Tapentadol - Availability and Dosage

Availability and Dosage

Tapentadol is available in the United States in both immediate release and extended release formulations as NUCYNTA® and NUCYNTA ER®, respectively, from Janssen Pharmaceuticals. The immediate release formulation is provided in 50 mg (yellow), 75 mg (orange), and 100 mg (red/orange) tablets, to be used once every 4–6 hours as needed to control pain, up to a maximum dose of 600 mg per 24 hour period (700 mg on day one). The extended release formulation is provided in 50 mg (white), 100 mg (very light blue), 150 mg (light blue), 200 mg (blue), and 250 mg (dark blue). The extended release dosage starts at 50 mg twice a day, and is then slowly titrated to an effective and tolerable dose in the range of 100 mg-250 mg twice a day, with a maximum dose of 500 mg (250 mg twice a day) per 24 hour period. The dosage and preparation used should be frequently re-evaluated by the prescribing physician, and the dose should be lowered if possible to the lowest effective dose if pain decreases.

All preparations of NUCYNTA® contain only the (R,R) stereoisomer, which is the weakest isomer in terms of opioid activity. (See "Tramadol" for more information on tapentadol's chemistry)