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Nucynta vs. Oxycodone: Comparing Pain Management Options

Nucynta vs. Oxycodone: Comparing Pain Management Options

Nucynta (Tapentadol) is a much more potent and safer choice of analgesic over Oxycodone, with a faster onset of action and lower risk of abuse. Its unique dual mechanism of action makes it more effective in treating acute and chronic body pain. In comparison, Oxycodone is a better therapeutic option for people looking for affordable opioid pain medicine.

Pain management is a critical aspect of healthcare, with various medications available to address different types of pain. Among the widely used options are Nucynta (Tapentadol) and Oxycodone, both effective in relieving moderate to severe pain. While they share similarities as opioid analgesics, they differ in mechanisms, benefits, side effects, and potential risks. This blog explores the key differences between Nucynta and Oxycodone, helping patients and healthcare professionals make informed decisions about their use.

Nucynta And Oxycodone- An Overview Of Pain Medication

Nucynta and Aspadol are the brand names of Tapentadol, a novel centrally-acting opioid analgesic with a dual mechanism of action. It has an improved side effect profile than other opioids and nonsteroidal anti-inflammatory drugs. The use of Aspadol for Pain Relief is recommended for severe chronic pain.

Tapentadol hydrochloride was first synthesized in the USA and marketed by Ortho-McNeil-Janssen Pharmaceuticals. It is orange in color and is considered one of the key identification factors for Tapentadol.

nucynta-and-oxycodone-an-overview

Oxycodone is a semi-synthetic opioid pain medication found in several products combined with other drugs, such as Oxycocet and Percocet. It was synthesized in 1917 and is increasingly used to treat acute and chronic non-malignant pain.

Similarities Between Oxycodone & Nucynta

There are three notable similarities between Nucynta and Oxycodone, including drug class, FDA approval, and Drug schedule, that should be considered while choosing the right therapeutic option.

Drug Class

Both Oxycodone and Nucynta are opioid pain medications.

Prescription opioids are powerful analgesics that relax the body to provide effective relief from pain.

FDA Approval

The clinical use of Oxycodone was approved by the U.S. Food and Drug Administration (FDA) in the year 1996.

The use of Nucynta was approved in the United States on 24 December 2008.

Classification And Labeling (Drug Schedule)-

Both Oxycodone and Tapentadol are Schedule II prescription drugs under the Controlled Substances Act (CSA) by the Drug Enforcement Administration (DEA).

Schedule II drugs are narcotics or opioid medications with a high abuse risk causing severe psychological or physical dependence. However, they are considered safe for medical use in the United States.

Nucynta Vs Oxycodone- Key Differences

When selecting the right opioid analgesic, knowing their distinct differences is crucial. The key distinct factors that we consider are generic and brand names, their manufacturers, structural differences, pregnancy categories, user reviews, and cost differences.

Generic And Brand Names-

Tapentadol Hydrochloride is available under the brand names Nucynta, Aspadol, and Palexia. No lower-cost generic Tapentadol is available in the market to date.

Oxycodone Chloride is available under the trade names OxyContin and Endone. It is also available as a generic tablet.

Manufacturer-

The brand drugs are manufactured and marketed by their pharmaceutical company. Thus, Nucynta is manufactured by Janssen Pharmaceuticals, Inc., whereas 1995-established pharmaceutical giant Signature Pharmaceuticals Ltd manufactures Aspadol.

Oxycodone, on the other hand, was manufactured by Purdue Pharma, Connecticut, U.S., which is currently restructuring as Knoa Pharma due to bankruptcy and legal issues.

Active Ingredients

Nucynta contains Tapentadol, which has dual mechanisms, mu-opioid receptor agonism, and norepinephrine reuptake inhibition. Oxycodone is the active compound in the formulation.

Pain Relief Mechanism

Nucynta provides pain relief through both opioid activity and modulation of norepinephrine, making it effective for neuropathic pain as well as nociceptive pain.

Whereas Oxycodone targets pain through opioid receptor binding, primarily effective for nociceptive pain.

Pregnancy Safety

Oxycodone is classified as a category B pregnancy medication, whereas Tapentadol is categorized as category C.

Category B medications do not demonstrate a risk to the fetus in animal studies, with no adequate and well-controlled studies in pregnant women. On the other hand, Category C drugs are medications with notable adverse effects on the fetus during animal studies with no reported and well-controlled studies in humans.

Ratings And Reviews

Tapentadol has an average user rating of 6.2 out of 10 from a total of 426 reviews, and Oxycodone has a rating of 6.8 out of 10 from 1,114 reviews on the website Drugs [2,3].

Insurance Coverage & Cost Comparison

The cost of Nucynta and Oxycodone is covered by most insurance companies as their medical use is approved by the FDA.

Healthnaturo retails Aspadol 100 mg tablets at $2.7 per pill. In comparison, the cost of 5 mg oral tablets of Oxycodone is $58 for 100 capsules [4]. However, its cost may vary based on the pharmacy and the pill package.

Oxycodone Vs Nucynta- A Comparison of Their Uses

Oxycodone Uses

Acute Pain:

  • Often prescribed for short-term pain after surgery or injury.

  • Effective for moderate to severe pain where rapid relief is required.

Chronic Pain Management:

  • Used in conditions like arthritis or lower back pain when other treatments are insufficient.

  • Available in extended-release forms for consistent relief.

Cancer Pain:

  • A common choice for managing severe pain in cancer patients.

  • Often used as part of palliative care.

Post-Surgical Pain:

Highly effective for managing pain immediately after surgical procedures.

Nucynta (Tapentadol) Uses

Neuropathic Pain:

  • Approved for diabetic peripheral neuropathy in adults.

  • Especially effective due to its norepinephrine reuptake inhibition properties.

Moderate to Severe Acute Pain:

  • Commonly used for pain from musculoskeletal injuries such as fractures or sprains.

  • Also prescribed for short-term post-operative pain.

Chronic Pain Conditions:

  • Used for long-term pain conditions when other opioids cause intolerable side effects.

  • Extended-release formulations are effective for managing consistent, moderate to severe pain.

Mixed Pain Types:

Suitable for conditions involving both nociceptive and neuropathic pain, such as complex regional pain syndrome.

A Comparison Of Tapentadol And Oxycodone Benefits

The comparison of the benefits helps identify the unique and distinct advantages of these prominent analgesics, further highlighting their efficacy and potency.

Benefits of Tapentadol

  • Nucynta is considered a next-generation opioid pain medication by Dewan Roshan Singh et al. in a 2013 study.

  • Its analgesic efficacy is similar to that provided by morphine, with an improved side effect profile.

  • It is the first FDA-approved analgesic with mu-opioid receptor (MOR) agonist and noradrenaline reuptake inhibition (NRI) action, based on a 2013 study by Dewan Roshan Singh et al.

  • Tapentadol or Nucynta has a better Gastrointestinal (GI) tolerability than oxycodone, says Nalini Vadivelu in a 2022 scientific review [5].

Benefits of Oxycodone

  • Oxycodone has a rapid onset of action due to its higher permeability across the blood-brain barrier, as suggested by a 2013 study by Klaus T. Olkkola et al.

  • Oxycodone is a safer pain medication than morphine.

Oxycodone And Nucynta Administration

  • The extended-release tablets of Nucynta and Oxycodone should not be taken with other around-the-clock opioid medication.

  • Do not chew or crush these tablets to avoid immediate and quick exposure to the active compounds that may result in a potentially fatal overdose.

  • These oral capsules and tablets should be swallowed with water.

  • Snoring Nucynta or oxycodone by crushing them into a fine powder and inhaling it through the nose is not advisable and may result in nosebleeds, runny nose, and damage to the nasal cavity. It also increases the risk of experiencing hypoxia, disorientation, slowed breathing, and overdose.

  • The Oxycodone oral solution should be measured correctly before administering. It is advised to use the dosing syringe provided with the medication. Do not use a kitchen spoon to measure the oral solution.

  • Abrupt discontinuation of Nucynta and Oxycodone treatment is not advisable as it increases the risk of experiencing withdrawal symptoms. The dosage of these opioid medications should be gradually lowered following a doctor's instruction.

Author's Note- Never share your opioid medicine (both Tapentadol and Oxycodone) with others, especially someone with a history of drug abuse, without consulting a doctor.

Oxycodone Vs Tapentadol- A Comparison Of Their Effectiveness

The effectiveness of both Oxycodone and Tapentadol can be drawn based on their onset of action, half-life, time needed to reach peak concentration, and duration of action.

Features

Oxycodone

Tapentadol

Onset of action

Oxycodone IR- 30 minutes

Oxycodone CR- 1 hour.

Thirty minutes for both Immediate and Extensive Release tablets.

Half-life

2 to 3 hours.

4 hours.

Serum concentrations peak

One to two hours.

1.25 hours.

Duration of action

Oxycodone IR- 3 to 6 hours

Oxycodone CR- 10 to 12 hours.

Tapentadol IR- 5 to 6 hours

Tapentadol ER- 12 hours.

The above comparison of the Tapentadol and Oxycodone dosage indicates that Nucyta has a faster onset of action and longer duration of action.

Tapentadol Vs Oxycodone- Side Effects And Safety Concerns

Improper dosing, administration, allergic reaction to the compounds in the medication, or having a history of any health disorder may lead to side effects. Ten common side effects of both Oxycodone and Tapentadol are listed below. It is, however, essential to note that this is not a complete list of all their possible health risks. If you experience any health concerns after taking either of the two opioid medications, it is recommended to consult a doctor immediately.

Sign And Symptoms

Tapentadol Frequency

Oxycodone Frequency

Indication

Vomiting

18%

12%

Do not require immediate medical help

Nausea

30%

23%

Do not require immediate medical help

Headache

Not common

7%

Do not require immediate medical help

Dry mouth

4%

6%

Do not require immediate medical help

Excessive sweating

Not common

5%

Do not require immediate medical help

Constipation

8%

23%

Do not require immediate medical help

Dizziness

24%

13%

In severe cases, consult a doctor

Weakness

Not common

6%

In severe cases, consult a doctor

Sleep issues

2%

Not common

Do not require immediate medical help

Itching

5%

Not common

Do not require immediate medical help

Tapentadol And Oxycodone- Drug Interaction

Both Tapentadol (Nucynta) and Oxycodone pain medications are metabolized by CYP enzymes, making them more susceptible to drug interactions.

Tapentadol can interact with 377 medications, whereas Oxycodone can interact with 573 known medications and chemical compounds.

Factors

Tapentadol

Oxycodone

Disease Interaction

14 Disease Interactions

16 interaction.

Major or Severe Interaction

184 severe interactions

208 Major interaction.

Moderate Interaction

189 Moderate interaction.

364 Moderate Interaction.

Minor Drug Interaction

1 minor interaction.

1 minor interaction.

Of the 374 known drug interactions, the common medications that should not be taken with Tapentadol are Alprazolam, Baclofen, Cyclobenzaprine, Carisoprodol, Fentanyl, Gabapentin, Hydrocodone, Lorazepam, Methocarbamol, Morphine, Methadone, Oxycodone, and Pregabalin.

Whereas Atazanavir, Butalbital, Baclofen, Clonazepam, Carisoprodol, Dantrolene, Erythromycin, Hydromorphone, Itraconazole, Ketoconazole, Ketamine, Methocarbamol, Rifampin, Ritonavir, Tramadol, Zolpidem, and Zaleplon are some medications that should not be co-adminstered with Oxycodone.

Can You Take Nucynta With Oxycodone?

The intake of Oxycodone with Tapenatdol is not advisable as it results in a major or severe drug interaction.

Taking them together causes Central nervous system depression that causes side effects including coma, profound sedation, and respiratory distress.

Nucynta Vs Oxycodone- Our Final Thoughts

Nucynta (Tapentadol) is hands down the better choice of opioid pain medication over Oxycodone due to its high potency and efficacy, safety profile, and lower risk of abuse and side effects. However, if pricing is a major factor of differentiation for you, we suggest Oxycodone tablets only if that is the case.

We have elaborated on our reasoning for choosing Tapentadol over Oxycodone one last time in the table below.

Tapentadol vs Oxycodone Pros and Cons in a Glimpse-

Factors

Tapentadol

Oxycodone

Pros

  • Fast onset of action

  • Nucynta ER has 12 hours of action, whereas IR tablets work for 5 to 6 hours.

  • Advisable for both acute and chronic pain

  • It has a lower risk of abuse.

  • Tapentadol has lesser chances of drug interaction compared to Oxycodone.

  • Chances of causing Respiratory depression are low.

  • The manufacturer of Nucynta or Aspadol is more reputable, and there is no legal trouble with the production of the medication.

  • Oxycodone CR acts for 10 to 12 hours.

  • Generic Oxycodone tablets act for 3 to 6 hours.

  • It can be taken for acute and chronic Pain.

  • More affordable.

Cons

  • Long-term use of Nycunta or Aspadol is not advisable.

  • Nucynta's price is comparatively higher.

  • Its use can impair and make it unsafe for people to drive and use heavy machinery.

  • It is not effective for treating all kinds of pains.

  • The long-term use of Oxycodone can cause dependency.

  • It has a lower safety profile with a higher risk of abuse.

  • One should not drive and use machines after the intake of the analgesic.

  • The chances of causing respiratory depression are high.

  • The manufacturer of Oxycodone is facing a lawsuit against the wide occurrence of overdose deaths associated with Oxycotin (The brand name of Oxycodone).

Author’s Note- The conclusion drawn in this comparative study of Tapentadol vs Oxycodone is based on our understanding and findings. It may differ from the diagnosis made by your physician after evaluating your health condition and previous medical his

FAQ's

Tapentadol is better than Oxycodone due to its higher potency and lower risk of abuse and side effects.

Tapentadol is better for Fibromyalgia as it has a faster onset of action and higher analgesic efficacy.

Both Tapentadol and Oxycodone can cause drowsiness.

Yes, Tapentadol is less addictive than Oxycodone due to its noradrenaline reuptake inhibition, which increases the level of noradrenaline in the body.

Yes, Tapentadol IR has a longer action duration than Oxycodone IR. Also, the incidence of constipation and nausea was significantly lower with Tapentadol IR than with Oxycodone.

References-

  1. Damage From OxyContin Continues to Be Revealed, nytimes. 

  2. Oxycodone User Reviews & Ratings, Drugs. 

  3. Tapentadol User Reviews & Ratings, Drugs. 

  4. Oxycodone Prices, Coupons and Patient Assistance Programs, Drugs. 

  5. Patient considerations in the use of tapentadol for moderate to severe pain, tandfonline. 

  6. Long-term safety and tolerability of tapentadol extended release for the management of chronic low back pain or osteoarthritis pain, PubMed. 

  7. A Study to Evaluate the Efficacy, Safety, and Tolerability of Tapentadol ER Compared With Placebo in Patients With Chronic, Painful Diabetic Peripheral Neuropathy, clinicaltrials.gov. 

  8. Nucynta Dosage, Drugs.