tapentadol and Serotonin-Syndrome

Tapentadol is a centrally acting analgesic that has been available for the management of acute and chronic pain in routine clinical practice since 2009.. This is the first integrated descriptive analysis of post-marketing safety data following the use of tapentadol in a broad range of pain conditions relating to the topics overall safety, dose administration above approved dosages, administration during pregnancy, serotonin syndrome, respiratory depression, and convulsion. The data analyzed pertain to spontaneous reports from healthcare and non-healthcare professionals and were put in the context of safety information known from interventional and non-interventional trials.. The first years of routine clinical practice experience with tapentadol have confirmed the tolerability profile that emerged from the clinical trials. Moreover, the reporting of expected side effects such as respiratory depression and convulsion was low and no major risks were identified. The evaluation of available post-marketing data did not confirm the theoretical risk of serotonin syndrome nor did it reveal unexpected side effects with administration of higher than recommended doses.. More than 8 years after its first introduction, the favorable overall safety profile of tapentadol in the treatment of various pain conditions is maintained in the general population.. Grünenthal GmbH.

Topics: Analgesics, Opioid; Chronic Pain; Clinical Trials as Topic; Dose-Response Relationship, Drug; Female; Humans; Pain; Product Surveillance, Postmarketing; Respiratory Insufficiency; Seizures; Serotonin Syndrome; Tapentadol

Recovery from ambulatory surgical procedures can be limited by postoperative pain. Inadequate analgesia may delay or prevent patient discharge and can result in readmission. More frequently, postoperative pain produces discomfort and interrupts sleep, contributing to postoperative fatigue. The development of effective analgesic regimens for the management of postoperative pain is a priority especially in patients with impaired cardiorespiratory, hepatic, or renal function. Tramadol and tapentadol hydrochloride are novel in that their analgesic actions occur at multiple sites. Both agents are reported to be mu-opioid receptor agonists and monoamine-reuptake inhibitors. In contrast to pure opioid agonists, both drugs are believed to have lower risks of respiratory depression, tolerance, and dependence. The Food and Drug Administration has approved both drugs for the treatment of moderate-to-severe acute pain in adults. This article provides an evidence-based account of the role of tramadol and tapentadol in modern clinical practice.

Topics: Analgesics; Animals; Cytochrome P-450 CYP2D6; Humans; Injections, Spinal; Pain, Postoperative; Perioperative Care; Phenols; Receptors, Opioid, mu; Serotonin Syndrome; Tapentadol; Tramadol

Awareness of rare differential diagnoses of common clinical presentations helps promote early detection and prompt management of serious conditions. A 54-year-old man, with an infected non-union following a high tibial osteotomy, presented with an acutely discharging abscess to his proximal tibia. He was generally unwell with a

Topics: Analgesics, Opioid; Bacteremia; Debridement; Diagnosis, Differential; Fever; Humans; Male; Middle Aged; Osteomyelitis; Osteotomy; Serotonin Syndrome; Staphylococcal Infections; Surgical Wound Infection; Tapentadol; Tibia