Tapentadol immediate release: a new treatment option for acute pain management

The undertreatment of acute pain is common in many health care settings. Insufficient management of acute pain may lead to poor patient outcomes and potentially life-threatening complications. Opioids provide relief of moderate to severe acute pain; however, therapy with pure μ-opioid agonists is often limited by the prevalence of side effects, particularly opioid-induced nausea and vomiting. Tapentadol is a novel, centrally acting analgesic with 2 mechanisms of action, μ-opioid receptor agonism and norepinephrine reuptake inhibition. The analgesic effects of tapentadol are independent of metabolic activation and tapentadol has no active metabolites; therefore, in theory, tapentadol may be associated with a low potential for interindividual efficacy variations and drug–drug interactions. Previous phase 3 trials in patients with various types of moderate to severe acute pain have shown that tapentadol immediate release (IR; 50 to 100 mg every 4 to 6 hours) provides analgesia comparable to that provided by the pure μ-opioid agonist comparator, oxycodone HCl IR (10 or 15 mg every 4 to 6 hours), with a lower incidence of nausea, vomiting, and constipation. Findings suggest tapentadol may represent an improved treatment option for acute pain

Post hoc analyses of data from a 90-day clinical trial evaluating the tolerability and efficacy of tapentadol immediate release and oxycodone immediate release for the relief of moderate to severe pain in elderly and nonelderly patients

Population-based studies indicate that pain-related problems are present in an estimated 25% to 50% of elderly people living in the community, and 40% to 80% of elderly people in nursing homes. Painful conditions often require treatment with strong analgesics, but elderly patients are more susceptible to adverse effects associated with opioid analgesics. Few published studies have addressed the tolerability-related issues associated with the use of opioids in elderly patients, and practice recommendations are based on extrapolation from younger patients and the limited information available about the pharmaco kinetics of opioids in older patients. The authors of this study evaluated the tolerability and efficacy of tapentadol immediate release versus oxycodone immediate release for the relief of moderate to severe pain experienced by elderly and nonelderly patients