{"id":4321,"date":"2019-05-27T12:01:16","date_gmt":"2019-05-27T16:01:16","guid":{"rendered":"https:\/\/www.singlecare.com\/blog\/?p=3401"},"modified":"2021-01-14T14:27:45","modified_gmt":"2021-01-14T19:27:45","slug":"nucynta-vs-oxycodone","status":"publish","type":"post","link":"https:\/\/www.singlecare.com\/blog\/nucynta-vs-oxycodone\/","title":{"rendered":"Nucynta vs. oxycodone: Differences, similarities, and which is better for you"},"content":{"rendered":"

Drug overview & main differences<\/a> | Conditions treated<\/a> | Efficacy<\/a> | Insurance coverage and cost comparison<\/a> | Side effects<\/a> | Drug interactions<\/a> | Warnings<\/a> | FAQ<\/a><\/p>\n

Nucynta and oxycodone are two FDA-approved opioid<\/a> prescription drugs indicated for the treatment of severe, acute pain. They are generally used for pain that cannot be relieved by non-opioid medications, or when a patient cannot tolerate other alternatives. Both pain medications are classified as narcotics (Schedule II<\/a>), meaning they have a high potential for abuse or dependence.<\/p>\n

The way Nucynta works is not completely understood. Some studies have shown that Nucynta is a mu receptor (pain receptor) agonist and a norepinephrine reuptake inhibitor, which leads to pain relief. Oxycodone works by binding to mu receptors in the brain, which weakens or blocks pain signals, resulting in pain relief.<\/p>\n

Because both drugs are very powerful, they are generally used in pain management situations where a milder (non-narcotic) pain reliever would not be effective or cannot be tolerated. Although both drugs are used for severe pain, they have many differences, which we will outline below.<\/p>\n

What are the main differences between \u200cNucynta and oxycodone?<\/h2>\n

Nucynta<\/a> (tapentadol) is an opioid, or narcotic, analgesic (painkiller). It is available in brand-name as both an immediate-release and extended-release tablet. The extended-release tablet is called Nucynta ER<\/a>. The initial dose is 50 mg to 100 mg every four to six hours as needed for pain. The dose may be adjusted by your doctor, and the maximum dose is 600 mg per day.<\/p>\n

Oxycodone<\/a> is also a generic opioid analgesic (and oxycodone IR, for immediate-release) and available in brand-name form as Oxycontin\u2014an extended-release tablet. The dosage varies, but a typical dose for immediate-release oxycodone tablets is 5 to 15 mg every four to six hours as needed for pain.<\/p>\n\n\n\n\n\n\n\n\n\n\n\n\n
Main differences between \u200cNucynta and oxycodone<\/span><\/th>\n<\/tr>\n<\/thead>\n
<\/td>\nNucynta<\/strong><\/td>\nOxycodone<\/strong><\/td>\n<\/tr>\n
Drug class<\/strong><\/td>\nOpioid (narcotic) analgesic<\/td>\nOpioid (narcotic) analgesic<\/td>\n<\/tr>\n
Brand\/generic status<\/strong><\/td>\nBrand<\/td>\nBrand and generic<\/td>\n<\/tr>\n
What is the generic\/brand name?<\/strong><\/td>\nGeneric: Tapentadol<\/td>\nBrand: OxyIR (immediate-release), Oxycontin (long-acting)<\/td>\n<\/tr>\n
What form(s) does the drug come in?<\/strong><\/td>\nImmediate-release tablet
\nExtended-release tablet<\/td>\n		Immediate-release tablet
\nImmediate-release capsule
\nExtended-release tablet
\nOral solution<\/td>\n<\/tr>\n
What is the standard dosage?<\/strong><\/td>\nInitial:
\n50 mg to 100 mg every 4 to 6 hours as needed. Dose may be adjusted by doctor as needed. Maximum of 700 mg per day on the first day of treatment, then the maximum dose is 600 mg per day after the first day<\/td>\n		Immediate-release tablet:
\n5 to 15 mg every 4 to 6 hours as needed
\nExtended-release tablet:
\n20 mg every 12 hours<\/td>\n<\/tr>\n
How long is the typical treatment?<\/strong><\/td>\nShort-term, may be used longer based on condition treated (such as chronic pain) and response<\/td>\nShort-term, may be used longer based on condition treated (such as chronic pain) and response<\/td>\n<\/tr>\n
Who typically uses the medication?<\/strong><\/td>\nAdults<\/td>\nAdults<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n
\n

Want the best price on Nucynta?<\/h3>\n

Sign up for Nucynta price alerts and find out when the price changes!<\/p>\n

Get price alerts<\/a><\/p>\n<\/div>\n

Conditions treated by \u200cNucynta and oxycodone<\/h2>\n

Both Nucynta and oxycodone have one indication for treatment, which is to manage acute pain in adults that is severe enough to require an opioid analgesic, and when alternative treatments are inadequate or not tolerated.<\/p>\n\n\n\n\n
Condition<\/strong><\/td>\nNucynta<\/strong><\/td>\nOxycodone<\/strong><\/td>\n<\/tr>\n
Management of acute pain in adults which is severe enough to require an opioid analgesic, and when alternative treatments are inadequate<\/td>\nYes<\/td>\nYes<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

Is \u200cNucynta or oxycodone more effective?<\/h2>\n

In a study<\/a> comparing immediate-release Nucynta to immediate-release oxycodone in patients with moderate to severe acute back pain, both drugs were found to be similarly safe and effective in treating back pain, as well as associated leg pain. Nucynta patients had less adverse effects related to the stomach.<\/p>\n

In a study<\/a> comparing the abuse potential of patients taking Nucynta or oxycodone, Nucynta was found to have less potential for abuse.<\/p>\n

The most effective medication for you should only be determined by your doctor who will look at your medical condition(s), history, and other medications you take.<\/p>\n

Coverage and cost comparison of \u200cNucynta vs. oxycodone<\/h2>\n

Due to state laws, if you are receiving an opioid painkiller for the first time, it is likely that you will receive a small quantity.<\/p>\n

Insurance coverage varies with Nucynta. Since it is more expensive and only available in brand name, your copay may be higher, or the drug may require a prior authorization<\/a> from your insurance company. Nucynta is generally not covered by Medicare Part D. The out-of-pocket price for Nucynta 50 mg, 30 tablets is usually around $250 but you can get it for as low as $211 with a SingleCare discount<\/a>.<\/p>\n

Oxycodone is usually covered by insurance as well as Medicare Part D. The out-of-pocket price for 30, 5 mg tablets can cost about $100 but you can use a Single coupon at participating pharmacies<\/a> and get it starting at $36.<\/p>\n\n\n\n\n\n\n\n\n
\u00a0<\/strong><\/td>\nNucynta<\/strong><\/td>\nOxycodone<\/strong><\/td>\n<\/tr>\n
Typically covered by insurance?<\/strong><\/td>\nVaries<\/td>\nYes<\/td>\n<\/tr>\n
Typically covered by Medicare Part D?<\/strong><\/td>\nNo<\/td>\nYes<\/td>\n<\/tr>\n
Standard dosage<\/strong><\/td>\n50 mg, #30 tablets<\/td>\n5 mg, #30 tablets<\/td>\n<\/tr>\n
Typical Medicare Part D copay<\/strong><\/td>\n$95-$482<\/td>\n$2-$56<\/td>\n<\/tr>\n
SingleCare cost<\/strong><\/td>\n$211+<\/td>\n$36-$62<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

Common side effects of \u200cNucynta vs. oxycodone<\/h2>\n

The most common side effects of Nucynta are nausea, vomiting, drowsiness, dizziness, constipation, dry mouth, and itching. Serious respiratory depression (slowed breathing, not getting enough oxygen), which could be life-threatening or fatal, may occur.<\/p>\n

With oxycodone, exact percentages are not reported, except that side effects occurred in greater than or equal to 3% of patients. The most common side effects are nausea, constipation, vomiting, headache, pruritus (itching), insomnia, dizziness, weakness, and drowsiness. Serious adverse reactions may include respiratory depression, respiratory arrest (breathing stops), cardiac arrest (sudden loss of heart function, breathing, and consciousness), low blood pressure, and\/or shock.<\/p>\n

Because of the serious risks, it is very important that if you take Nucynta or oxycodone, that you take the drug exactly as prescribed and do not take additional doses. You should also be monitored for respiratory depression, especially when starting one of these drugs or during a change in dose.<\/p>\n

Other adverse events may occur. Consult your healthcare provider for a full list of side effects.<\/p>\n\n\n\n\n\n\n\n\n\n\n\n
\u00a0<\/strong><\/td>\nNucynta<\/strong><\/td>\nOxycodone<\/strong><\/td>\n<\/tr>\n
Side Effect<\/strong><\/td>\nApplicable?<\/strong><\/td>\nFrequency<\/strong><\/td>\nApplicable?<\/strong><\/td>\nFrequency<\/strong><\/td>\n<\/tr>\n
Nausea<\/td>\nYes<\/td>\n30%<\/td>\nYes<\/td>\n\u22653%<\/td>\n<\/tr>\n
Vomiting<\/td>\nYes<\/td>\n18%<\/td>\nYes<\/td>\n\u22653%<\/td>\n<\/tr>\n
Constipation<\/td>\nYes<\/td>\n8%<\/td>\nYes<\/td>\n\u22653%<\/td>\n<\/tr>\n
Dry mouth<\/td>\nYes<\/td>\n4%<\/td>\nYes<\/td>\n% not reported<\/td>\n<\/tr>\n
Drowsiness<\/td>\nYes<\/td>\n15%<\/td>\nYes<\/td>\n\u22653%<\/td>\n<\/tr>\n
Dizziness<\/td>\nYes<\/td>\n24%<\/td>\nYes<\/td>\n\u22653%<\/td>\n<\/tr>\n
Itching<\/td>\nYes<\/td>\n5%<\/td>\nYes<\/td>\n\u22653%<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

Source: DailyMed (Nucynta<\/a>), DailyMed (oxycodone<\/a>)<\/p>\n

Drug interactions of \u200cNucynta vs. oxycodone<\/h2>\n

Using benzodiazepines or other CNS depressants, including other opioid medications<\/a>, in combination with Nucynta or oxycodone can lead to low blood pressure, respiratory depression, profound sedation, coma, and\/or death. The combination should be avoided. However, if no other option is available, the lowest doses of each medication for the shortest time period should be used, and the patient should be closely monitored, especially at the beginning of treatment and during any changes in dose.<\/p>\n

Taking Nucynta or oxycodone with drugs that increase serotonin can also increase the risk of serotonin syndrome<\/a>, a life-threatening condition caused by a buildup of too much serotonin. These drugs include antidepressants such as serotonin reuptake inhibitors, muscle relaxants, MAO inhibitors (MAO inhibitors should not be used within 14 days of Nucynta or oxycodone), and triptans for migraine.<\/p>\n

Taking oxycodone with certain medications that are metabolized by an enzyme called CYP3A4 or CYP2D6 may result in a drug interaction. These drugs are known as enzyme inhibitors and include macrolide antibiotics, azole antifungals, and protease inhibitors. Using them together with oxycodone can result in higher levels of the opioid, which can be very dangerous. These drugs interact with oxycodone, but not Nucynta.<\/p>\n

Other drugs, known as enzyme inducers, have the opposite effect as inhibitors, lowering the level of opioid so that it is not as effective or can even cause withdrawal symptoms. Inducers can affect Nucynta or oxycodone.<\/p>\n

Consult your healthcare provider for a full list of drug interactions.<\/p>\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n
Drug<\/strong><\/td>\nDrug Class<\/strong><\/td>\nNucynta<\/strong><\/td>\nOxycodone<\/strong><\/td>\n<\/tr>\n
Alprazolam
\nClonazepam
\nDiazepam
\nLorazepam<\/td>\n		Benzodiazepines<\/td>\nYes<\/td>\nYes<\/td>\n<\/tr>\n
Alcohol<\/td>\nAlcohol<\/td>\nYes<\/td>\nYes<\/td>\n<\/tr>\n
Codeine
\nFentanyl
\nHydrocodone
\nHydromorphone
\nMethadone
\nMorphine
\nTramadol<\/td>\n		Opioids<\/td>\nYes<\/td>\nYes<\/td>\n<\/tr>\n
Baclofen
\nCarisoprodol
\nCyclobenzaprine
\nMetaxalone
\nTizanidine<\/td>\n		Muscle relaxants<\/td>\nYes<\/td>\nYes<\/td>\n<\/tr>\n
Amitriptyline
\nCitalopram
\nDesipramine
\nDesvenlafaxine
\nDuloxetine
\nEscitalopram
\nFluoxetine<\/td>\n		Antidepressants<\/td>\nYes<\/td>\nYes<\/td>\n<\/tr>\n
Phenelzine
\nRasagiline
\nSelegiline
\nTranylcypromine<\/td>\n		MAO inhibitors<\/td>\nYes<\/td>\nYes<\/td>\n<\/tr>\n
Furosemide
\nHydrochlorothiazide<\/td>\n		Diuretics<\/td>\nYes<\/td>\nYes<\/td>\n<\/tr>\n
Benztropine
\nDiphenhydramine
\nOxybutynin
\nTolterodine<\/td>\n		Anticholinergic drugs<\/td>\nYes<\/td>\nYes<\/td>\n<\/tr>\n
Almotriptan
\nEletriptan
\nRizatriptan
\nSumatriptan
\nZolmitriptan<\/td>\n		Triptans for migraine<\/td>\nYes<\/td>\nYes<\/td>\n<\/tr>\n
Clarithromycin
\nErythromycin
\nFluconazole
\nKetoconazole
\nRitonavir<\/td>\n		CYP3A4 or CYP2D6 inhibitors<\/td>\nNo<\/td>\nYes<\/td>\n<\/tr>\n
Carbamazepine
\nPhenytoin<\/td>\n		CYP3A4 inducers<\/td>\nYes<\/td>\nYes<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

Warnings of \u200cNucynta and oxycodone<\/h2>\n

There is a boxed warning on both Nucynta and oxycodone, which is the strongest warning required by the FDA (United States Food and Drug Administration).<\/p>\n