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Tapentadol: Can It Kill Two Birds with One Stone without Breaking Windows?

  • Chang, Eun Jung (Department of Anesthesia and Pain Medicine, School of Medicine, Pusan National University) ;
  • Choi, Eun Ji (Department of Anesthesia and Pain Medicine, School of Medicine, Pusan National University) ;
  • Kim, Kyung Hoon (Department of Anesthesia and Pain Medicine, School of Medicine, Pusan National University)
  • 투고 : 2016.06.21
  • 심사 : 2016.06.28
  • 발행 : 2016.07.01

초록

Tapentadol is a novel oral analgesic with a dual mode of action as an agonist of the ${\mu}$-opioid receptor (MOR), and as a norepinephrine reuptake inhibitor (NRI) all in a single molecule. Immediate release (IR) tapentadol shows its analgesic effect quickly, at around 30 minutes. Its MOR agonistic action produces acute nociceptive pain relief; its role as an NRI brings about chronic neuropathic pain relief. Absorption is rapid, with a mean maximal serum concentration at 1.25-1.5 h after oral intake. It is present primarily in the form of conjugated metabolites after glucuronidation, and excretes rapidly and completely via the kidneys. The most common adverse reactions are nausea, dizziness, vomiting, and somnolence. Constipation is more common in use of the ER formulation. Precautions against concomitant use of central nervous system depressants, including sedatives, hypnotics, tranquilizers, general anesthetics, phenothiazines, other opioids, and alcohol, or use of tapentadol within 14 days of the cessation of monoamine oxidase inhibitors, are advised. The safety and efficacy have not been established for use during pregnancy, labor, and delivery, or for nursing mothers, pediatric patients less than 18 years of age, and cases of severe renal impairment and severe hepatic impairment. The major concerns for tapentadol are abuse, addiction, seeking behavior, withdrawal, and physical dependence. The presumed problem for use of tapentadol is to control the ratio of MOR agonist and NRI. In conclusion, tapentadol produces both nociceptive and neuropathic pain relief, but with worries about abuse and dependence.

키워드

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피인용 문헌

  1. Comparative pharmacology and toxicology of tramadol and tapentadol vol.22, pp.5, 2018, https://doi.org/10.1002/ejp.1196
  2. Cardiac Arrest Following Drug Abuse with Intravenous Tapentadol: Case Report and Literature Review vol.18, pp.None, 2016, https://doi.org/10.12659/ajcr.904695
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  4. Tapentadol, the new kid on the block in India: Is it time to worry? vol.62, pp.6, 2020, https://doi.org/10.4103/psychiatry.indianjpsychiatry_332_20
  5. Dual μ-opioid receptor and norepinephrine reuptake mechanisms contribute to dezocine- and tapentadol-induced mechanical antiallodynia in cancer pain vol.876, pp.None, 2016, https://doi.org/10.1016/j.ejphar.2020.173062
  6. Repeated Administration of Clinical Doses of Tramadol and Tapentadol Causes Hepato- and Nephrotoxic Effects in Wistar Rats vol.13, pp.7, 2020, https://doi.org/10.3390/ph13070149
  7. Sublingual delivery of chondroitin sulfate conjugated tapentadol loaded nanovesicles for the treatment of osteoarthritis vol.31, pp.1, 2021, https://doi.org/10.1080/08982104.2020.1730400