Added: Carlos Hirst - Date: 07.10.2021 00:57 - Views: 30698 - Clicks: 3191
Dr Casey Parker. Now, I am a simple rural doctor. When I saw the name tapentadol , I immediately assumed that it was a new version of tramadol, but with more letters to confuse the chaps over at the patent office. I was sort of correct. Tramadol is a prodrug. It gets metabolised in the liver by the cytochrome p enzymes into a few active chemicals.
But here is the problem — the actual amounts of each of the active metabolites is a bit of a genetic lottery. To some extent, you can ask a patient what effects they felt if they had a dose of tramadol ly. In my experience, you get pretty clear likes or aversion to tramadol. Then then there is the risk of serotonin syndrome and seizures. So, how is the new kid on the block different? Tapentadol is not a prodrug — it does not rely on metabolism to get it working. So it is what it says on the box — an opioid analgesic.
In addition: it has a strong mu-opioid receptor agonist effect, similar to oxycodone it has noradrenaline reuptake inhibitory effects, but not much effect on serotonin reuptake, which makes it a little cleaner there are no active metabolites yet known — so that sounds cleaner, too. That all sounds nice and neat. A cleaner, direct-acting opioid with fewer side effects. But there must be a catch, right? There always is. The biggest issue is that there is just not enough data available about the safety or efficacy of tapentadol.
In the trials used to get it registered, the drug was only just better than a placebo for chronic pain. We need to see some real-world safety data and clinical outcome studies to say exactly how much benefit this drug has. As with any potent opioid, tapentadol is to be used with caution in patients with respiratory failure, other sedatives or noradrenergic agents.
It needs to be avoided for at least two weeks after ceasing monoamine oxidase inhibitors MAOIs such as moclobemide though this is rarely used in Australia. Tapentadol side effects are predictable: constipation, nausea and vomiting with some dizziness in up to a third of patients. The risk of developing tolerance and potential for abuse or diversion is likely to be similar to other opiates once the word gets out. This is definitely one to watch carefully when prescribing. In summary Tapentadol is probably better than tramadol. It has a more predictable pharmacology, but the evidence is not yet in.
Watch this space. to comment. Have been on Tapentadol mg slow release for chronic knee pain and arthritic pain for approx 6 months. I tend to have addictive traits. Smoker until 6 yrs ago. Drinker Moderate most days yet i can not say the Tapentadol has any addictive draw to me.
Even now i can stop taking it for a few days without withdrawls except return of increased pain. Anyway better than the highly addictive Oxy meds. Wow, this was an interesting read! I see now that I am in the latter category, the one that builds up tolerance. And that's a shame, because I'm terrified of drugs like these, but my pain was overwhelming. When I started taking it, I could do with a day, and I had days where I didn't take any- mainly because I was too scared, not because the pain had lessened.
Now my dose is anywhere from in 24 hours, where 5 is a really bad day. I never take 2 at once, being a scaredy cat, and I monitor very intently when I took the pill. I was considering talking to my doctor about going cold turkey, but honestly I'm afraid of the pain becoming worse - and then have no form of lessening it.
Should I try this other one, or just quit it all and see how it goes? Been with chronic pain for nearly 5 years now, and I'm 25 years. I'm tired of being in pain and tired of being tired.. Thank you for this post! Very informative, and a fun read.
Charlotte, you poor girl, 25 and in so much pain! Good luck I hope you get this as this post is fairly old. I have been experiencing pain and tingling in my left arm, which was later diagnosed as from a pinched nerve around C7 in my neck. Had Endone for 2 weeks for pain management, did not like it.
GP prescribed Targin - did not like, very wary of addictive properties of these oxycodones. While waiting to see neck specialist, GP suggested Palexia 50mg sustained release Tapendatol. Started with 2 at night, got down to 1 per night within a fortnight. Used 2 hours before successful MRI. When I finally got from neck specialist he deferred possible surgical procedure due to my controlled pain situation. Have now been off Palexia for over a week. Have 2 paracetamol tablets a day. Feel confident now that Palexia's Tapendatol worked well in my situation with less side effects than the oxycodones.
The mu-opioid receptor effect is much weaker than oxycodone. It is very effective, however, because unlike oxycodone it also utilizes noradrenaline. My has had chronic pain for over five years tried everything from dry needling nerve blocks nothing worked her doctor gave her palexia to try. First time she took it she was pain free so excited. But this was the start of hell for me she got euphoric feeling from it then she started taking higher does she would be erratic at night scratching herself talking constantly totally different person then sleep till 2 in the afternoon because it kept her up all night.
Opioids maybe great for short term pain but they should never be given to someone with chronic long term pain. I've had a really unusual experience with taking Palexia IR before I get out of bed in the mornings. I would do this to get on top of the pain and then take 50 mg with breakfast. The pain has been extreme for 6 approx months. I did this as my usual beginning of the day but the pain felt like it fort back angrily. It was excruciating and now as I have stopped taking the IR before I suffer every morning. Have I finally gone mad. Thanks for a very straightforward and easy to understand analysis, I've been on oxycodone for sometime now and it's ceased to be effective except at doses that are becoming way in excess of what I'm comfortable with, my pain specialist wants to shift me over to Tapentadol but I like to research these things before I agree to it Been on mg SR Tramadol for about 9yrs due to chronic back pain from horse riding accidents.
Not game to try this other drug for fear of it not working and being in constant pain again. Aint broke dont fix it i say. I have been in cronic pain for about five yes , from a pain in the tummy to sever cronic pain, and nobody can tell me what it is, I have had every test, every scan, every thing that is going, I have taken TARGIN 30mls for about two years and I have had to fight doctors to get it, it is the only medicine that gives me relief.
I have moved to another doctor because my doctor I was seeing for two years refused to give me any medication at all i was in bed and my husband tried to find out what was going on and I am going to another doctor and the same thing I have to beg for help, what is another medicine that is available to me , I can't go on much longer please help. Been on panadeine forte for many years after a multi trauma accident.
Have tried Tapentadol and no nausea. Only take prn. Seems to do the trick. My daughter was prescribed palexia in by her gp for chronic shoulder and neck pain. From the first dose she was hooked on it after 3 months on it became suicidal. Her doctor told her to stop taking it but it was too late she dependant on it getting it from other doctors and different medical reasons. Then got it off a friend without prescription on line and ended up in a bad place. She is now getting help from her pain specialist to taper off it.
It has been over 2 years of hell and still a long way to go. It destroys people and there families. Done everything… Used used et cetera and lost good friends. Went back to Sydney after almost 10 years as couldn't work in construction anymore. Had a pharmacy background and when started at the rehab center ass disp tech and told the pharmacist about tramadol in , with ABIs were switched much to their distaste. Only recently heard of tramadol derivative and in currently ketamine infusion to reset Receptors. At one stage I was the second highest prescribed pain NSW on the equivalent of 5 to 7 g of Morphine, wish I could have started biogenic straightaway.
I lifted people and my back was bad. Did everything in the book. Have taken analgesia since ageMedications similar to tramadol
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Old doc, new drugs: Tapentadol versus tramadol