Looking for info on experiences with Nucynta or Tramadol for TN II Neuropathic Pain?

I have been on Oxycontin ER for about 6 months and am not getting adequate pain relief with 10 mg twice/day..only constipation...lol. I probably need a higher dose but am reluctant due to side effects and the risk of driving while taking these meds. I am also starting to slide down the slippery slope of depression again and do not want another go-round with any of the antidepressants because they all gave me horrid side effects and made me into a not-very-nice person. I would like to wean off the oxy and try tramadol because of its serotonin-NE reuptake inhibition. I talked to my MD and she thought it a good idea. However....recently have read info about bad reactions & poor pain relief with tramadol and better pain relief and less side effects with Nucynta. Looking for comments &/or suggestions??

I know I'm replying to a very old thread, but maybe this post will help someone other than the OP.

My wife just switched from tramadol to tapentadol (nucynta), and although tapentadol provides better pain relief than tramadol, she's having more side effects from the tapentadol than she ever did from tramadol. The side effects aren't terrible and we think they're mostly related to the rebound when tapentadol's short duration wears off. It could also simply be that she spent about a year on tramadol and did not wean off, as her pain doc didn't think there would be a withdrawal issue during the switch. Made sense, as they are very similar in effect, but every is different.

Now for the hopeful part =)

We're seeing her pain doc again tomorrow to ask about combining the two, as I've seen a few cases where the combo of tramadol and tapentadol help Atypical TN patients more than anything else they've tried: http://www.drugs.com/comments/tapentadol/nucynta-for-pain.html

I'll post back with the results.

Also, the rebound she's experiencing might be alleviated by switching from IR tapentadol to ER, so we're going to discuss that as well.

I am a psyco therapist in an acute psych hospital so I am familiar with many different meds. I think Tramadol is a very effective med for pain management. It can be most beneficial to avoid rapid tolerance. Addiction is almost certain with opioids

Physical dependence is inevitable with long term opioid use, as opposed to addiction (always needing higher doses and drug-seeking behavior). I have been on opiate therapy for several years and never need more than has been prescribed. I was actually able to taper down to a lower dose when my pain lessened. Unfortunately I have developed problems with slow-gut and constipation from them and thus I am looking for an alternative. What was TN2 and responded to MVD, came back with a vengence and is now diagnosed as neuropathic pain. I tried Nucynta and got very little pain relief from it. What I did get was unremitting nausea and HORRIBLE abdominal pains that had me doubled up.

Thanks for the info. How long was your wife on tramadol and what kind of dose did she take? I tried nucynta, but had bad reactions to it and did not get pain relief.

dankoni said:

I know I'm replying to a very old thread, but maybe this post will help someone other than the OP.

My wife just switched from tramadol to tapentadol (nucynta), and although tapentadol provides better pain relief than tramadol, she's having more side effects from the tapentadol than she ever did from tramadol. The side effects aren't terrible and we think they're mostly related to the rebound when tapentadol's short duration wears off. It could also simply be that she spent about a year on tramadol and did not wean off, as her pain doc didn't think there would be a withdrawal issue during the switch. Made sense, as they are very similar in effect, but every is different.

Now for the hopeful part =)

We're seeing her pain doc again tomorrow to ask about combining the two, as I've seen a few cases where the combo of tramadol and tapentadol help Atypical TN patients more than anything else they've tried: http://www.drugs.com/comments/tapentadol/nucynta-for-pain.html

I'll post back with the results.

Also, the rebound she's experiencing might be alleviated by switching from IR tapentadol to ER, so we're going to discuss that as well.

I have been suffering from ATN for 3 years now. About 6 months ago my father (a retired physician) told me to try Tramadol. Up to then I had been using Percocet to handle my pain. I was really surprised that the Tramadol was quite effective. In a lot of cases, it helps more than the Percocet. I definitely have more side affects from the Percocet. I have experienced zero side affects from the Tramadol. I have to take the Tramadol every day for pain control.

I hate having to rely on opiates to control my pain, but they bring my pain down to a livable 5 instead of a painful 7-8. I have finally made my peace with the fact that these meds are necessary for me and I should not be ashamed of taking them. I don't think about addiction. It is hard enough to cope with pain every waking moment so I shouldn't waste my time with guilt.

Glad the tramadol is helping you. I'll just have to try it and see if it works for me. We are all so different in what works for us. I would not worry about addiction either. Yes, our bodies will become dependent on the meds......but true addiction is like alcoholism...they just have to have it .....for reasons other than relief from the pain of TN. And that is not us!

flute cutey said:

I have been suffering from ATN for 3 years now. About 6 months ago my father (a retired physician) told me to try Tramadol. Up to then I had been using Percocet to handle my pain. I was really surprised that the Tramadol was quite effective. In a lot of cases, it helps more than the Percocet. I definitely have more side affects from the Percocet. I have experienced zero side affects from the Tramadol. I have to take the Tramadol every day for pain control.

I hate having to rely on opiates to control my pain, but they bring my pain down to a livable 5 instead of a painful 7-8. I have finally made my peace with the fact that these meds are necessary for me and I should not be ashamed of taking them. I don't think about addiction. It is hard enough to cope with pain every waking moment so I shouldn't waste my time with guilt.

I just started Tramadol and it is working very well. An unexpected pleasant benefit is that it helps the scalp pain/burning .
I do have concerns about the long list of side effects.

I’ve been taking tramadol for a couple of years now. I take it once a day at around 12:30 pm and it gives me enough of a boost, working with the gabapentin well, to get through the afternoon and if I’m having a quiet day I can sail through the evening but all bets are off if I’m out talking, driving, etc. it’s a very delicate balance.


What dose are you taking? Is it extended release formulation? How does it compare to the dose of whatever you were taking before?

Thanks for the info and glad it is helping you.


Moxie said:

I just started Tramadol and it is working very well. An unexpected pleasant benefit is that it helps the scalp pain/burning .
I do have concerns about the long list of side effects.

I take 75 mg regular tramadol. Was just reading about the tapentadol. Sounds faster acting and stronger but doesn’t have the serotonin re uptake inhibitor properties.

Actually, both tapentadol and tramadol have SNRI and SSRI properties, though tramadol has a stronger SSRI effect, whereas I think tapentadol has a stronger SNRI effect.

From the tramadol wiki: Pharmacologically, tramadol is similar to levorphanol and tapentadol in that it not only binds to the mu opioid receptor, but also inhibits the reuptake of serotonin and norepinephrine.


Bellalarke said:

I take 75 mg regular tramadol. Was just reading about the tapentadol. Sounds faster acting and stronger but doesn't have the serotonin re uptake inhibitor properties.

I have both typical TN and peripheral neuropathy in my feet. My pain doctor put me on Nucynta for a couple of years, and honestly I don't think it did much. It may have helped a bit with the burning in my feet, but nothing for the TN. I stopped taking Nucynta when I switched to a new insurance company and they wouldn't approve it. Nucynta is ridiculously expensive without insurance. Anyhow, the insurance company said I had to take MS Contin instead, which I've done, and I don't think that stuff does much for the pain either.

Nucynta should be dosed in am then 12 hrs later with a different dose of it for breakthrough pain. This can work. It is very expensive and not on most RX plans so the cost could be. $400 a month!!!

I take both Oxycontin and Tramadol. I tried only Tramadol for about 6 mo. Pain was causing high blood pressure which caused constant headaches on top of facial pain. Back on Oxy with the Tramadol. Per Dr orders. He put me on Methadone instead of Oxycontin because of difference in cost. But the Methadone made me so sleepy I couldn't function and didn't help the pain as well.