NUCYNTA ER (tapentadol): TITRATE TO AN OPTIMAL THERAPEUTIC DOSE

Available in 50 mg, 100 mg, 150 mg, 200 mg, and 250 mg tablets.1

INITIATE1

For patients receiving their first opioid analgesic

  • Start with 50 mg ~q12h

For patients converting from other opioids*

  • There are no established conversion ratios for conversion from other opioids to NUCYNTA ER defined by clinical trials. Initiate dosing using NUCYNTA ER 50 mg orally every 12 hours
  • Discontinue all other tapentadol and tramadol products when beginning and while taking NUCYNTA ER
TITRATE1
  • Individually titrate NUCYNTA ER to a dose that provides adequate analgesia and minimizes adverse reactions
    • Dose increase 50 mg no more than twice daily every 3 days
  • Continually reevaluate patients receiving NUCYNTA ER to assess the maintenance of pain control and the relative incidence of adverse reactions, as well as monitoring for the development of addiction, abuse, or misuse
MAINTAIN1
  • The maintenance dose is 100 mg to 250 mg twice daily
  • Maximum 24‑hour dose is 500 mg. Do not exceed a total daily dose of 500 mg

*Patients who are opioid‑tolerant are those receiving, for 1 week or longer, at least 60 mg oral morphine per day, 25 mcg transdermal fentanyl per hour, 30 mg oral oxycodone per day, 8 mg oral hydromorphone per day, 25 mg oral oxymorphone per day, or an equianalgesic dose of another opioid.

CONVERSION FROM NUCYNTA TO NUCYNTA ER1

  • Patients can be converted from NUCYNTA to NUCYNTA ER using the equivalent total daily dose of NUCYNTA and dividing it into 2 equal doses, separated by ~12‑hour intervals
  • Although the maximum approved total daily dose of immediate‑release NUCYNTA is 600 mg per day (700 mg on the first day of therapy), the maximum total daily dose of NUCYNTA ER is 500 mg
NUCYNTA ER must be swallowed whole, with or without food.

Please see full Prescribing Information for complete information on DOSAGE AND ADMINISTRATION.

Reference:
  1. NUCYNTA ER [package insert]. Stoughton, MA: Collegium Pharmaceutical, Inc.; 2021.