Comparative Toxicity of Tapentadol and Tramadol Utilizing Data Reported to the National Poison Data System

Tsutaoka, Ben; Ho, Raymond; Fung, Stacey M.; Kearney, Thomas E.

doi:10.1177/1060028015604631

Cited by 38 publications

(26 citation statements)

References 21 publications

(57 reference statements)

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“…7 Tapentadol is a synthetic opioid that inhibits the reuptake of serotonin and norepinephrine and also binds to the human μ-opioid receptor. 4,5 It has been shown in preclinical models that the μ-opioid activity of tapentadol is reversed through administration of opioid antagonists. 2,3 Since tapentadol is known to be a weak serotonin and norepinephrine reuptake inhibitor similar to tramadol, it is unlikely that naloxone will reverse these effects.…”

Section: Discussion Opioid Intoxication: Pathophysiology Clinical Prmentioning

confidence: 99%

“…4,5 Postmarketing surveillance of tapentadol has revealed the potential for the development of serotonin syndrome with the concomitant use of serotonergic drugs. These drugs include serotonin and norepinephrine reuptake inhibitors (SNRIs), selective serotonin reuptake inhibitors (SSRIs), tricyclic antidepressants (TCAs), monoamine oxidase inhibitors (MAOIs), and triptans.…”

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confidence: 99%

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Probable Tapentadol-Associated Serotonin Syndrome after Overdose

et al. 2016

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Purpose: Drug-induced serotonin syndrome is a potentially life-threatening condition. An Ovid MEDLINE, and PubMed search from 1950 to October 2015 revealed one published case report of suspected tapentadol-induced serotonin syndrome. We report a probable case of tapentadolinduced serotonin syndrome after overdose. Case Summary: A 48-year-old male was found unresponsive after a witnessed overdose of medications including tapentadol. After administration of naloxone by emergency medical services, the patient became combative and presented with altered mental status. He was managed with physical and pharmacologic restraints in the emergency department. Other medications that could be implicated in the patient's presentation include duloxetine and amitriptyline. It was suspected that the opioid properties of tapentadol were masking the patient's signs and symptoms of serotonin syndrome. The patient was admitted to the medical intensive care unit, remained stable, and was discharged 2 days later. Currently, there is one published case report of suspected tapentadolinduced serotonin syndrome after an overdose. The manufacturer of tapentadol reported no cases of serotonin syndrome during clinical trials, but there have been postmarketing cases reported with co-administration of other serotonergic drugs. Conclusion:We report a probable case of tapentadol-induced serotonin syndrome after overdose. Further research is needed to better understand the pharmacology and incidence behind this adverse event.

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Section: Discussion Opioid Intoxication: Pathophysiology Clinical Prmentioning

confidence: 99%

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confidence: 99%

Probable Tapentadol-Associated Serotonin Syndrome after Overdose

et al. 2016

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“…All full agonist opioid medications as well as partial agonists (e.g., tramadol, tapentadol, butorphanol, buprenorphine) can cause sedation and respiratory depression (Yung et al, 2017). Consequently, clinicians need to practice increased vigilance in assessing and monitoring all hospitalized patients receiving opioids for pain control to ensure effective and safe pain management (Chang, Bijur, Baccelieri, & Gallagher, 2009;Choi et al, 2008;Hutchison, 2006;Komatsu et al, 2007;Maestroni et al, 2007;Manolaraki et al, 2008;Sami Mebazaa, Mestiri, Kaabi, & Ben Ammar, 2008;Tsutaoka, Ho, Fung, & Kearney, 2015;van der Schrier et al, 2017;Yassen et al, 2007;Zeng et al, 2015). The onset and severity of OIUAS and OIRD depend on many factors, including opioid formulation, dose, and mode of delivery; coadministration with other medications; and patient-centered factors related to drug absorption, metabolism, and elimination (Shenk et al, 2016;Takmaz et al, 2008;Weingarten, Hawkins, et al, 2015;Weingarten, Herasevich, et al, 2015;Zedler, et al, 2018).…”

Section: Rationalementioning

confidence: 99%

American Society for Pain Management Nursing Guidelines on Monitoring for Opioid-Induced Advancing Sedation and Respiratory Depression: Revisions

Jungquist

Quinlan-Colwell

Vallerand

et al. 2020

Pain Management Nursing

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a b s t r a c tObjectives: This report presents up-to-date evidence and expert consensus-based revisions to the ASPMN 2011 guidelines that inform interprofessional clinical decision-making for hospitalized adults receiving opioid analgesics. Design: Systematic review of the literature. Methods: A 14-member expert panel was charged with reviewing and grading the strength of scientific evidence published in peer reviewed journals and revising the ASPMN 2011 existing guidelines. Panel members formulated recommendations based on the strength of evidence and reached consensus through discussion, reappraisal of evidence, and voting by majority when necessary. The American Society of Anesthesiologists evidence categories for grading and classifying the strength of the evidence were used. Recommendations were subjected to a critical review by ASPMN members as well as external reviews. Results: The 2011 guidelines were found to still be relevant to clinical practice, but new evidence substantiated refinement and more specific recommendations for electronic monitoring. The revised guidelines present risk factors divided into three categories: patient-specific, treatment-related, and environment of care. Specific recommendations for the use of electronic monitoring are delineated. Conclusions: All hospitalized patients that are administered opioids for acute pain are at risk of opioid induced advancing sedation and respiratory depression, but some patients are at high risk and require extra vigilance to prevent adverse events. All patients must be assessed for level of risk. Adaptations to the plan of care and monitoring strategies should be driven by iterative re-assessments according to level of risk.

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“…Tramadol was associated with higher convulsion and vomiting rates. Although these drugs have similar mechanisms of action, tapentadol was associated with clinical effects significantly more toxic 27 . A case report was published about the death of a 34-year male after the use of endovenous tapentadol.…”

Section: Contentsmentioning

confidence: 99%

Tapentadol: what every doctor needs to know about this new drug

Mosele¹,

Almeida²,

Hess³

2018

Brazilian Journal of Pain

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BACKGROUND AND OBJECTIVES:Acute and chronic pain is a major problem with repercussion in our society, causing impairment in the quality of life of patients as well as socioeconomic losses, due to work absenteeism. This review aims to analyze the use of tapentadol, an analgesic not yet available in Brazil, with a dual mechanism of action, in the treatment of acute and chronic pain syndromes. CONTENTS: A review about this new drug was made on the Pubmed database using the keywords "tapentadol" and "opioids," evaluating its pharmacological and clinical aspects comparing with other current drugs in pain treatment, as well as its indications and contraindications in the management of patients with pain disorders. CONCLUSION: Tapentadol has been shown to be effective in the treatment of acute and chronic pain, with potency equivalent to the opioids currently used. In addition, it developed less tolerance, less adverse effects and better therapeutic response in chronic neuropathic pain when compared to pure μ-opioid receptors agonists. Keywords: Dual mechanism of action, Opioids, Tapentadol. RESUMO JUSTIFICATIVA E OBJETIVOS:A dor aguda e crônica consiste em um problema de grande repercussão em qualquer sociedade atual, causando degradação na qualidade de vida dos próprios pacientes e comprometimento socioeconômico pelo absenteísmo laboral. O objetivo deste estudo foi analisar o uso do tapentadol, um analgésico ainda não disponível no Brasil e com duplo mecanismo de ação, no tratamento das síndromes dolorosas agudas e crônicas. Tapentadol: what every doctor needs to know about this new drug CONTEÚDO:Foi realizada uma pesquisa na base de dados Pubmed utilizando os descritores "tapentadol" e "opioides" para revisão da literatura mundial sobre esse novo fármaco, avaliando as características farmacológicas e aspectos clínicos do seu uso na realidade atual, em comparação com os fármacos já existentes no mercado, assim como suas indicações e contraindicações no manuseio do paciente com dor. CONCLUSÃO: O tapentadol se mostrou eficaz no tratamento de dores agudas e crônicas, com potência equiparável aos opioides já comercializados. Além disso, desenvolveu menos tolerân-cia, menos efeitos adversos e melhor resposta terapêutica na dor crônica neuropática quando comparado com agonistas receptores opioides tipo μ puros. Descritores: Duplo mecanismo de ação, Opioides, Tapentadol. INTRODUCTIONPain is a problem of great proportion, involving 20 to 25% of the population with an increasing incidence. Despite the extraordinary advances in anatomy, physiology, diagnosis and pain management, more than 50% of patients report improper relief. This can be related to the neuroplasticity process of the pain pathways 1 , creating a persistent "memory" of the aggressive event and neuronal hiperexcitability 2,3 . Understanding chronic pain neurobiology is fundamental to target the treatment. Thus, the use of drugs that act on more than one pathophysiologic mechanism, as tapentadol, can be a new weapon in the therapeutic armamentarium aga...

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Comparative Toxicity of Tapentadol and Tramadol Utilizing Data Reported to the National Poison Data System

Cited by 38 publications

References 21 publications

Probable Tapentadol-Associated Serotonin Syndrome after Overdose

Probable Tapentadol-Associated Serotonin Syndrome after Overdose

American Society for Pain Management Nursing Guidelines on Monitoring for Opioid-Induced Advancing Sedation and Respiratory Depression: Revisions

Tapentadol: what every doctor needs to know about this new drug

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