Oxycodone vs Tapentadol

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.