Tapentadol Vs Hydrocodone- Is Nucynta Stronger Than Hydrocodone?

 

Tapentadol Vs Hydrocodone is one of the most sought-after comparisons prevalent in people with severe chronic pain. So, let us break down the key features of these two effective opioid analgesics. 

Tapentadol and Hydrocodone are opioid pain medications approved by FDA for treating moderate to severe chronic pain. Over a period of time, both analgesics have shown impeccable efficacy and benefits, making their comparison very common. 

This Tapentadol vs Hydrocodone comparative study is an extensive evaluation to answer the following question to help you choose the right opioid analgesic. 

• Is Nucynta stronger than Hydrocodone?
• Can I take Nucynta with Hydrocodone?
• Nucynta vs Hydrocodone- Whis the best suited for you? 

 

Tapentadol Vs Hydrocodone- An Overview

Tapentadol, also known as the orange pain pill, is a centrally-acting analgesic with a dual mechanism of action that helps treat acute and chronic pain. Nucynta and Aspadol are popular tapentadol brand with similar effectiveness and is used as a generic Tapentadol.

 

Similarities And Differences

Even though Hydrocodone and Tapentadol are prescription opioid analgesics, a few characteristics set the two apart. Some frequently noted similarities and differences between Tapentadol and Hydrocodone are listed below [1,2].  

Affordability- 

According to the price listed on the website Drugs, the cost of Hydrocodone is $9.52 per pill [13]. On the contrary, Aspadol 100mg online at Health Naturo is $2.7 per pill. 

Hydrocodone and Aspadol prices and availability may differ based on the pharmacy and pill package. 

Legal status- 

The legal status of Tapentadol (Aspadol) in the different countries is listed below.

• AU- S8 (Controlled drug)
• UK- Class A (Schedule 2 CD)
• US- Schedule II
• CA- Schedule I
• EU- Rx-only
• DE- Anlage III (Special prescription form required).

On the other hand, the legal status of Hydrocodone is-

• US- Schedule II drug
• AU- S8 (Controlled drug)
• UK- Class A (Controlled drug)
• CA- Schedule I
• DE: Anlage III (Special prescription form required).

Composition- 

Tapentadol contains Tapentadol Hydrochloride as the active compound. The other inactive compounds present in its formulation are Microcrystalline Cellulose, Povidone K 30 USP, Polyvinylpyrrolidone, Colloidal Silicon Dioxide, Croscarmellose Sodium, and Magnesium Stearate.
Whereas Hydrocodone tablets are available in a combination of acetaminophen + hydrocodone and ibuprofen + hydrocodone for pain relief. It is also formulated with homatropine methylbromide as a cough medication.
It is available by itself as an extended-release formula under the brand name Zohydro ER.

Pill Identification- 

The Tapentadol 100mg tablet is an orange round tablet with "O-M" and "100" imprinted on each side of the tablet [3].
On the other hand, the Hydrocodone pill shape and color may vary depending on their strength and manufacturer. The most prevalent Hydrocodone shape is oval capsule-shaped. They may range from white, orange, and yellow in color [4].

Apart from these factors, a few other comparisons between Tapentadol and Hydrocodone are listed in the table below.

 

 

Nucynta Vs Hydrocodone- Working Mechanism

Hydrocodone- 

Following an oral administration, the Hydrocodone tablet is metabolized in the liver to form hydromorphone. The elimination is through the kidney. Clinical studies indicate hydromorphone to be responsible for the analgesic effect of Hydrocodone. The analgesic reaches the maximum serum concentration within one hour. 

Tapentadol (Nucynta)- 

The Tapentadol oral tablet is broken down in the liver and is eliminated through the kidney. It has 30 minutes of the onset of action and lasts for 5 to 6 hours. This analgesic has a dual mode of action and is effective in treating acute and chronic pain. 

 

Uses And Benefits 

Clinical uses and benefits of Hydrocodone 

• Hydrocodone is an effective treatment option for managing severe acute pain that does not often respond well to other medicines. It is, however, essential to note that Hydrocodone is not a PRN medication (administered as needed) and should be taken as prescribed by your physician.  
• It has an antitussive  (used for preventing or relieving a cough) property prescribed as a cough suppressant in adults [5]. 

 

 

Medical benefits of Tapentadol 

• The dual mechanism of action of Tapentadol makes it a much safer opioid choice in the market. With a low risk of abuse and dependency, Tapentadol can be used for long-term use. 
• It effectively treats acute pain following an injury and burns. 
• Tapentadol is prescribed for chronic musculoskeletal pain. 
• The analgesic property of Tapentadol helps control diabetic neuropathy that requires round-the-clock pain relief. 
• It is a better analgesic option for treating post-operative pain, according to a study by Tiziana D’Amato et al. comparing the effectiveness of Tapentadol and Oxycodone. 

 

Tapentadol Vs Hydrocodone- Dosage & Administration 

Proper dosing and administration of a medication ensure the best benefits with lower risks of experiencing side effects. The basic information one must have before taking Tapentadol and Hydrocodone is listed below. 

 

Tapentadol is an oral pill that should be swallowed without being broken or crushed. It can be taken two to three times a day, depending on the cause and severity of your condition. Patients with a hepatic disorder should maintain an 8-hour gap between two dosages. The Tapentadol analgesic should not be abruptly discontinued, as it can cause withdrawal symptoms. Thus, the Tapentadol tapering-off method is recommended by physicians, which involves lowering the dose of the drug before completely halting its use. 

Hydrocodone Dosing and Administration Regimen-

The initial dose of Hydrocodone recommended for beginners is 5mg every 4 to 6 hours. It is advisable not to take more than 8 tablets a day. Based on the severity of the pain, the dose can be increased up to 10mg. 

The Hydrocodone combination medications are available as oral tablets, capsules, and syrups. They should be taken every 4 to 6 hours as prescribed by your physician.

Taking the medicine at the same time every day enhances its benefits. While administering the oral syrup, do not use a regular spoon to measure the dose. Instead, use a properly marked dropper. 

 

Drug Interaction- Can I Take Nucynta With Hydrocodone?

Drug Interaction is a reaction between two or more medicines or compounds when co-administered. It can lower the effectiveness and potency of the drugs and increase the risk of side effects. 

People often take Tapentadol (Nucynta) with Hydrocodone for a better analgesic effect; however, mixing Tapentadol and Hydrocodone can cause serious drug interaction [6]. 

Taking Tapentadol with Hydrocodone can cause central nervous system depression, resulting in sedation, respiratory distress, and coma in severe cases. It may also increase the risk of hypotension (sudden drop in blood pressure). 

Hydrocodone can interact with 552 drugs, whereas Tapentadol can interact with 372 medications. A few other medicines that should not be taken with Tapentadol and Hydrocodone are listed below. 

 

 

Nucynta vs Hydrocodone- Abuse Potential 

Long-term use of Hydrocodone can be a significant cause of addiction. It is a prescription drug found in over 200 commercial products [8]. 

 

The Hydrocodone addiction symptoms include constipation, anxiety, slower heart rate, weight loss, headache, fever, breathing issues, nasal congestion, and tightness in the chest. Most of these signs can be treated as a clue for the concerned people to understand what is happening. Suspected people with Hydrocodone abuse may further witness-

• Blurry vision results in the person's inability to walk, focus, and bump into things and objects.
• It may result in confusion, affecting the person's ability to focus. 
• Signs of depression may appear as a lack of interest in socializing with friends and family. 
• If such people suffer from a seizure after taking the analgesic, it clearly shows Hydrocodone abuse [9]. 

The risk of Tapentadol addiction and abuse is low. A study indicates that Tapentadol is the least frequently abused opioid [10]. Another study confirms the low abuse risk of Tapentadol compared to other opioids due to its lower affinity for the mu-opioid receptor [11]. 

 

Three case studies conducted by a team of professionals showcase the ability of Tapentadol to cause addiction and dependency [12]. 

 

 

Case 1- A 20-year-old patient with 8 months of Tapentadol use and a history of substance abuse is seen to develop tolerance to Tapentadol within 1 month of use. 

 

Case 2- A 34-year-old man with nicotine and alcohol dependence experienced euphoria, hallucination, and a perception of time moving fast after taking Tapentadol 100mg. He developed cravings and tolerance within two months of use. Four years of Tapentadol use developed signs of dependency with no severe health risk. 

 

Case 3- A 30-year-old man taking Tapentadol 50mg for abdominal pain developed tolerance within 6 months. He also experienced a decrease in libido and erectile dysfunction. After 7 months of regular use, he noticed withdrawal signs such as body aches, fatigue, insomnia, and lack of self-confidence. 

 

Precaution And Warning

While taking Tapentadol and Hydrocodone, following the precautionary measures will lower the risk of side effects. 

• The use of Hydrocodone and Tapentadol can cause dizziness, sedation, and drowsiness, making it unsafe to operate heavy machinery and drive. 
• Taking alcohol with Tapentadol and Hydrocodone is not advised. It can increase the risk of experiencing dizziness and drowsiness. 
• The use of Hydrocodone with ibuprofen should be discontinued after 10 days of continuous use. 
• Tapentadol dose is not recommended for adults below 18 years of age. 
• Children and people below 18 years should take hydrocodone tablets or cough syrups after consulting a doctor. 
• People over 65 years should take the analgesic after consulting a doctor.
• The risk of addiction is higher in people with a history of abuse. 
• People with kidney, liver, and heart disorders should take Tapentadol and Hydrocodone dosage after consulting a doctor. 

 

Nucynta Vs Hydrocodone- Possible Side Effects 

Both Tapentadol and Hydrocodone can cause side effects; however, the severity of the adverse effect depends on the dose and the administration of the medication. Some of the notable side effects of Tapentadol and Hydrocodone are listed below. It is, however, important to note that this is not the complete list of all their possible health risks.