Pain management can be complex, and choosing the proper medication can be overwhelming, especially when it comes to opioid pain medications.

The two most commonly prescribed options for moderate to severe pain are Oxycodone and Tapentadol, both potent medications with unique benefits and risks.

While Oxycodone has been used for pain management for decades, Tapentadol is a newer option on the market. But how do these drugs compare in terms of effectiveness, side effects, safety, and more?

In this comparative blog, we will break down the differences between Oxycodone and Tapentadol, helping you better understand how each works, when they are used, and which one is the right one for you.

Understanding Tapentadol And Oxycodone

Tapentadol is a centrally-acting opioid pain medicine with a dual mechanism of action.

It is sold under various brand names, such as Nucynta, Palexia, and Aspadol. The use of Aspadol for pain management is recommended for severe chronic pain.

Oxycodone is a semi-synthetic opioid pain medicine that treats severe pain. Some common brand names for Oxycodone are Dazidox, Percolone, Endocodone, and Roxybond [1].

Difference Between Tapentadol And Oxycodone

Mechanism of Action

Oxycodone: Oxycodone works by interacting with opioid receptors in the central nervous system (CNS). These receptors are involved in transmitting pain signals and regulating other functions such as coughing, mood, and breathing.

Oxycodone blocks pain signals by activating these receptors, resulting in pain alleviation [2].

Tapentadol: Tapentadol treats pain in two ways. It attaches to specific mu-opioid receptors in the brain; as a result, it changes the way you recognize pain. Tapentadol also increases the levels of norepinephrine in your brain, which may help regulate pain [3].

Effectiveness

In a study by David Biondi et al., comparing Nucynta immediate-release to Oxycodone immediate-release in patients with moderate to severe acute back pain, both medications were found to be similarly safe and effective in treating back pain, as well as associated leg pain. Tapentadol users have fewer side effects related to the stomach.

What Forms do the Medications Come In?

Tapentadol – Immediate-release tablet, Extended-release tablet

Oxycodone – Immediate-release tablet, Immediate-release capsule, Extended-release tablet

and Oral solution.

Onset Of Action:

Oxycodone IR- 30 minutes

Oxycodone CR- 1 hour

Tapentadol: 30 minutes of both immediate and extended-release tablets.

Half-Life

The half-life of a medication is the time required for the concentration of a drug’s active substance to decrease to half of its initial amount in the body [4].

The half-life of Oxycodone is 2 to 3 hours, and that of Tapentadol is 4 hours.

Duration of Action

The duration of action of Tapentadol and Oxycodone is as follows:

Tapentadol IR- 5 to 6 hours

Tapentadol ER- 12 hours.

Oxycodone IR- 3 to 6 hours

Oxycodone ER –  10 to 12 hours.

Ratings

On the popular website drugs, Tapentadol has an average rating of 6.4 out of 10, and Oxycodone has a rating of 6.9 out of 10 [5] [6].

Pregnancy Category

Tapentadol is classified as a Category C drug, whereas Tapentadol is classified as a Category B pregnancy drug.

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

Similarities Between Oxycodone And Tapentadol

There are a few notable similarities between Oxycodone and Tapentadol, including FDA approval, drug class, and drug schedule, that should be considered while choosing the right option.

FDA Approval

The US Food and Drug Administration approved the medical use of Oxycodone in the year 2006, and the use of Tapentadol was approved in 2008.

Drug Class

Oxycodone and Tapentadol are both opioid pain medications. Opioids are powerful pain medications that provide effective relief from pain.

Classification

The Drug Enforcement Administration (DEA) classified Tapentadol and Oxycodone as Schedule II controlled substances.

Schedule II controlled substances are drugs or other substances with a high risk of abuse, causing severe psychological and physical dependence. However, they are safe if taken under the supervision of a healthcare professional [7].

In a study by M Soledad Cepeda et al. comparing the abuse potential of people taking Tapentadol or oxycodone, Tapentadol was found to have a lower risk of abuse.

Dosing Information

The available dosage strengths of Tapentadol are [8]:

Immediate-release: 50 mg, 75 mg, 100 mg

Extended-release: 50 mg, 100 mg, 150 mg, 200 mg, 250 mg.

Oxycodone is available in several forms and strengths, including [9]:

Extended-release tablets: 10 mg, 15 mg, 20 mg, 30 mg, 40 mg, 60 mg, 80 mg

Immediate-release tablets: 5 mg, 10 mg, 15 mg, 20 mg, 30 mg

Oral solution: 5 mg/5 mL, 20 mg/mL

Capsules: 9 mg, 13.5 mg, 18 mg, 27 mg, 36 mg.

Side Effects

The most common Tapentadol side effects are vomiting, drowsiness, nausea, constipation, dry mouth, dizziness, and itching. Severe respiratory depression may also occur in rare cases, which could be fatal or life-threatening.

On the other hand, the most common adverse effects of Oxycodone use are constipation, vomiting, nausea, pruritus (itching), weakness, drowsiness, insomnia, and headaches. Serious side effects may occur in some patients, such as respiratory depression, low blood pressure, or respiratory arrest.

Because of the serious risks, it is essential that if you take Tapentadol or Oxycodone, you take the medication exactly as prescribed by a healthcare provider and do not take additional doses [10].

Drug interactions of ‌Palexia Vs. Oxycodone

Both Tapentadol and Oxycodone can interact with various drugs, including the following. However, this table does not list all the medications that may interact with Tapentadol and Oxycodone. Therefore, always consult a healthcare provider before combining any medication with either drug.

Can You Take Tapentadol And Oxycodone Together?

In general, combining Oxycodone and Tapentadol is not recommended due to the increased risk of adverse effects and the potential for overdose. Both are potent opioid pain medications, and taking them together can amplify the side effects such as dizziness, drowsiness, and respiratory depression. In some cases, a combination of treatments may be necessary for effective pain management, but it should only be done under the strict guidance of a doctor.

Warnings Of Tapentadol and Oxycodone

• Opioid pain medications have the potential for abuse, addiction, and misuse. This can lead to overdose and, in extreme cases, death. Patients should be assessed for risk before administering an opioid and should be carefully monitored.
• Accidental ingestion, especially by children, can lead to a life-threatening overdose. Therefore, these medications should be stored out of the reach of children.
• People with significant asthma, respiratory depression, gastrointestinal obstruction, or hypersensitivity to any ingredients should refrain from using Tapentadol or Oxycodone.
• Do not drive or operate heavy machinery until you know how these medications affect you.
• Snorting oxycodone or Tapentadol by crushing them into a fine powder and inhaling it through the nose is not advisable, as it may lead to nosebleeds, damage to the nasal cavity, and a runny nose. It can also increase the risk of disorientation, hypoxia, overdose, and breathing difficulties.
• Do not abruptly discontinue the intake of Oxycodone or Tapentadol, as it can cause several withdrawal symptoms. The dosage of these medications should be lowered gradually following the doctor’s instructions.

Conclusion

Tapentadol and Oxycodone are both powerful opioid medications used for managing moderate to severe pain. Still, they share a few distinct differences in how they work, their side effects, and dosage strengths.

Ultimately, the choice between Tapentadol and Oxycodone should be guided by individual patient needs, pain type, risk factors, and a thorough discussion between the patient and the healthcare provider. Always consult a healthcare provider to determine the most appropriate and safe option for you.