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Tapentadol Overdose – Risks, Side Effects & Prevention

Reviewed by Dr. Kamemba

  • September 4, 2023

Reviewed by Dr. Tulman

  • September 4, 2023

It’s no news that fentanyl, heroin, and other opioids can lead to a potentially life-threatening overdose, but what about tapentadol? Contrary to what many people are led to believe, a tapentadol overdose is possible, and it can be no less dangerous than that of other opioids.

If you or someone you love has been prescribed tapentadol, it is in your best interest to learn how to prevent and recognize a tapentadol overdose. 

This article will explain most things about tapentadol and its overdose, including symptoms, risk factors, and more.

What Is Tapentadol? 

Tapentadol is an opioid pain reliever prescribed for moderate to severe acute and chronic pain that doesn’t respond to non-opioid painkillers. It’s an atypical opioid, as it is not only an opioid agonist but also a norepinephrine reuptake inhibitor (NRI).

Derived from tramadol—another dual-acting opioid—tapentadol was discovered in the 1980s but was only approved by the U.S. Food and Drug Administration (FDA) in 2008. Compared to tramadol, tapentadol has more potent opioid effects but weaker effects on norepinephrine reuptake.

In the United States, tapentadol is most commonly sold under the brand name Nucynta®, which comes in both immediate-release (IR) and extended-release (ER) versions of the drug. 

Although tapentadol is commonly used to relieve chronic pain and is thought to be less addictive than typical opioids, such as oxycodone, it is classified as a Schedule II controlled substance. This means that it still carries a high potential for abuse, dependence, and addiction that may increase with long-term use.

Tapentadol Usage in the US 

Since tapentadol is a fairly new medication in the United States, not much research has been conducted on it compared to other opioids. 

With that in mind, here are some statistics and scientifically proven facts about tapentadol:

  • Just over 500,000 tapentadol prescriptions were issued in 2019.
  • Tapentadol is 65% less likely to lead to opioid abuse than oxycodone.
  • Tapentadol overdoses are far less likely than those of typical opioids.

Can You Overdose on Tapentadol? 

Although tapentadol has a lower risk of overdose than most other opioids, you can still overdose on this medication if you take too much or mix it with other substances, such as alcohol. If not treated on time, a tapentadol overdose could be lethal.

The dosage amount leading to a tapentadol overdose varies from person to person, depending on weight, consumption method, and other factors. One of the most critical factors is tolerance. Opioid-naïve people may overdose on lower amounts of tapentadol than those with a high tolerance.

You should always follow your doctor’s instructions to minimize the risk of a tapentadol overdose. If you think you might’ve missed a dose, skip it and take the next scheduled dose to avoid an accidental overdose. Generally, you shouldn’t take more than 600 mg of tapentadol in one day.

Is Tapentadol Safe?

Belonging to the opioid family of drugs, tapentadol isn’t safe and can lead to opioid abuse, dependence, and addiction. Although approved by the FDA, it is strictly controlled due to these risks.

While taking tapentadol precisely as instructed reduces these risks, even those who take it responsibly can develop an addiction to it, especially when taking it for long-term pain management.

Besides the risks of abuse, dependence, and addiction, tapentadol can also cause various side effects, ranging from mild to potentially life-threatening. 

The most common tapentadol side effects are:

  • Constipation
  • Dizziness
  • Drowsiness
  • Headache
  • Nausea and vomiting
  • Stomach ache

Some severe tapentadol side effects that require immediate medical attention include:

  • Allergic reaction (hives, breathing difficulties, facial swelling, etc.)
  • Confusion
  • Difficulty breathing
  • Extreme drowsiness
  • Fainting
  • Seizures

As a dual-acting opioid, tapentadol can cause serotonin syndrome when mixed with other drugs that alter serotonin levels, such as antidepressants. This potentially life-threatening condition is characterized by symptoms such as:

  • Agitation
  • Confusion
  • Diarrhea
  • Increased heart rate and blood pressure
  • Shivering
  • Stiff muscles
  • Sweating 

Tapentadol Overdose: Signs and Symptoms

Tapentadol Overdose: Signs and Symptoms

As a centrally-acting opioid, tapentadol can cause respiratory depression when taken in large doses. As such, slowed and shallow breathing is a tell-tale sign of a tapentadol overdose. If left untreated, respiratory depression can be fatal and cause brain cell death.

Other signs and symptoms of tapentadol overdose include:

  • Blurred vision
  • Cardiac arrest
  • Cold and clammy skin
  • Coma
  • Decreased heart rate
  • Extreme confusion
  • Fainting
  • Low blood pressure
  • Muscle stiffness or limpness
  • Muscle weakness
  • Pinpoint pupils
  • Severe drowsiness
  • Sweating
  • Unresponsiveness

Some symptoms of tapentadol overdose can look very similar to the side effects of tapentadol. If you notice any of these signs, it’s best to assume that it’s an overdose and call 911. Treating a tapentadol overdose on time can save your or your loved one’s life.

How Does Tapentadol Affect Your Body? 

The main effect of tapentadol is pain relief. Like other opioids, it mimics endorphins—chemicals our body produces that help alleviate pain—and binds to opioid receptors in the central nervous system (CNS). 

By doing so, tapentadol blocks pain signals from reaching the brain, reducing the perception of pain. It also elevates the levels of norepinephrine in the brain, which enhances its pain-relieving properties.

In addition to this, tapentadol can also trigger dopamine release, resulting in feelings of euphoria and deep relaxation. This increases its potential for abuse, as some people may take tapentadol just to feel “high.” Not to mention, people are wired to seek out and repeat activities that release dopamine, which makes opioids, including tapentadol, addictive.

How Long Do Tapentadol Effects Last? 

The duration of tapentadol’s effects depends on various factors, the most major being the formulation of the drug. 

Immediate-release tapentadol typically starts working within 30 minutes after consumption and provides pain relief for 4–6 hours, depending on the dosage, metabolism, and other factors. Meanwhile, the effects of extended-release tapentadol last for 12 hours.

Risk Factors Leading to Tapentadol Overdose 

The main risk factors leading to a tapentadol overdose are tapentadol abuse, relapse, and taking tapentadol in combination with other drugs. 

Here’s what you need to know about each of these risk factors:

  • Tapentadol abuse. Taking tapentadol more frequently, at larger doses, or in other ways than prescribed (e.g., by crushing and dissolving it in water) can increase the risk of a tapentadol overdose. 
  • Relapse. Over time, tapentadol use leads to tolerance, meaning you need larger amounts of the drug to feel its effects. However, if you quit taking tapentadol, your tolerance will decrease, which makes relapse very dangerous. Due to lowered tolerance, your usual dose of tapentadol may be enough to cause an overdose.
  • Mixing tapentadol with other substances. Taking tapentadol with other substances increases the risk of side effects and overdose. Some substances known to interact with tapentadol are alcohol, antidepressants, muscle relaxants, sedatives, benzodiazepines, and antipsychotics. You should also never take tapentadol with other opioids.

If you’re taking any other substances besides tapentadol, including herbal medicines and supplements, inform your doctor about them to make sure they can be safely taken with tapentadol. 

Tapentadol Addiction

Tapentadol addiction is a treatable condition that stems from the chemical changes in the central nervous system caused by tapentadol use. Opioids, including tapentadol, increase the production of opioid receptors while decreasing that of endorphins. This chemical imbalance is the fundamental cause of opioid addiction.

While taking tapentadol as prescribed can reduce the risk of becoming addicted to it, it doesn’t eliminate it. Even when taken responsibly, opioids alter the brain. Long-term tapentadol use and abuse, particularly, increase the likelihood of developing tapentadol addiction.

As mentioned above, tapentadol use can lead to tolerance, which is a sign of physical dependence on opioids. When those dependent on opioids quit taking tapentadol, they experience uncomfortable and often painful withdrawal symptoms. 

Unfortunately, it’s not uncommon for people to relapse in hopes of easing their pain and discomfort. Eventually, dependence may develop into a tapentadol addiction.

The main signs and symptoms of tapentadol addiction are:

  • Abusing tapentadol (e.g., taking more than prescribed)
  • Becoming more isolated from family and friends
  • Trying to obtain tapentadol by lying, stealing, doctor shopping, etc.
  • Continuing to use tapentadol after the pain is gone
  • Using tapentadol despite its negative effects 
  • Struggling to quit, reduce, or otherwise control tapentadol use
  • Experiencing intense tapentadol cravings 
  • Neglecting personal and professional obligations

Tapentadol Withdrawal Symptoms

Tapentadol withdrawal symptoms indicate that your body is detoxing from the medication. They occur when you either quit tapentadol or decrease its dosage after developing dependence or addiction to it. Abruptly quitting the drug can result in particularly intense withdrawal symptoms.

The most common tapentadol withdrawal symptoms are:

  • Anxiety
  • Cravings
  • Diarrhea
  • Dilated pupils
  • Goosebumps
  • Nausea
  • Runny nose
  • Shivering
  • Sleep disturbances
  • Stomach pain
  • Sweating 
  • Tremors
  • Vomiting

While opioid withdrawal often resembles the flu, it can be potentially life-threatening. For this reason, you shouldn’t quit tapentadol without medical supervision. By seeking professional help, you can minimize the risk of relapse, overdose, and death.

Generally, tapentadol withdrawal symptoms are milder than those of other opioids. Their duration depends on your age, organ health, and many other factors, including the formulation of tapentadol. 

The onset of tapentadol withdrawal symptoms usually begins within 6–30 hours after taking the last drug dose. These symptoms usually ease off within a week, though some symptoms, such as cravings, may last longer. 

Withdrawal symptoms from immediate-release tapentadol tend to occur earlier and subside quicker than those from the extended-release version of the drug. 

ANR Treatment for Tapentadol Addiction 

Accelerated Neuro-Regulation (ANR) is an ultra-modern tapentadol addiction treatment that has helped more than 24,000 people worldwide break the chains of addiction and reclaim control of their lives. 

ANR Treatment for Tapentadol Addiction 

Unlike traditional treatments, ANR addresses the underlying causes of opioid addiction by re-regulating your brain’s endorphin-receptor system. By removing the root cause of addiction, the ANR treatment negates the risk of relapse, helping you make a long-lasting recovery!

Most importantly, the ANR treatment is very safe, as it is:

  • Tailored to each patient and their medical history 
  • Performed in an ICU setting of an accredited hospital
  • Carried out by a team of highly experienced medical professionals, including critical care physicians and anesthesiologists

Safety and effectiveness aren’t the only benefits of the ANR treatment. While other treatments last weeks, months, or even years and can still lead to relapse, the average hospital stay for ANR is just 36 hours! 

If you’re looking to successfully conquer tapentadol addiction and forget about the fear of relapse, ANR is the way to go. Contact us today to schedule a free consultation!

Key Takeaways 

Hopefully, this article cleared up any questions you had about tapentadol overdose.

Now, let’s reiterate the most important points we covered:

  • Tapentadol is a dual-acting opioid painkiller commonly prescribed for acute and chronic pain management.
  • The most common tapentadol overdose symptoms include difficulty breathing, slow heart rate, extreme drowsiness, and pinpoint pupils.
  • Relapse, tapentadol abuse, and combining the drug with other substances greatly increase the risk of a tapentadol overdose.
  • ANR is a modern tapentadol addiction treatment that negates the risk of relapse and subsequent overdose, allowing you to overcome tapentadol addiction safely and effectively.

Additional Information

Tramadol Overdose: Signs, Symptoms & Treatment

How Long Does Tapentadol Stay in Your System?

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Dr. Andre Waismann

Dr. Waismann identified the biological roots of opioid dependency, Since then he has successfully treated more than 25,000 patients worldwide that are struggling with opioid addiction.


Throughout his career, he has lectured and educated health professionals in dozens of countries around the world to this day.

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