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Oxycodone vs Tapentadol

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Oxycodone and tapentadol are both prescription analgesic medications that are used to manage moderate to severe pain. (1) They both work by blocking pain signals in the brain, but they differ in their chemical makeup and how they affect the body. However, tapentadol is also a norepinephrine reuptake inhibitor, meaning it increases the levels of this neurochemical to assist with pain signal regulation. (2)

Only use prescription opioids, such as oxycodone and tapentadol, in accordance with a doctor’s instructions. Misuse can result in serious health issues, tolerance, dependence, addiction, and overdose. If you’ve been using opioids in ways they were not intended, you may have an opioid use disorder and could benefit from comprehensive addiction treatment.

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How Does Oxycodone Work?

Oxycodone is a potent painkiller that acts on certain brain receptors responsible for pain relief. It’s commonly used to manage pain related to conditions such as injury, surgery, or cancer. It is typically found in tablet form in both immediate-release (IR) and extended-release (ER) versions.

What Is Tapentadol?

Tapentadol (brand name Nucynta) is a relatively new opioid medication that also increases levels of norepinephrine, a neurotransmitter that helps regulate pain signals. (3) Tapentadol can be used to manage moderate-to-severe acute and chronic pain associated with conditions such as diabetic neuropathy and fibromyalgia. Like oxycodone, tapentadol is commonly found in both immediate- and extended-release tablets.

It’s important to note that although oxycodone and tapentadol are similar in terms of their pain-relieving properties, they are chemically different, and therefore their effects may vary.

Drug Classes & Scheduling of Tapentadol & Oxycodone

Both oxycodone and tapentadol are Schedule II controlled substances in the U.S., as assigned by the Drug Enforcement Administration. This classification indicates that both drugs have a high potential for misuse and can lead to psychological or physical dependence. Therefore, their use is heavily regulated by the government. (4)

How Are Oxycodone & Tapentadol Comparable?

There are many similarities and a few differences between oxycodone and tapentadol. These distinctions affect when and how these drugs are prescribed and administered.

Similarities Between Oxycodone & Tapentadol Include:

  • Management of moderate to severe pain.
  • Work by attaching to opioid receptors in the brain and spinal cord.
  • Side effects, such as dizziness, drowsiness, nausea, and constipation.
  • Potential to be habit-forming and lead to tolerance, dependence, and addiction.

Differences Between Oxycodone & Tapentadol Include:

  • Oxycodone is generally considered to be a stronger medication than tapentadol.
  • Tapentadol is a newer medication than oxycodone and has a different chemical structure.
  • Tapentadol has a dual mechanism of action, serving as both a painkiller and a norepinephrine reuptake inhibitor. (5)
  • Tapentadol use may be less likely to cause sedation, constipation, hyperalgesia, and respiratory depression than oxycodone, making the former a potentially safe option. (6)
  • Unlike oxycodone, at the time of this writing, tapentadol is not available in generic form, and therefore oxycodone may be more cost-effective. Generic versions are not expected to be released until after June 2025.

Medical Applications

Both oxycodone and tapentadol are used clinically to treat acute and chronic moderate to severe pain related to a variety of conditions.

Medical Applications for Oxycodone Include:

  • Pain related to injury, cancer, and surgery.
  • Cough suppression for persistent cough.
  • Relief from dyspnea (difficulty breathing) in those with advanced cancer or other terminal conditions. (7)
  • Occasionally, oxycodone is used as a component of general anesthesia during surgeries.

Medical Applications for Tapentadol Include:

  • Neuropathic pain related to damage or dysfunction of the central nervous system.
  • Chronic low back pain, a common condition often challenging to manage with other medications.
  • Pain related to fibromyalgia, a chronic condition marked by widespread tenderness and pain.

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Variations in Doses & Administration

Oxycodone and tapentadol are administered in similar ways, but they vary in terms of dosage. They are both available in IR or ER tablet form, as well as oral solutions taken with a dropper. Also, oxycodone is sometimes delivered intravenously in clinical settings.

Oxycodone Formulations & Dosages Include:

  • Immediate-release tablets that contain 5mg, 10mg, 15mg, 20mg, or 30mg for rapid pain relief with a duration of 4-6 hours.
  • Extended-release tablets that contain 10 mg, 15 mg, 20 mg, 30 mg, 40 mg, 60 mg, or 80 mg for prolonged pain relief for 12 hours or longer.
  • Oral solution that contains 5 mg of oxycodone per 5 mL of solution with a duration of 3-6 hours.

Tapentadol Formulations & Dosages Include:

  • IR tablets may contain 50 mg, 75 mg, or 100 mg for rapid pain relief with a duration of 4-6 hours.
  • ER tablets may contain 50 mg, 100 mg, 150 mg, 200 mg, or 250 mg for prolonged pain relief for 12 hours or longer.
  • Oral solution that contains 20 mg of tapentadol per 1 mL of solution with a duration of 3-6 hours.

Typical Adverse Side Effects of Oxycodone & Tapentadol Include:

  • Dizziness.
  • Profound sedation.
  • Impaired cognitive function.
  • Impaired motor skills.
  • Nausea and vomiting.
  • Constipation.
  • Respiratory depression.
  • Hyperalgesia (increased pain sensitivity).

Drug Interactions While Taking Oxycodone & Tapentadol

Oxycodone and tapentadol have several potential drug interactions in common. These may result in severe short-, long-term, or life-threatening effects. If you are using oxycodone or tapentadol, even as directed, you may need to avoid using other medications that can adversely interact with these opioids. If you have a valid prescription, make sure you inform your healthcare provider about any other medication you are taking.

Drug Interactions Include:

  • Central Nervous System Depressants—These include other opioids, benzodiazepines, barbiturates, and alcohol, which can increase the risk of respiratory depression, sedation, and other serious side effects.
  • Antidepressants—These include monoamine oxidase inhibitors (MAOIs), serotonin-norepinephrine reuptake inhibitors (SNRIs), and selective serotonin reuptake inhibitors (SSRIs), can lead to high blood pressure, hyperthermia, and serotonin syndrome, a potentially severe, life-threatening condition. (8)
  • Anticholinergics—These include antihistamines, antipsychotics, and tricyclic antidepressants, can increase the risk of side effects such as constipation, urinary retention, and blurred vision.
  • CYP3A4 inhibitors and inducers—These include certain antibiotics, antifungals, HIV medications, and some anticonvulsants.

Prices, Availability, & Accessibility

Oxycodone and tapentadol prices vary widely based on whether a patient’s payments are private, partially or fully covered by insurance, or subject to co-pays and deductibles. Prescription discount programs such as GoodRx can sometimes help with costs, regardless of whether the patient has insurance or not.

On average, generic oxycodone can be obtained for a nominal cost. For example, an oxycodone 5 mg oral tablet prescription can be purchased for around $13 for a 20-tablet supply, depending on the pharmacy. Because tapentadol is not available in generic form, it may be significantly more expensive without health insurance coverage. Even with a GoodRx coupon, 30 tablets of 50 mg Nucynta can cost as much as $285. (9)

Dangers of Dependence & Addiction

Like all opioids, oxycodone and tapentadol come with the risk of tolerance, dependence, and addiction. Tolerance is a condition that develops in response to repeated use of a substance and results in a reduction of both positive and negative effects over time. This encourages many individuals to use ever-increasing amounts of the drug to achieve the desired effects.

Tolerance and increased substance use can rapidly lead to dependence, another condition that develops over time in response to repeated exposure to drugs or alcohol. Physical dependence is a consequence of a person’s body becoming accustomed to the continual presence of a substance. When use is discontinued, withdrawal symptoms result, a product of the body struggling to re-establish chemical balance. These symptoms can be extremely unpleasant and include flu-like symptoms, such as dysphoria, shakiness, aches and pains, nausea, vomiting, and diarrhea.

Addiction is an all-encompassing term that describes the development of tolerance, physical and emotional dependence, and compulsive drug use despite experiencing adverse effects. For example, full-blown addiction is often associated with social isolation, damaged relationships, criminal activity, and financial issues that remain unaddressed regardless of the devastating effects they have on one’s life.

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If you or a loved one is struggling with opioid misuse or addiction, reach out to Guardian Recovery to learn more about our streamlined admissions process and full continuum of care. You can speak with a skilled Treatment Advisor and receive a free, no-obligation health insurance benefits check.

Through the use of medical detox, intensive inpatient and outpatient programs, evidence-based methodologies, and aftercare, we strive to provide individuals with the tools and support they need to overcome addiction and begin their journey to a healthier, more fulfilling life.

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Disclaimer: Does not guarantee specific treatment outcomes, as individual results may vary. Our services are not a substitute for professional medical advice or diagnosis; please consult a qualified healthcare provider for such matters.

  1. https://my.clevelandclinic.org/health/drugs/21483-analgesics
  2. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4942642/
  3. https://my.clevelandclinic.org/health/drugs/20516-tapentadol-extended-release-tablets
  4. https://www.dea.gov/drug-information/drug-scheduling
  5. https://www.sciencedirect.com/topics/pharmacology-toxicology-and-pharmaceutical-science/norepinephrine-reuptake-inhibitor
  6. https://my.clevelandclinic.org/health/symptoms/23550-hyperalgesia
  7. https://my.clevelandclinic.org/health/symptoms/16942-dyspnea
  8. https://www.mayoclinic.org/diseases-conditions/serotonin-syndrome/symptoms-causes/syc-20354758
  9. https://www.goodrx.com/nucynta

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Reviewed professionally for accuracy by:

Ryan Soave

L.M.H.C.

Ryan Soave brings deep experience as a Licensed Mental Health Counselor, certified trauma therapist, program developer, and research consultant for Huberman Lab at Stanford University Department of Neurobiology. Post-graduation from Wake Forest University, Ryan quickly discovered his acumen for the business world. After almost a decade of successful entrepreneurship and world traveling, he encountered a wave of personal and spiritual challenges; he felt a calling for something more. Ryan returned to school and completed his Master’s Degree in Mental Health Counseling. When he started working with those suffering from addiction and PTSD, he found his passion. He has never looked back.

Written by:

Cayla Clark

Cayla Clark

Cayla Clark grew up in Santa Barbara, CA and graduated from UCLA with a degree in playwriting. Since then she has been writing on addiction recovery and psychology full-time, and has found a home as part of the Guardian Recovery team.

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