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Tapentadol Versus Tramadol - What you must know

Tapentadol Versus Tramadol - What you must know

Tapentadol Vs. Tramadol is an extensively talked about comparison for its high potency in treating chronic pain in users. Suffering from such pain is one of the most common reasons for people seeking medical help as it restricts their mobility. A survey report by CDC states that about 20.8% of American adults struggle with body pain [1]. Most chronic pain does not respond well to the conventional analgesic and requires more potent treatment options. Two common FDA-approved analgesics to be prescribed for severe pain are Tapentadol and Tramadol. This pharmacological comparison of Tapentadol and Tramadol is to help treaders make a better decision between the two extensively popular opioid pain medications.


Tramadol Vs. Tapentadol( legislation Status )

Before we begin comprehending the differences and similarities between Tapentadol and Tramadol, it is significant to have better insight into these analgesics. Both the pain medication are centrally acting and helps in treating acute and chronic pain. However, Tapentadol is a relatively new painkiller on the market. It belongs to the Benzenoid class of drugs with a dual-mode of action. Tramadol is considered the second option for pain treatment by WHO (World Health Organisation) and shows about 1/10th the potency of morphine [2]. 




Generic Name 



Brand names

Nucynta, Aspadol 



Cadila Pharmaceuticals Ltd

Zydus Cadila Healthcare Ltd

FDA approval 

Yes in the year 2005

Yes, in the year 2008

Legal status 

Australia (controlled drug)

Canada (Schedule I)

UK (Schedule II)

USA (Schedule II)

Australia (Prescription only)

Canada (Prescription only)

UK (Schedule III)

USA (Schedule IV)

Elimination half-life

4 to 6 hours

2 to 6 hours


Urine and feces


Best Price

$2.77 $7.11

Structural Difference between Tapentadol & Tramadol

Tapentadol and Tramadol are synthetic opioids and are structurally related. They show enhanced therapeutic effects from combining the monoamine reuptake inhibitor and their opioid receptor [3].




The above figure from Practicalpainmanagement shows that both Tapentadol and Tramadol analgesics are phenypropylamines. Even though both pain medications work as opioid receptor agonists, they differ in their binding affinity. In a study of Tapentadol vs. Tramadol, the latter has a binding relationship six thousand times less than morphine. In comparison, the binding factor of Tapentadol is 18 times less than morphine. Thus, distinguishing Tapentadol as a much more efficient analgesic of the two[4]. 

Tapentadol & Tramadol- Similarities Assessment 

Both the analgesics showcase resemblances on specific comparative grounds, making it hard for most users to decide. 





Analgesic effect




30 minutes from intake 

30 minutes from intake 

Duration of action

6 hours 

Nucynta IR- 4 to 6 hours [5]

Nucynta ER- 10 to 12 hours

Long-term usage 

For not more than three weeks of continuous use 

For not more than three weeks of constant usage 

Pregnancy indication

Not advised 

Not advised 

Class of drug

Opioid Analgesic 

Opioid Analgesic 

Age restrictions

For the age group of 17 to 65 years 

For people between 17 to 65 years.

Guideline for the use of Tramadol & Tapentadol

The ingestion of the analgesics differs as they are available in different dosages and formulations. 





Dosage form 

Oral tablets and injection 

Oral tablets 

Dosage strength

50mg, 100mg, 150mg, and 200mg

Tapentadol 100mg and 50mg

Route of administration

Oral tablets- by mouth 

Injections- directly into the vein

Other- Intramuscular and rectal [6]

Oral tablets- by mouth

Intake of meal 

One can take the meal 1 to 2 hours before taking the dosage

The intake of light meals one can take about an hour before taking the dosage. 

Dosage Gap

4 to 6 hours

IR formulation (4 to 6 hours)

ER formulation (12 hours)


A study by Srinivas Kalyanaraman Iye et al. on patients after cardiac surgery demonstrates that Tapentadol is a more potent pain medication than Tramadol [7]. These patients were using both these pain medication dosages for postoperative discomfort.




Source of Figure: Journal of Annals of Cardiac Anaesthesia

The above graph from the same study shows that patients taking Tramadol also use "rescue analgesic" for better results. Medical experts often provide rescue analgesics when the primary pain medication fails to deliver effective results. 

Tapentadol vs. Tramadol  - Pharmacodynamic interactions




Using opioid analgesics with other medicines can induce drug interaction. It can cause unpredicted side effects with diminished or heightened drug action possibilities. Do not take the following medications with opioid drugs without the supervision of a physician. 

  • Butorphanol

  • Nalbuphine

  • Alcohol

  • MAO inhibitors

  • Antidepressants 

  • Sleep medication

  • Cough Medication

  • Anti-anxiety drug

  • Muscle relaxers

  • Antihistamine medication

Tapentadol vs. Tramadol- Which is a safer choice?

Tapentadol is a highly tolerant pain medication making it a safer option. However, improper administration and abuse can result in developing adverse signs in users. Some side effects one may experience from these opioid analgesics are-


Side effects 







Do not immediate medical help




Do not immediate medical help




Do not immediate medical help

Muscle tightness



Advisable to consult a doctor

Mood swings



Do not immediate medical help

difficulty breathing or swallowing



Advisable to consult a doctor




Advisable to consult a doctor




Advisable to consult a doctor


In a clinical investigation by Srinivas Kalyanaraman Iye et al., 30 people taking Tramadol experienced Psychosis.  Whereas people taking Tapentadol showed no signs of the condition [7].




Dependency and abuse potential of opioid analgesic

Improper intake and overdosing increase the risk of abuse in users. In the Tapentadol vs. Tramadol comparative investigation, both the analgesics show similar potency for addiction. Taking the opioid analgesic with other substances can also elevate the effects of abuse. A person must be able to identify the signs of abuse early to prevent the user from developing an addiction. Signs of abuse of Tapentadol and Tramadol s in users are-


Tramadol: Signs of abuse [9]

Tapentadol: Signs of abuse [10]

Pupil becoming small 

Chest pain


Clammy skin


Trouble breathing

Slurred speech

Excessive sweating

Impaired coordination



Loss of consciousness 

Change in the appetite of the user

Swelling in legs and hands 


Scientific data on the conversion of Tramadol to Tapentadol

Several studies incorporate the safety guidelines in patients switching from Tramadol to Tapentadol. A survey by H.G. Kress on cancer patients shows people with prior Tramadol therapy can directly switch to Tapentadol, with 70 percent of the patients experiencing improved results. The reasons to discontinue Tramadol in such patients are lack of efficacy and high risk of acquiring dependency. 

User review and testimonial 

The evaluation of the opioid pain medication from trusted medical and health sites indicates its effectiveness and user experience. Several reviews on the prestigious website Drugs show the use of Tapentadol in treating diabetic neuropathic pain 


Tapentadol Rating summary

Tramadol Rating summary


The Tramadol and Tapentadol reviews offer a close insight into these opioid drugs. It also allows people to decide on the suitable analgesic for treating their body pain.

Tapentadol vs. Tramadol- Our final thoughts

In this comparative study of Tapentadol Vs. Tramadol, both the analgesics, portray similar potency in treating body pain. We can conclude by saying Tapentadol is a more tolerant drug than Tramadol, making it a safer choice of opioid medication. Another common comparison of the opioid analgesic is "Carisoprodol vs Tramadol". 

The risk of addiction and abuse of Tramadol is comparatively higher. People struggling to make a decision can do so after considering factors such as the person’s health, age, and ongoing medication and treatment. It is best to consult a physician before buying Tapentadol or Tramadol for body pain.


  1. Prevalence of Chronic Pain and High-Impact Chronic Pain Among Adults- United States, 2016, CDC, 2018.

  2. Tramadol, Drugbank
  3. Repeated Administration of Clinically Relevant Doses of the Prescription Opioids Tramadol and Tapentadol Causes Lung, Cardiac, and Brain Toxicity in Wistar Rats Joana Barbosa, MDPI. 
  4. Is Tapentadol a Glorified Tramadol? Jeffrey Fudin and Phillip Boglish, practicalpainmanagement, 2016.

  5. “Tapentadol”, Wikipedia
  6. “Tramadol”, Wikipedia
  7. Comparison of tapentadol with tramadol for analgesia after cardiac surgery, Srinivas Kalyanaraman Iye et, al, annals, 2015.

  8. “Tapentadol tablets- uses, side effects and more” and “ Tramadol Hcl- Uses, side effects and more”, WebMD. 
  9. Tramadol Symptoms And Warning Signs, addictioncenter
  10. Tapentadol (Oral Route), Mayoclinic