Considering Tapentadol As A First-Line Analgesic: 14 Questions

Abstract

Tapentadol is the newest centrally acting analgesic to be approved by the US FDA and regulatory bodies in other countries. It has been called the first-in-class of a novel-acting analgesic mechanism of action that combines µ-opioid receptor agonist activity with neuronal norepinephrine-reuptake inhibition in a single molecule. This duality of action should combine inhibition of ascending (afferent) pain-transmitting signals with activation of descending (efferent) pain-attenuating systems (e.g., diffuse noxious inhibitory controls). However, not all novel mechanisms of action impart the characteristics needed for an analgesic to be considered for first-line therapy. These key questions may help inform clinical decision making.

KEYWORDS:

• analgesic
• multimodal
• nonopioid
• opioid
• pain therapy
• reuptake inhibition

Financial & competing interests disclosure

JV Pergolizzi is a speaker for Janssen, Grunenthal, Purdue Pharma, Mundipharma, Insys Therapeutics and Johnson & Johnson; he is a researcher for Purdue Pharma, Covidien and Insys Therapeutics; he is a consultant for Grunenthal, Janssen, Purdue Pharma, Covidien, Merck and Johnson & Johnson. He is co-founder of NEMA Research, Inc., a clinical research organization which provides clinical, regulatory and product development services to a number of pharmaceutical companies. F Breve is an independent consultant, received no financial consideration, and has nothing to disclose. R Taylor is executive director of operations at NEMA Research, Inc. RB Raffa is a speaker, consultant and/or basic science investigator for several pharmaceutical companies involved in analgesics research but receives no royalty (cash or otherwise) from sale of any product. SE Strasburger is a student, received no financial consideration, and has nothing to disclose. JA LeQuang is Director of Scientific Communications at NEMA Research, Inc. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

No writing assistance was utilized in the production of this manuscript.