Tapentadol for Chronic Pain conditions: information for patients at East and North Herts NHS Trust

Patient Name: NHS number:

Consultant Name:

Important: You should not stop taking tapendatol suddenly. Please contact your doctor before stopping.

Why do I need tapentadol?

Tapentadol is a medicine used to treat chronic pain conditions which are not usually relieved by normal painkillers.

How long will tapentadol take to work?

As the dose is increased gradually to reduce side effects it may take a few weeks for you to get the full effect. Your consultant will agree an individual pain relief goal with you. This goal may not be a complete loss of pain, but an improvement in pain such that you are able to undertake an activity such as walking to local shops.

Should I continue to take other regular painkillers?

It is important that you continue to take your other regular painkillers, unless you have been advised to stop taking these by your consultant.

What are the possible side effects?

The most common side effects of tapendatol includefeeling sick (nausea), constipation, dizziness, drowsiness or headache.Most of these side effects may be reduced by increasing the dose gradually and they may disappear after taking the same dose for a few days.

You must not drive or operate machines if you are drowsy, dizzy or have side-effects that affect your ability to perform these activities. Please refer to the Patient Information Leaflet (PIL) you received with the medication for further information on side effects.

You should not stop taking tapentadol suddenly.If you stop taking tapentadol suddenly you may experience withdrawal effects. These may include feeling restless, irritable, anxious, weak or sick (nausea), loss of appetite, diarrhoea, watery eyes, runny nose, increase in size of the pupils in the eyes (dilated pupils), difficulty sleeping, yawning, sweating, shivering, muscle or joint pain, backache, abdominal cramps, increase in blood pressure, breathing or heart rate. If you experience any of these complaints after stopping tapentadol, please contact your doctor.

Is it safe for me to take other medicines or alcohol with tapentadol?

Your doctor or pharmacist will tell you which medicines are safe to take with tapentadol. Before you take or buy any new medicines check with your doctor or pharmacist.Do not drink alcohol whilst you are taking tapentadol, because some side effects such as drowsiness may be increased.

How do I take tapentadol?

Swallow the tablets whole with a drink of water.Tapentadol can be taken on a fullor empty stomach.

You will be prescribed tapentadol modified-release 50mg and 100mg tablets.The dose should be taken and increased as set out in the following section and table. Your consultant will discuss and record the following:

  • Pain relief goal: ………………………………………………………
  • Target dose: ………………………(the maximum total daily dose is 500mg)
  • The dose and time interval between dose increases (see table overleaf)

You can use breakthrough pain medication as advised by your consultant for breakthrough pain while the dose is being increased.

How do I obtain supplies of tapentadol?

  • Your hospital consultant will prescribe tapentadol for ONE MONTH from your first appointment. The prescription must be taken to the hospital pharmacy for dispensing.
  • After two weeksof taking tapentadol you need to call the consultant secretary (Susan Collins or Rebecca Collins on 01438 285992 or 01438 285458)and leave a message letting the consultant know your pain response as per the traffic light assessment tool (overleaf).
  • If you have had some benefit to tapentadol the consultant will then prescribe the next months supply and the prescription will be ready for collection in the hospital pharmacy within two weeks of the telephone call.
  • This process should be repeated for the next month’s supply and until your next outpatient appointment with the consultant.
  • If your consultant wants you to stop taking your tablets, they will tell you how to do this. This may include gradual reduction of the dose.
  • If you run out of medication at any point please contact the consultant secretary (Susan Collins or Rebecca Collinson 01438 285992 or 01438 285458). If you have any questions about your medication you can call the pharmacy patient helpline on 01438286150 (2pm to 4pm, Monday to Friday).
  • After three months of taking tapentadol your consultant will assess your pain response at an outpatientappointment. If a good response has been achieved then the consultant will issue a further prescription for a months supply to be dispensed at the hospital pharmacy.
  • Following this your GP will issue ongoing prescriptions that can be dispensed at a community pharmacy.

What is the traffic light assessment tool?

The traffic light assessment tool (below) is used to assess your pain response to tapentadol. Your consultant will explain the tool to you.

You should keep increasing the dose guided by the table below and traffic light response until:

a)Your pain relief goal or maximum pain relief is reached (increasing the dose does not improve pain relief)

b)Any side effects cannot be tolerated (if pain relief is good then the total daily dose can be reduced by 50mg)

c)Target dose achieved (your ongoing treatment plan will be discussed at your next review appointment)

You should complete the ‘Pain Response’ and ‘State any side effects’ sections in the table below for each dose increase and bring to your next review appointment for discussion.

Time interval
(to be completed by consultant) / Dose to be taken / Pain Response
(please circle) / State any side effects
Morning / Evening
Days…….. / 50mg / 50mg / Green Amber Red
Days……. / 50mg / 100mg / Green Amber Red
Days……. / 100mg / 100mg / Green Amber Red
Days…… / 100mg / 150mg / Green Amber Red
Days …….. / 150mg / 150mg / Green Amber Red

Further information on tapentadol can be found in the patient information leaflet supplied with the tablets.

Tapentadol modified-release tablets are available in a variety of strengths. When a stable dose has been achieved, and you have used up your existing supply, the tablet strength may be changed to reduce the number of tablets you need to take every day.

Traffic Light Assessment Tool

Approved by Hertfordshire Medicines Management Committee September 2014Page 1 of 2