Tapentadol
Tapentadol
Patient Information
Chronic Pain Service
- Author ID: LB / SD
- Leaflet Ref: Pain 040
- Version: 4
- Leaflet title: Tapentadol
- Last review: July 2025
- Expiry Date: July 2027
Introduction
Tapentadol (Palexia) SR (slow release) pain medicine useful for the management of moderate to severe chronic osteoarthritis for back, knee or hip pain in adults.
Aims
Tapentadol is a narcotic (opioid/morphine) that combines two roles of action; it works in the brain and nervous system by binding to receptors thereby reducing pain message travelling to the brain and increasing pain killing messages from the brain.
Before taking Tapentadol
To make sure Tapentadol is safe for you tell your doctor if you have:
Any breathing problem or lung disease, head injury, brain tumour or seizures. If you are pregnant, planning to become pregnant, or are breast-feeding.
If you are taking any medications for nausea, depression, Parkinson’s, migraine and headaches.
Have known or suspected stomach or bowel blockage (paralytic ileus).
Taking a Monoamine Oxidase Inhibitor (MAOI, phentazine) (antidepressant) or have taken MAOI’s within the past 14 days.
Have a known hereditary problem of; galactose intolerance, Lapp lactase deficiency or glucose- galactose malabsorption.
Have a history of drug misuse, alcohol addiction, mental illness or urinary problems, liver or kidney disease, gallbladder, pancreas, thyroid problems.
Dosing information
Tapentadol (SR) should be taken twice daily, approximately every 12 hours and is recommended for patients not currently taking an opioid painkiller. The starting dose is 50mg twice daily. However, if you are currently taking opioid analgesia, the recommended starting dose should take into account the total 24-hour daily dose. If treatment is to be discontinued, this is done by gradually weaning down your dosage to prevent withdrawal symptoms. This process will be done with discussion with your doctor.
How should I take Tapentadol?
Take the tablet with a full glass of water and can be taken with or without food. Do not crush, chew, or break the tablet. This medication may impair your thinking or reactions, therefore avoid driving or operating machinery until you know how the drug will affect you. Do not drink alcohol as it increases sedative effects.
Never take larger amount, or for longer than prescribed. If you miss a dose, take as soon as you remember, do not take extra to make up for missed dose. If you take too many tablets seek medical advice (symptoms: slow breathing, slow heart rate, muscle weakness, cold and clammy skin, pinpoint pupils, and fainting).
Tapentadol is classed as a ‘controlled drug’ therefore if you are travelling abroad; you are advised to carry a letter from your doctor explaining why you have been prescribed it.
What are the side effects with taking Tapentadol?
Most medicines can cause mild unwanted side effects and can be expected to go away after a little while although not everyone experiences them. If you have other symptoms which you may be due to Tapentadol, speak with your doctor or pharmacist.
The following side effects can occur:
Constipation, mild nausea, stomach pain, headache, tiredness, mild drowsiness, dizziness, skin itching, or dry mouth.
However you should seek medical advice if you experience:
Weak or shallow breathing, weak or increased heart rate, light headedness, agitation, hallucinations, fever, or sweating. Muscle stiffness twitching/seizures, severe drowsiness or dizziness, confusion, problems with speech or balance.
Alternatives
Your pain specialist will have discussed alternatives with you in your consultation. Every patient is unique and therefore specific alternatives cannot be given on an information leaflet as not all treatments are suitable for everyone.
Contact Information
If you have any questions, please contact the Pain Management Team on Telephone:
01942 773099.