Dr. Jordan - Recommending Botox & sympathetic nerve block

[JeanieC]

New Mom and Ezer,

Nucynta is a drug with opiate and SSRI components. It is supposed to be particularly helpful for neuropathic pain. Generic name is tapentadol, but tramadol/Ultram is a different drug. I'm not sure if you were saying they were the same but that was the way it read to me. I thought I should make this post because Nuycynta has a major interactions warning with tramadol because of serotonin syndrome.

[ezer]

JeanieC,
Nucynta has been developped by the same pharmeceutical company as Tramadol as a potential replacement (the same way Lyrica is trying to replace Neurontin).
http://en.wikipedia.org/wiki/Tapentadol

While its action reflects aspects of tramadol and morphine its ability to kill pain is more on the order of hydrocodone and oxycodone, so not as weak as tramadol but not as strong as morphine.[3] Tapentadol is a new molecular entity that is structurally similar to tramadol (Ultram). It has opioid and nonopioid acitivity in a single compound.

http://en.wikipedia.org/wiki/Tramadol

Structurally, tapentadol is the closest chemical relative of tramadol in clinical use. Tapentadol is also an opioid, but unlike both tramadol and venlafaxine, tapentadol represents only one stereoisomer and is the weaker of the two, in terms of opioid effect.

Unfortunately for Grunenthal, the pharmaceutical company, Nucynta was classified by the FDA as schedule II which will limit its market (In many countries, Tramadol is available OTC).

[JeanieC]

Thanks for this information, Ezer, although I can't quite figure it out even after reading about all this on several websites and pondering over it for a while.
I suppose the main information would be that you could take tramadol or nucynta but not both of them?

[calluna]

Just wanted to say thankyou for posting this information about tapentadol/Nucynta. My major help is from tramadol, and I note that tapentadol is likely to have more effect on neuropathic pain. For me, this absolutely has to be worth investigating!

JeanieC, I'd say you are right. Basically you wouldn't combine two drugs with the same action - for instance ibuprofen and naproxen - or tramadol and tapentadol - and in this case the specific risk is serotonin syndrome. With regard to interactions, it is the same with any other drug with SNRI or SSRI action - any TCA interacts with both tramadol and tapentadol.