg |
30 - 40 mg
45 - 60 mg 60 - 80 mg 90 - 120 mg 120 - 160 mg 150 - 200 mg |
100 mg
150 mg 200 mg 300 mg 400 mg 500 mg |
These recommendations are guides only. Individual patients require doses to be adjusted. Expected equianalgesic doses for Nucynta ER are based on limited clinical support from the manufacturer using a 5:1 ratio of Nucynta ER to oxycodone.
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