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Tapentadol (Aspadol)- A Promising Treatment for Regional Pain Syndrome

Tapentadol (Aspadol)- A Promising Treatment for Regional Pain Syndrome


Tapentadol, marketed under the brand name Aspadol, presents a promising treatment option for Regional Pain Syndrome (RPS). By targeting multiple pathways involved in pain modulation, tapentadol offers the potential for effective pain relief with potentially fewer opioid-related side effects compared to traditional opioids. However, its use should be carefully considered, with close monitoring by healthcare providers to optimize pain management while minimizing risks.



Regional Pain Syndrome (RPS) is a complex condition characterized by persistent pain in a specific region of the body, typically following injury or trauma. Managing RPS presents a significant challenge due to its multifaceted nature and varying response to conventional pain medications. However, amidst this challenge, Tapentadol, marketed under the brand name Aspadol, emerges as a promising therapeutic option.

In recent years, clinical studies have demonstrated the efficacy and tolerability of getting Aspadol or Tapentadol to alleviate RPS-associated pain and enhance the overall quality of life for affected individuals. It provides effective pain relief and also mitigates the risks commonly associated with traditional opioids, such as respiratory depression and dependence.

This article aims to explore the pharmacological characteristics of Tapentadol, its clinical benefits in the treatment of RPS, and its implications for the future.


Introduction To Tapentadol And  Regional Pain Syndrome (RPS)

Aspadol, the brand name of Tapentadol, is a centrally acting analgesic medication used primarily for the management of moderate to severe pain. Also known as the orange pain pill, it exhibits a dual mechanism of action, acting as both a mu-opioid receptor agonist and a norepinephrine reuptake inhibitor. This unique pharmacological profile provides effective pain relief while potentially reducing the risk of opioid-related side effects such as respiratory depression and constipation.

Tapentadol is only available as brand drugs and thus is retailed as Aspadol, Nucynta, or Palexia pills. 

Regional Pain Syndrome (RPS), also known as Complex Regional Pain Syndrome (CRPS), is a chronic pain condition that typically affects one limb, often after an injury or trauma. RPS is characterized by persistent, disproportionate pain, usually accompanied by changes in skin color, temperature, and swelling in the affected area. The exact cause of RPS is not fully understood, but it is believed to involve abnormal nervous system responses and inflammation.


The Role Of Tapentadol In Regional Pain Syndrome Management




Tapentadol helps manage regional pain syndrome by inculcating a dual mechanism of action. The Aspadol Extensive Release (ER) formulation is advisable for managing chronic pain associated with complex region pain syndrome. 

Mu-opioid receptor agonism

Tapentadol works primarily through agonism at mu-opioid receptors in the central nervous system (CNS). Tapentadol controls the transmission of pain signals thus reducing body pain by binding to these receptors.

Norepinephrine reuptake inhibition

It also inhibits the reuptake of norepinephrine, a neurotransmitter involved in the descending inhibitory pain pathways. 

This dual modulation of both ascending nociceptive pathways (via mu-opioid receptor agonism) and descending inhibitory pathways (via norepinephrine reuptake inhibition) contributes to Tapentadol's analgesic efficacy.


Clinical Trials Involving Tapentadol For RPS

Based on 58 member reports published by the website stuffthatworks, Tapentadol is not commonly tried and used for managing RPS [1]. The potency of effectiveness reported by the websites is listed below. 





Worked extremely well


Worked very well 


Worked fairly well 


Not significant


Dosage Recommendations And Administration Guidelines 

The recommended dosage of Aspadol is 100 mg. The maximum recommended daily dose is 700 mg.

Patients should be educated about the importance of adhering to the prescribed dosage regimen and avoiding dose changes without medical supervision.

Administration Guidelines-

  • Aspadol for renal pain syndrome should be taken not more than three times a day. 

  • It should be administered orally. 

  • Maintain a dosage gap of 12 hours for Aspadol ER.  

  • Tablets should be swallowed whole and can be taken with or without food.

  • Tapentadol should be tapered gradually to minimize the risk of withdrawal symptoms in patients who have been receiving prolonged treatment or who may be at risk of opioid dependence.

Health Concerns And Safety Profile Of Tapentadol 

  • Close monitoring of patients receiving Tapentadol is recommended.

  • It is essential to inform patients about the potential risks of Tapentadol, including respiratory depression, sedation, and opioid dependence.

  • Tapentadol may cause drowsiness and impair cognitive and motor functions. Patients should avoid activities requiring mental alertness, such as driving or operating heavy machinery.

  • It can cause hypotension (low blood pressure), especially during the initial stages of treatment or when doses are increased.

  • Its use during pregnancy and breastfeeding is not advisable [2]. 


Importance Of Holistic Management In RPS

Holistic management addresses both physical and psychological symptoms

The alternative therapies include the following ways-

  • Trying physical therapies that target the specific affected area may help. 

  • Heat therapies are advisable.

  • Doing gentle exercises such as yoga can help reduce pain in joints and tissues. 

  • Switch to diets that help in reducing inflammation or try supplements such as fish oil and vitamins. 

  • Using topical pain medications such as capsaicin cream or lidocaine cream [3]. 


Our Final Thoughts On The Use of Tapentadol For RPS

It is important to note that Tapentadol is not the first-line treatment for complex regional pain syndrome, but it is an effective solution to managing chronic body pain within 30 minutes of intake. It also comes without the health risks associated with the other opioid pain medication often prescribed for chronic pain management. 

Aspadol can cause dependency if used for the long term and thus must be taken under the supervision of a physician. 


Tapentadol, or its brand drug, can be used for both acute and chronic pain.

Yes, the use of Tapentadol is advised for nerve pain.

It takes 30 minutes for Tapentadol to help manage complex regional pain syndrome.


  1. Tapentadol in Complex Regional Pain Syndrome, stuffthatworks.

  2. Tapentadol: MedlinePlus Drug Information, medlineplus. 

  3. Alternative Therapies to Treat Complex Regional Pain Syndrome (CRPS), sapnamed.