June 26, 2009 - 10:00pm
As some of you may know, a totally new analgesic was just approved and is out already. The drug, brand name Nucynta (tapentadol) is a mu-agonist similar to other opiates. I had originally assumed the drug would be worthless like tramadol, since it is related in its mechanism of action. But apparently, I am wrong. First off, the drug is Scheduled as a CII, which means high abuse and addiction potential, which is not something tramadol is at all. Also, it is indicated for treatment of moderate to severe pain, which tramadol would not even be close to. I have not much info on the drug, and I am trying to get some feedback on anyone that has taken it. It will be interesting to see how it works.
June 26, 2009 - 10:46pm
#2
yes
same risk of seizures as tramadol. It seems to me to be a way stronger version of tramadol, which would give it a great advantage over pure opiates. Tramadol works via the inhibition of serotonin reuptake. similar to how antidepressants work. This is a novel way to approach analgesia, but it wasn't strong enough to have any appreciable effect. It seems like this is a step in the right direction, especially for certain types of nerve pain.
June 26, 2009 - 10:51pm
#3
NJRx242
That's a bummer. I am not a huge fan of anything antidepressant related except Amitriptiline which was a Godsend for my Migraines. I had some terrible experiences with Zoloft , Lexapro, Remeron, and a few others. Another story for another time...
Hopefully, it will help people with nerve pain.
June 26, 2009 - 11:30pm
#4
HA!
Finally a medical professional stating/ acknowledging that Tramadol is "worthless."
June 27, 2009 - 12:12am
#5
NJR have you prescribed any
NJR have you prescribed any yet? And how do you pronounce the name of it?
June 27, 2009 - 1:08pm
#6
Phonics
I'm gonna go out on a limb...
NEW-SIN-TAH
June 27, 2009 - 1:17pm
#7
That makes senses.
That makes senses.
June 27, 2009 - 1:44pm
#8
Without consulting some literature
I'm going off memory here, but I believe I participated in a discussion about this drug awhile back in a conference. I seem to recall the focal point being the ability of the drug to forestall the development of tolerance. When used in conjunction with other more traditional opioids, a given dosage could be maintained indefinitely.
I also could be WAY off base here and thinking of something totally different. I do not have the time to verify right now, if this sounds familiar to anyone else in the know, please chime in.
MF
June 27, 2009 - 2:02pm
#9
I don't think I would elect to try this drug
It just doesn't sound like it would have any special benefits for me. I'm sure they will find a market for it. Because it's similar to Ketorolac, only stronger I guess, I mean it's C-II. I think that it will be useful for peripheral neuropathy, although it's not indicated for chronic pain management at this time. When I first heard about this drug months ago, I wondered to myself "Do we really need ANOTHER opiate pain medication". I think there are enough choices and combinations now, that I feel research money could be spent more prudently in other areas...Like I said, I'm sure there will eventually be a market for this drug; I don't see it being a very large one and honestly I don't think this drug will go very far.
Ray
June 27, 2009 - 3:38pm
#10
I have heard hat they intend
I have heard hat they intend to use it in acute cases only NJ, not chronic, but will wait and see, they said that about a few others too, LoL
June 27, 2009 - 8:09pm
#11
Correct
Only indicated now for acute pain, it seems like it could be a good new drug, depending on its analgesic potency. The abuse potential was most compared to cravings, dependence, etc. to hydromorphone, hence the strict scheduling of it. We haven't dispensed any yet, just ordered it for monday from our wholesaler. I had two calls though already this weekend asking for it. I will read some more about it on monday with the package insert and post some more info.
June 27, 2009 - 8:42pm
#12
Thank you NJ, I know
Thank you NJ, I know personally I'd be interested to see how it get's on, they have not Introduced it here in Ireland just yet, but I think they will by late august. All the best .
June 27, 2009 - 8:51pm
#13
Nucynta
NJRx242, when you read the insert and post more info, please give us a description of the tablet - color, shape, imprint and scoring etc.
Thanks!
I can't find the .pdf package insert at the FDA or anywhere online yet. There is nothing other than press releases right now.
June 27, 2009 - 9:18pm
#14
Yup it will probably be crazy
Yup it will probably be crazy expensive. The developers have to recoup their cost for development through price gouging.
June 29, 2009 - 10:21pm
#15
Some info
I read some more on it. It seems to be a pure opiod agonist, with pretty strong binding to the mu and kappa receptors, weak delta receptor binding. All the same side effects as regular opiates, with respiratory depression the same as other opiates, constipation, etc. Less headaches associated as compared to oxycodone for degenerative arthritis in a clinical trial. It is indicated for acute pain only as of now. Unfortunately, I have no comparison as to its potency compared to other opiates. When I figure it out, ill post it. It also has an interaction with antidepressants, causing possible serotonin syndrome with seizures, etc. when combined or for people at risk. This leads me to believe that it inhibits reuptake of serotonin as does tramadol. However, I don't think it is as weak as tramadol, or else it wouldn't be scheduled so strictly.
July 3, 2009 - 10:36pm
#16
Amitryptyline/Elavil
This old timer tricyclic anti-depressant potentiates the effect of seratonin and norepinephrine in the CNS and also has significant anti-cholinergic properties. I'm not sure if that would qualify it as an SRI since it simply potentiates and doesn't inhibit reuptake, but I believe the results are similar. This has been used for quite some time and is effective in treating some CP such as Trigeminal Neuralgia which qualifies as an acute pain w/out a doubt. It makes me wonder if this New Drug isn't just a retread on the old Elavil tire. I agree with str8up, "Do we really need this?" We are already awash in analgesics, what is needed is better use, I.E. better prescribing, of the drugs we have now.
Personally, I smell a rat. One of the "Big Pharm" species, I do believe . . .
Q 
July 4, 2009 - 10:30am
#17
Tramadol
has proven to be a drug of abuse. It should have been scheduled from the get go. Could it be that the FDA is covering their rears in light of the current witch hunt involving opiate pain medications in general?
Sounds like Tramadols stronger, inbred cousin; just another useless synthetic, (probably wrought with neuro. side effects) for doctors to try as first or second lines before they will be ALLOWED to prescribe effective medication.
July 4, 2009 - 7:23am
#18
You got it, FeliksD
Hey Cat, do you know if "Potentiates the Effect of Seratonin" is similar to a "Seratonin Reuptake Inhibitor's" action. I believe it's the same in that potentiate means increase in efficacy and a reuptake inhibitor allows seratonin to attach and release from it's neural receptor several times instead of once before it is taken in to the neuron. This is of course a rather simplified explanation of the bio-chemical process, but twill serve.
As far as addiction goes, Elavil can be as nasty as Ultram/Tramadol and two of our posters, T. Calderone and Marlboro 100mg have both reported nasty side effects from this drug (Elavil). I believe that Nucynta is, at it's roots, a reworking of amitryptyline and, now that you bring it up, tramadol. Does anyone else out there, Allgood or Dr. Bob for example, know if this Nucynta is an old p*rost*itute in a nu dress?
I find it telling that in my pre-cancer days I was Rxed both of these drugs as if they were candy. I was not told anything about the severe potential side effects nor about their potential for physical addiction. I was also given multiple refills, unlike Class IIs. Whenever I was Rxed a Class II, it was lecture time as to how powerful and dangerous this Vicodin is. My poor, sweet Dental Asst., just the other day, was going to give me a scrip for 16 Vicodin after my root canal. She looked so serious when she gave me the lecture, just as she had been taught. When I showed her my Fentanyl patch she was shocked that I could still function. It really makes me mad that an age old source of pain relief (Opioids) has been so completely demonized by this puritanical nation, but there I go again, preaching to the choir.
Q
July 4, 2009 - 10:40am
#19
Q-
Your explanation is plenty good. These two phrases are just worded differently. It's a semantic difference. By" inhibiting reuptake", the effects of an SSRI are going to "potentiate" seratonins effects....
It really is the same girl on another street.
Look at Vyvanse, or Focalin XR. Both old friends with different clothes on. But nobody would know if they weren't told....
BILLIONS of dollars in R&D HAS TO yield something, dosen't it? 
All my best Q.
July 4, 2009 - 11:57am
#20
Thanks Cat!!!
I always like to run my ideas past you, Feliks, because you have a uniquely broad perspective. I'm not sure if you're a polymath but your wide overview suggests the possibility. Man, I hate Vyvance! I tried it on my psychiatrist's recommendation and, fortunately, on his free samples . . . that was his only bad Rx for me in 8-9 years. As you know, I was diagnosed with ADHD 8 years ago and was Rxed Ritalin at that time. It did help somewhat but not enough, and I didn't care for the side effects. I think it was 1.5 years later that he switched me to Adderall XR 20 mg @1 p/d. I still sing it's praises and haven't needed/wanted to change the dosage amount in all this time . . . and it still takes me 40-50 days to use up the #30 Rx 'cause I only take it when I have a long, complex or tedious task ahead of me. I've tried dexadrine as well but I didn't like it either.
I thought the side effects of Ritalin were bad, Vyvance had some of the same ones only much more intense. They both made me feel "speedy" as in methamphetamine use. I felt like I had tachycardia as well as severe dry mouth, restlessness, and a sort of constant background anxiety. Those are the effects that they shared, but the Vyvance had some other problems as well. Instead of helping me to focus on the task at hand I was jumping from one thing to another, never finishing what I had started. It also caused me to be even more domineering in conversations than I already am. These are the two ADHD traits that I most wanted to rid myself of and Vyvanse only made them more pronounced! Thanks for letting me know that Focalin XR is so similar, I'd hate to make that mistake twice.
There is one thing in your reply that I would like to correct, if I may be so bold. heehee As I understand this Nucynta, it is a Seratonin Reuptake Inhibitor or SRI and not a Selective SRI or SSRI. This makes a big difference as it basically separates two different classes of anti-depressants. Oh what a difference a single letter can make.
I hope all is well on the home front buddy . . . how did the "Solar Powered Spinal Fusion" work out? Do I need to call my broker and invest in your start-up? Have a great 4th, you gotta love it, huh?
Q
July 4, 2009 - 1:52pm
#21
Nucynta
I have been just prescribed on Nucynta and all I have really felt with this "new" drug is that I get severe headaches, I also am on Perocets too, it seems to me that they work better then this new drug. Can anyone out here tell me that they have used this new drug and did it work for you all.
Thanks a million for the response back
July 4, 2009 - 2:29pm
#22
Hi Tike . . . Quincy here
So far, you are the first person to post that they have been Rxed Nucynta and you say that you have taken it as well. I see by your profile that you are a relatively recent member of this board, as am I. There is a Pain Management Dr. (PMD) whose tag is MooreFeen as well as a licensed U.S. Pharmacist, tag NJRx242, on this thread already. Neither of them have a patient/customer that have tried Nucynta yet. It looks like you are gonna be the guinea pig for now because, if you scroll up the list of replies, you'll see that a lot of us want to know about this drug.
These medical professionals are both CPs and they are really good guys, in case you were wondering. It would be helpful if you could give us a little more info, like what condition were you prescribed Nucynta for? Do you have Chronic Pain (CP), can you tell us what causes it and how long you have had it? What kind of pain were you prescribed the Percocets for? All that sorta stuff, if you want to let us know, would be wonderful. You will probably get a lot of responses after you post a little more of your medical history relating to this Rx. Thanks . . . Q
July 4, 2009 - 4:44pm
#23
Q
...I stand corrected. 
I'm far from being a polymath, but the "00" title does carry with it the need to for a working knowledge in several fields....heh heh
Headache from Nucynta, huh? Neurological side effects already. Hope tike isn't on any MAOI's... Seriously, the drug being so new, and with such a small amount of clinical knowledge of the drug, I would pay particular attention to any side effect upon initiating therapy with this medicine- no matter how benign they might seem.
Hope everyone has a safe holiday...
July 4, 2009 - 8:31pm
#24
Response to everyone
Yes I have been on pain meds i.e. percs, vicodin, ms-contin and now this new drug Nucynta. The reason is that I have a fracture on my L5/S1 I cannot spell it right but its sponithesis I think. But it has gotten worse over the year. I fell while I was in the middle east and I just took another xray and they confirmed that is is broken. So for me its meds or surgery. So that is alittle history of why I must have pain medicine. I have been on this new drug now for about 3 days. I do not see any difference at all. I also have my percs, but only 5/325. They seem to work alot faster and better for me. As I stated before the only side effect that I am getting with this is headaches. But maybe I just havent given it quite a chance yet. But it is a immediate release form, and I am on 75mg every four hours. I really cannot wait until someone else tries it and tells me if it really is like tramodol/ultram.
I think that I will call doc back on Monday and just get back on my percs 10/325 only because they seem more effective for me!! The doc did say he would do that if they didn't work for me. Just put me back on the percs. So in all honesty its a new drug and he is trying it out on me. He said hes only prescribed it to three of his patients and they seem to like it. He also said that its without the motrin in it, so its not %@$$*## my liver. But again things work different for others. I will keep taking it to see maybe it will help. But I just dont think its strong enough for me. The thing that makes me wonder, is that I will take 10/325 percs, and I am taking Nucynta 75mgs. Do you all think that it is stronger then percs? Please if you do find any information out from another please let me know. I appreciate your alls responses so quick
July 4, 2009 - 8:21pm
#25
Oh yeah
What is MAOI's... This is what I have been taking,
Nucynta, 75mg every four hours
kadian 50 mgs every 12 hours
July 4, 2009 - 8:30pm
#26
Thanks
I just posted a comment, but I am really waiting for someone else that is on it, can tell me what in the world its going to do for me. I just do not see any difference. I realize its morphine/tramadol together, and I have the 75mgs It is suppose to be immediate release but as Ive stated I cannot tell the difference only side effect is headaches from it.
July 4, 2009 - 8:33pm
#27
Another question
It does say that if the first dose doesnt work right away that I can take another one one hour after the first does. Is that really safe. I have been alittle nervous taking this medication since it is so new. I really need some more information on this drug.
July 4, 2009 - 9:00pm
#28
Hey tike . . .Quincy
Sounds like you are in a world of hurt, buddy. I'm not a Dr., so take my advice with that in mind, OK? If I was in your shoes, I'd call my Doc first thing Monday morning and get a prescription for the Percocet 10/325s you were talking about in your reply #24. A fracture in that spot has got to be a pain in the azz. lol I'd definitely tell my Doc about the headaches from the Nucynta as well. Man, I'd be pretty upset if my Dr. ever used me as a guinea pig for some new drug . . . from what's already been posted on this thread, it doesn't look like anything I'd want to take, that's for darn sure. If a new pain relief drug was giving me headaches I'd stop taking it right away . . . I mean, the stuff is supposed to get rid off your pain, not give you more of what you already have plenty of, right? Good luck and let us know how it turns out . . . Q
PS: I've been Rxed Tramadol once, it gave me a headache and nausea so I stopped taking it. I got my Dr. to Rx me Percocet 5/325s 4 p/d and that worked great for my cracked ribs.
July 4, 2009 - 10:06pm
#29
I would be willing to be a
I would be willing to be a guinea pig for my doctor as long as he gave me a Rx for my usual medication too, just in case it didn't work...
July 4, 2009 - 11:26pm
#30
now now
Long term studies notwithstanding...I'm not so sure I'd echo your enthusiam, chum? Concommitant usage is just adding more variables into an already ambiguous situation.
Don't get me wrong; it's probably a safe bet you won't grow a tail anytime soon. But practically speaking, that must've been one heck of a sales rep or narcicistic idiot savant pm potentially expediting your tolerance in the name of boredom.
Then again-your doc could be all that or just really bored--or both?
:-P
July 5, 2009 - 12:59am
#31
I'm thinking you misread the
I'm thinking you misread the post. The original RX along with would be only if the new med didn't work. NOT to take along with the new med. Most of us have been on our meds for a loooong time and if something didn't work, we'd be sure to go into withdrawls not to mention the pain we'd be suffering if something didn't work. My Doc always gives me a new med along with my old meds with the instructions to fill or continue my old meds after an agreed upon time on the new med, if I was not getting appropriate relief. I feel this is the compassionate, and appropriate way to handle new medications as long as the relationship is trustworthy with your Doc. The other thing we have done early on while we were still learning each other, was for him to only write for 1 or 2 weeks of the new med and schedule a no-charge follow up in 1 - 2 weeks just to see about the med and make the appropriate changes(30 day script or back to old med) at that time. This is being a responsible MD in my opinion it shows they really are concerned with your well being, not just that monthly check.
July 5, 2009 - 4:33pm
#32
Thanks Quincy
I appreciate all the comments from the post on this new medication. I have stopped taking the meds, but like some had said, its all about the withdrawals that most of us are scared to chance. But this time I am going to my gut instinct and have stopped it for sure. come tomorrow morning, I am sure he will right my script that I am use too. I am here in NE and they seem to be quite funny about all this. I came from Seattle and no care in the world if it didnt work, they didnt go thru all this counting meds, showing meds, taking your meds. I mean this is getting so ridulious for some of us. Ones that do not abuse our meds, and really need it. I do get very angry about this. Because these docs also have to watch themselves and I sure do understand that too. But it is almost like they think you are addicted off the bat, and for me I do not have that problem it is as plain as day in MRI's and CT, XRays that I have a fractured bones in my back, therefore in the worst spot for me. I am not very heavy gal, and sometimes I wished I was just so I would have more cushion, but this is not the point. I am upset with these meds. I do have another question, this clinic that I go to now, will probably make me bring my meds, and watch me throw them down the toilet, they costed me (Nucynta) 80 tabs for 45.00. I still have most of all those, why should I give it to him and let them throw it down the toilet? What can I say to the nurse or doc when they tell me that. I dont need them, is there any other solution to this issue that you all can help me with .
Thanks again for everyone input.
July 5, 2009 - 4:36pm
#33
What is this acronymn
What is MAOI's
July 5, 2009 - 4:50pm
#34
MAOI
It's an older class of antidepressant, most people aren't on these anymore because of all the interactions with almost EVERYTHING, including food.... yea.
Oh, and it stands for MonoAmine Oxidase Inhibitor.
I just usually wait for the voice on the new med commercials to say "Talk with your doctor before taking with MAOIs"
July 5, 2009 - 9:31pm
#35
tike
There have been a few controversial threads on this site regarding returning meds to doctors. The only real concerns are what happens once they are out of your hands and the money that you are out. If you ask to be there when they dispose of them you risk appearing distrustful of your doctor and that can turn around and bite you.
I would just bring it up when you talk to the doctor/nurse/assistant/whoever on the phone. Mention it before they do. Say something like "how about I bring in the unused meds and dispose of them with you guys?" That way you aren't questioning their idea of disposing of them without you. Chances are if you're offering they might just assume that they have no reason to believe you won't do it yourself if asked to.
Hope it all works out well for you..
July 7, 2009 - 7:54am
#36
You will never belive this
Hi everyone,
Well called doc to discontinue Nucynta because they were causing me headaches really bad. And guess what he said, this was after he told me if it does not work just call back and we will put you back on the stuff you were on earlier this year. So I did just that, and now his nurse calls back and says he has changed his mind about putting me back on percs. What is going on with these PM Clinics, when I lived in WA I never had a problem with my PM Doc and my meds. If it didnt work we try something else. I have a fracture in my L5 S1 I mean what else kinda proof do you need to give these folks, what is working and what does work for you. I just am not getting it. So anyways with all my responses here, doc decides to put me on Lortab, Norca whatever its called. He knew they did not work for me because on my first visit, I showed him I was not taking them. I needed something stronger. Am I missing something
July 7, 2009 - 12:51pm
#37
Hey tike, quincy here . . .
I just read your post about the PM Dr. . . . that really stinks. WA is definitely a lot more open minded than NE in most things, I guess that goes for pain treatment too. I figure that any gal that would come right out and say that she'd sometimes rather have a big azz for a pain cushion LOL than to be in a constant hurt has got to be the real deal, Chronic Pain wise. We have been getting a veritable flood of drug seekers and Dr. shoppers on this site in the last 6-7 weeks, so I hope that you understand the collective hesitance to give advice on this subject.
You asked if you were missing something, maybe you are but since I don't know you I'm gonna have to guess on this a little bit . . . I hope that I don't get you mad. Do you detect any sort of a personality clash with this PM Dr. or the clinic staff in general? I realize that your posts reflect your anger at the situation you are in as well as the untreated pain. Do you think that some of this anger is leaking out when you talk to the Dr. or the staff? There are a lot of great Drs. out there, but like every group of people, you are going to have some "problem's". Drs. go on guard whenever a new patient request's opioid pain medication, just like the CPs on this site worry about who they're giving advice to. You can easily red flag yourself by being too demanding and all the MRIs, CTs, and X-Ray films aren't going to change that initial impression.
Given this predilection towards refusing to Rx opioids or, Opioidaphobia, it's often neccessary to bite your tongue, no matter how much you hurt or how much proof you have. That's really all the advice I can give you on this. If you are in a small town, then it could be a lot of hassle for you to find another Dr. It sounds like that's what you're gonna have to do, though. Things like this almost make me glad that I have a lethal cancer caused pain and not CP. My wife is disabled with DDD, Fibromyalgia, Foraminal Stenosis, and a few other painful things and it still took a year or so to convince her Dr. to Rx her adequately for her pain. That is pretty much the situation that you face, you have to build up a trusting relationship with your PM Dr. and his staff before you will be accepted as "real". I know that it's awful and unfair but, those are the rules . . . I sure hope that you find relief quickly. Oneir's advice about how to handle the "return medication" thing is exactly what I'm talking about . . . you need to establish trust first, then you can move on. Good Luck and let us know how it turns out . . . Q
July 7, 2009 - 6:57pm
#38
amitripaline & nerve pain
first let me say hello from Canada (Ontario) I take 75mg of am. @ bedtime. helps me with nerve pain, helps me sleep, helps with my mood. But! be careful. i accidently double-dosed one night and when i woke up i found i had been (ready for this) FRYING STRAWBERRIES without a scintilla of rememberence. sounds funny but it frightened me terribly! i know, & yup i use a dossete.
July 7, 2009 - 10:18pm
#39
Sorry if Im repeating
Sorry if Im repeating anything that may have already been written or misunderstanding that posts reguarding my post but, this post is going to target the posters who have a problem with it only being approved for the use in acute pain. All short acting opiate/opioid medications are either indicated for acute pain or make no mention of the use of the medication in long term therapy. So I dont see the fact that Nucynta is only indicated for acute pain being a problem.
MAOI= MonoAmine Oxidase Inhibitor
Also NjRx, Tramadol does not work solely on the inhibition of serotonin. It factually is a weak inhibitor of serotonin and norepinephrine reuptake. It does however bind to the μ -opioid receptor via the metabolite M1 which is the active metabolite of Tramadol. Nucynta, is probably more similar to the M1 metabolite of Tramadol than tramadol itself since the metabolite M1 is 6x's more potent than tramadol and is 200x's more potent at binding to the μ -opioid receptors. Oh yea, the μ opioid/opiate receptor is the one responsible for euphoria, physical dependance, constipation, slowed breathing, and most of the analgesia from the centrally acting opioid analgesic Tramadol.
July 7, 2009 - 10:31pm
#40
Kirby, not sure if you
Kirby, not sure if you already have this information or not but here goes:
50mg tablets are Yellow debossed with O-M and 50 on the other side
75mg tablets are Yellow-Orange debossed withe with O-M and 75 on the other side
100mg tablets are Orange debossed with O-M and 100 on the other side
All tablets are film coated and available in bottles of 100 and hospital dose packs of 10
This info is from the Nucynta Prescribing Information leaflet.
July 8, 2009 - 7:35am
#41
Solo 5010
Have you ever been Rxed Tramadol? I'm asking because your post makes it sound super potent and the NuCynta, according to your post, would be 6 times as potent as Ultram/Tramadol. My disabled wife and I have both been Rxed Tramadol and found it totally ineffective in treating either our acute or chronic pain. This was after taking it as per Dr.'s instructions for 1 month. We both had unpleasant side effects (headaches, nausea, constipation) and we discontinued it's use. There have been several Topics posted as well as a poll regarding the efficacy of Tramadol and according to the majority CPs on this board, it is one weak puppy . . . barely efficaceous at best. So, if you have been Rxed Ultram/Tramadol, what is your opinion?As far as I'm concerned, this new drug looks like a souped up Ultram, but 6 X 0 = 0 .
To pillsafety: By am. do you mean amitriptyline/Elavil? Were you Rxed it for facial neuralgia, tic douloureux, or Trigeminal Neuralgia? You mentioned that it helped with your moods, were you being treated for depression? Elavil is a tricyclic anti-depressant that potentiates (or inhibits the reuptake, a semantic bit of hair splitting) the actions of seratonin and norepinephrine as do Tramadol and NuCynta. If you are being treated just for pain, 75, let alone 150 mgs is a hefty dose. Chronic depressives are Rxed those higher amounts, but the usual dosage for facial neuralgia, etc. is 25-30 mgs. You might want to check with your Dr. to see what he thinks, because I am NOT a Dr.
Solo, do you see what I'm getting at here? Elavil is time tested and very inexpensive and it seems to do a lot of what NuCynta does without the M1 metabolite and mu-opioid receptor problems. It is effective in treating chronic acute pain like TGN when used in small doses. I think Big-Pharm is pushing an expensive new drug down our throats when it isn't needed. I'm interested in your opinion on this, thanks . . . Q
July 8, 2009 - 7:49am
#42
I'm with Tike on this one!!
I too have been prescribed Nucynta and it definitely seems like an identical twin to Tramadol/Ultram.
July 8, 2009 - 8:51am
#43
Thanks, Flgirl!
Do you have any side effects or is just plain ineffective? I really hated the whole business behind Ultram! The Davis's Drug Guide for Nurses specifically states that "when prescribing Ultram the Dr. should emphasize the analgesic strength of this medication". Sounds like someone is trying real hard to sell a placebo, doesn't it?
Q
July 8, 2009 - 9:33am
#44
Side Effects...oh yea Q
I was prescribed Nucynta yesterday 75mg every 4-6 hrs. Took the first dose and didn't get any relief after about an hour, took another one, which is supposed to be okay. Within an hour of that, bad bad headache started. Then I started feeling very agitated, felt like I couldn't even really think straight. In the night, while sleeping I woke up with nasty stomach cramps. Called my doctor immediately this morning and we're discontinuing and going back to my old pain medication which is Magnacet 10/400. My feeling about this new medication is it may be a bit stronger than Ultram, which was more or less like slapping a band aide on a boo boo to me. Not convinced this is the next new great thing! For adequate pain relief, I'm no where near convinced this medication is worth it's weight at all. Not to mention, I have insurance which is pretty good, but the cost of the medication WITHOUT insurance was $411. Pretty expensive med for trial and error in my opion. Good Luck!!!
July 8, 2009 - 11:27am
#45
$411 WOW!!!!!
OH MAN!!! Sorry to be shouting with all the caps there but that's the first post that gives the uninsured price. I knew it was gonna be expensive, but come on Big Pharm, do you guys have to make all your profit off the first customer?
OK, I'm back down to Earth. Those side effects sound nasty, I'm glad your Doc wasn't like tike's. At least you get to go back to your previous med. I've never heard of Magnacet 10/400, is that like Percocet 10/325? That's 10 mgs of Oxycodone w/ 325 mgs APAP/Tylenol. You can tell that I'm no fan of Ultram and this stuff sounds even worse. Why they are pushing it, I don't know. I do have an opinion though, wouldn't you know it? It sounds like Opioidaphobia to me . . . better to undermedicate your patients than to have to face the very real problem of drug dependency. There are lots of good PMDs out there but I keep reading these horrifying posts about the bad ones. Good Luck girl . . . Q
July 8, 2009 - 11:38am
#46
Sorry for the shock factor there Quincy ;)
The Magnacet was "new" too, well not new I don't guess, but my history for my back problems consisted of Vicodin 7.5/750 from my PC. After a year of that with no light at the end of the tunnel, we discussed Pain Management, which so far has been great, aside from the &*&? I received yesterday. Magnacet 10/400 which is what I am taking is 10mg of Oxycodone and 400mg of Acetamenophen. So by way of Percocet, normally you would get a 10/325 of Percocet, this seems to just be a bit more of the Tylenol. It does however have a longer acting effect, which has been GREAT considering I felt like I was having to take too many of the older Vicodin and was beginning to get a little unnerved about that. Being that apparently you understand the Ultram thing, we agree totally on that.....what a waste!! Actually I had tried that for breakthrough while on the Vicodin. Just nasty nasty stuff. I've heard some people SWEAR by it...go figure! My new PM doctor more or less laughed at me mentioning the Ultram from the past. So far he's been great and although I'm still fairly new with the whole process of how Pain Management Centers work, so far so good. I too have been reading some real horror stories. By the way, LOVE LOVE the opioidaphobia thing....LOL...good call!! Thanks and I'll keep you posted as well, you me, okay? ;)
July 8, 2009 - 2:08pm
#47
Quincy and Rmmfloridagal
Gees, alot of comments along with opinions. Number 1 I would never be upset on your opinions, this is how we learn about different things here. Thank you so much Quincy for everything. Just to let you know I have cancelled all PM docs for now, and sticking with my family doc. We are both comfortable now that if I need something he will indeed give it to me. Number 2 We have finally made a decision on surgery, I will have it done in DEC this year. We feel that it would be best to get it fixed, (just if someone doesnt know what I have) A FRACTURED L5/S1 it has gotten worse, and he wants me to get it fixed. 2 Fusions. So that is that. These PM doc's have me so very upset. IT seems that everytime I call or go its a bother. I am really a likeable person and do not ask for much, and have reason to know that I need the meds. NO questions asked. I do what the doc tell me to do and do my meds right. They lied to me, when he said it was a new drug, call him if there was changes or it wasnt working, he would put me back on my other pain meds and then changed his mind, please tell me what that is about. Again I have sufficient reasoning for having the meds and have been on them for quite sometime.
Rmmfloridagal, wow it seems to me that we have alot in common, the only thing is that we dont have the great docs like you have whereever your at. I never had this MUCH problem in WA NEVER. Never was I questioned for my pain with my pm doc. There is only 4 pm docs here in NE so I guess maybe that is why. I dont know, but I want to feel like I am the patient not on trial. Does everyone know what I mean. Nucynta is worthless. Bad bad headaches.....well any other info please dont hesitate to enlighten me okay
July 8, 2009 - 2:41pm
#48
Thanks, tike
That just plain stinks the way that you were being treated and I am soooo glad that you have a good, caring, family Doc to take care of you the way you deserve. Take care of yourself and thanks for understanding my point and not getting mad at me. Good luck with the surgery, tike, and keep in touch with us other CPs, ok?
Q
July 8, 2009 - 2:43pm
#49
Crazy reading the reports on
Crazy reading the reports on how ineftective this new medication is I wonder if that FDA Panel over-reacted by placing it in Schedule II!
July 8, 2009 - 4:41pm
#50
What a concept . . .
The FDA overreacting? Never I say, Never. LOL
Does it have the seizure issues as Tramadol does? I will see if I can find more info. Thanks for the heads up. I may ask my doc about it.
Check these webpages out!
http://www.biocompare.com/News/NewsStory/279467/NewsStory.html
http://www.medicalnewstoday.com/articles/155091.php
http://www.bio-medicine.org/medicine-news-1/NUCYNTA-28TM-29--28tapentadol-29-CII-Immediate-Release-Tablets-Now-Available-for-Relief-of-Moderate-to-Severe-Acute-Pain-49726-1/