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Side Effects of Tapentadol (Nucynta)


Side Effects of Tapentadol (Nucynta)

Tapentadol, available as Nucynta, is an opioid (narcotic) medication, used to treat moderate to severe pain. It is available as immediate-release and extended-release for acute and around-the-clock treatment of pain. Nucynta is a federally controlled substance (C-II) because of its abuse potential. It is very important to inform your healthcare provider if you (or a family member) have ever abused or been dependent on alcohol, prescription medicines, or street drugs.

Nucynta and Addiction

There is a risk of abuse or addiction with narcotic pain medicines. If you have abused drugs in the past, there is a higher chance of developing abuse or addiction again.


The Nucynta label reported by the FDA advises Nucynta can cause physical dependence. Be cautious of the withdrawal symptoms: feeling anxious, sweating, sleep problems, shivering, pain, nausea, tremors, diarrhea, upper respiratory symptoms, hallucinations, and hair “standing on end”.

Before Starting Nucynta Treatment

Do not take Nucynta if you have severe lung problems, have a paralytic ileus (the intestines are not working normally), or are taking a monoamine oxidase inhibitor (MAOI) medicine or one within the last 14 days.


Inform your doctor about medical conditions, such as having trouble breathing or lung problems,, had a head injury, liver or kidney problems, convulsions or seizures, dependency problems with alcohol, pancreas or gall bladder problems, and past or present substance abuse or drug addiction.


If you are taking any medicine that makes you sleepy, tell your healthcare provider. Nucynta can make you sleepy and affect your breathing. If pregnant, do not use Nucynta before discussing with your healthcare provider, or if you are planning to become pregnant, or are breast-feeding.

Serious Side Effects

According to the FDA, Nucynta can cause life-threatening breathing problems. If you show any signs of breathing troubles, slow or shallow breathing, slow heartbeat, severe sleepiness, a cold, clammy skin, feeling faint, dizzy, confused, cannot think, walk or talk normally, a seizure, or hallunications, seek medicial assistance as soon as possible.

Common Side Effects

The common side effects associated with Nucynta usage are:

  • Nausea
  • Dizziness
  • Vomiting
  • Sleepiness
  • Itching

(Nucynta label reported by the FDA).

Drug Interactions

Serotonin syndrome is a rare, life-threatening problem that could occur if you take Nucynta with selective serotonin reuptake inhibitors (SSRIs), monoamine oxidase inhibitors (MAOIs), serotonin and norepinephrine reuptake inhibitors (SNRIs), triptans, and other medicines.


Nucynta can cause seizures in those at higher risk for seizures or who have epilepsy. This can make you feel dizzy if you get up too fast from sitting or lying down. Do not drive, operate machinery, or participate in potential dangerous activites until you are sure about Nucynta’s effects. In addition, do not consume alcohol while on Nucynta as it increases the chance of having dangerous side effects.

About Pharmacogenetic Testing

Unlike other similar opioid pain relievers like Ultram or Percocet, Nucynta is not significantly metabolized by CYP2D6 and hence can be used as an alternative pain relieving medication in individuals with altered CYP2D6 activity who are at higher risk of developing side effects with other opioid medications.

Know Your Risk with the Rxight® Genetic Test

Rxight® genetic testing gives patients their individualized analysis detailing their metabolism of medications. The Rxight® test shows genes that codes for metabolic enzymes and how they process medications including Nucynta and hundreds of other prescription and over-the-counter medications.


For more information on Rxight® pharmacogenetic testing, contact us at 1-888-888-1932 or email us at support@Rxight.com.


Contributors to this Article:
Michael Sapko, MD, PhD; and Deborah Kallick, PhD, Medicinal Chemistry

Read more about Rxight® Genetic Health Testing