tapentadol and Pain--Intractable

A 52-year-old woman had been prescribed oral medication of acetaminophen, non-steroidal anti-inflammatory drugs (NSAIDs), and oxycodone for intractable pain associated with thoracic metastasis of breast cancer. However, the pain control was poor. Although pregabalin and gabapentin were used as supplementary analgesics, they could not be continued because of their side effects. Based on the noradrenalin reincorporation-inhibiting action of tapentadol, a combination therapy of tapentadol and oxycodone was introduced and satisfactory pain control was achieved. No side effects from the combined opioids were observed. This finding indicates the potential of administrating a combination therapy of m-opioid receptor agonists(such as morphine, oxycodone, and fentanyl)with tapentadol, which has a noradrenaline reincorporation-inhibiting action, as an effective remedy for alleviating intractable pain complicated with neuropathic pain.

Topics: Analgesics, Opioid; Bone Neoplasms; Breast Neoplasms; Female; Humans; Middle Aged; Oxycodone; Pain, Intractable; Phenols; Tapentadol

Chronic back pain is a leading cause of disability worldwide and it is still inadequately treated. Tapentadol is a dual-acting analgesic drug μ-opioid receptor (MOR) agonist/norepinephrine reuptake inhibitor, carrying a lower risk for opioid withdrawal symptoms and opioid-related adverse effects in comparison to potent opioid drugs. This study investigates the effectiveness, safety and tolerability of the prolonged release oral formulation of tapentadol (tapentadol PR) in 27 patients affected by refractory chronic low back pain during a long-term follow-up (up to 51 months).. This is an observational study conducted at the Pain Therapy and Palliative Care Unit of University Hospital of Cagliari, Italy. We enrolled 27 patients affected by chronic low back pain refractory to other pharmacological treatments according to the inclusion criteria. We prospectively evaluated oral tapentadol PR therapy during a long-term follow-up (up to 51 months) according to the following outcomes: pain intensity during the previous 72 hours (Numeric Rating Scale 3), quality of life (Short Form-12 Health Survey), self-reported treatment effectiveness (Patient Global Impression of Change scale), physician evaluation of treatment effectiveness (Clinician Global Impression of Change scale), treatment-related adverse effects, reason for tapentadol therapy interruption and tapentadol dosage.. All the patients reported a significant improvement of pain intensity and quality of life at the last follow-up.. These results show the long-term effectiveness, safety and tolerability of oral tapentadol PR for the treatment of refractory chronic low back pain in a real-life clinical setting.

Topics: Adult; Aged; Aged, 80 and over; Chronic Pain; Delayed-Action Preparations; Female; Humans; Low Back Pain; Male; Middle Aged; Pain Management; Pain, Intractable; Phenols; Prospective Studies; Tapentadol; Time Factors; Treatment Outcome