Skip to main content

Research Repository

Advanced Search

Is tapentadol different from classical opioids?: a review of the evidence

Langford, Richard M.; Knaggs, Roger; Farquhar-Smith, Paul; Dickenson, Anthony H.

Authors

Richard M. Langford

Paul Farquhar-Smith

Anthony H. Dickenson



Abstract

Tapentadol is a single molecule able to deliver analgesia by two distinct mechanisms, a feature which differentiates it from many other analgesics. Pre-clinical data demonstrate two mechanisms of action: mu-opioid receptor agonist activity and noradrenaline re-uptake inhibition. From these, one may predict that tapentadol would be applicable across a broad spectrum of pain from nociceptive to neuropathic. The evidence in animal models suggests that norepinephrine re-uptake inhibition (NRI) is a key mechanism and may even predominate over opioid actions in chronic (and especially neuropathic) pain states, reinforcing that tapentadol is different to classical opioids and may, therefore, be an a priori choice for the treatment of neuropathic and mixed pain. The clinical studies and subsequent practice experience and surveillance support the concept of opioid and non-opioid mechanisms of action. The reduced incidence of some of the typical opioid-induced side effects, compared to equianalgesic doses of classical opioids, supports the hypothesis that tapentadol analgesia is only partially mediated by opioid agonist mechanisms. Both the pre-clinical and clinical profiles appear to be differentiated from those of classical opioids.

Citation

Langford, R. M., Knaggs, R., Farquhar-Smith, P., & Dickenson, A. H. (2016). Is tapentadol different from classical opioids?: a review of the evidence. British Journal of Pain, 10(4), doi:10.1177/2049463716657363

Journal Article Type Article
Acceptance Date Apr 30, 2016
Online Publication Date Jul 25, 2016
Publication Date Nov 1, 2016
Deposit Date Jan 22, 2018
Publicly Available Date Jan 22, 2018
Journal British Journal of Pain
Print ISSN 2049-4637
Electronic ISSN 2049-4645
Publisher SAGE Publications (UK and US)
Peer Reviewed Peer Reviewed
Volume 10
Issue 4
DOI https://doi.org/10.1177/2049463716657363
Keywords Tapentadol, opioids, pain pharmacology, analgesics, analgesic mechanisms of action
Public URL http://eprints.nottingham.ac.uk/id/eprint/49225
Publisher URL http://journals.sagepub.com/doi/10.1177/2049463716657363
Copyright Statement Copyright information regarding this work can be found at the following address: http://eprints.nottingham.ac.uk/end_user_agreement.pdf

Files


160427 BJP_Is tapentadol different from classical opioids_ A review of the evidence_manuscript_Revised.pdf (304 Kb)
PDF

Copyright Statement
Copyright information regarding this work can be found at the following address: http://eprints.nottingham.ac.uk/end_user_agreement.pdf





You might also like



Downloadable Citations