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Thread: Nucynta ER & IR - Pain Management Experience/compared to other opiods

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    Nucynta ER & IR - Pain Management Experience/compared to other opiods 
    #1
    Personally I have read all the threads on various forums saying that Nucynta is weak, or Nucynta doesn't have much of a euphoric effect. I disagree with every single one of these posts. The one thing I would note is that for me it takes a week or so to start feeling the full effects of the drug. I moved from NY to NC a few months ago. In NY I was receiving Nucynta 100mg 4x a day for Back Pain(Herniated L5-S1). After I moved to NC I had trouble finding a Pain clinic that would work with my coverage from NY. I went through withdrawal from Nucynta which was terrible and I described in a previous post. When I first got into a clinic down here they started me on half my old Nucynta dose 50mg 4x a day which pretty much did nothing for me but I took it to let it build up in my system for the month.

    This month after the abnormal results of my disco-graph came back I talked with my doctor about getting back to my normal dose of Nucynta and she said that they don't prescribe IR Nucynta over 300mg, and thus the Nucynta ER was born. She said she would work me back up to 400-500mg over the next couple months starting me on Nucynta ER 100mg 2x a day and Nucynta IR 50mg 2x a day. I have to say I wake up less "hungover" taking an ER before bed over the IR, probably because it stretches out the medication a bit more but the one thing I have been finding out is that the ER seems very unpredictable when it comes to potency. There will be times when I am almost not sure I took my ER, and others where out of nowhere I am ready to nod out. I do get a pleasant euphoria from the Nucynta, the kind that makes you just want to kick back and close your eyes, it makes me VERY sociable and if I am kept busy keeps my energy up... kinda of like an upper and downer at the same time.

    I'm still not feeling the level of relief I was feeling when I was on the 100mg 4x a day except the times I take the 50mg on top of my ER's. At my next appointment I am going to ask for my Nucynta ER to go up to 150mg 2x a day and still get the 50mg IR 3x a day as needed. Below I am going to give my *rating* of Nucynta compared to other drugs I have taken.

    I have taken hydrocodone, oxycodone, Opana IR & ER, Morphine Sulfate SR, Nucynta IR & ER

    talking pain relief Best(1) to Worst(5):
    1. Opana IR/ER
    2. Nucynta IR/ER
    3. Oxycodone
    4. Morphine SR
    5. Hydrocodone

    talking euphoria Best(1) to Worst(5):
    1. Oxycodone
    2. Opana IR/ER
    3. Nucynta
    4. Hydrocodone
    5. Morphine SR

    Comparing doses mg for mg in strength here is my personal experience/opinion
    Opana(5mg)=Oxycodone(10mg)=Morphine Sulfate(15mg)=Hydrocodone(20mg)=Nucynta(75mg)

    now these are just my personal experiences...it seems everyone reacts a bit different to certain medications. I wish my stomach could deal with the Opana as all around I think that was the best drug that dealt with my pain, but Nucynta is a close second at the right dose.
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    #2
    Greenlighter jonnystiffin's Avatar
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    hey im in nc too and i completly agree with you , nucynta is amazing
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    #3
    Im in NC too and im surprised you rated oxy over opana in terms of euphoria. Ive never taken opana orally though so maybe its different then but i know if you IV opana to me its the best thing out there. Id take opana over heroin the only bad part is that it doesnt last as long.
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    #4
    Quote Originally Posted by freakout9903 View Post
    talking pain relief Best(1) to Worst(5):
    1. Opana IR/ER
    2. Nucynta IR/ER
    3. Oxycodone
    4. Morphine SR
    5. Hydrocodone

    talking euphoria Best(1) to Worst(5):
    1. Oxycodone
    2. Opana IR/ER
    3. Nucynta
    4. Hydrocodone
    5. Morphine SR
    I have 3 slipped disks in my upper back thoracic. A fairly rare affliction but one that has caused me considerable discomfort. With the exception of Opana I have been on one level or or another of these medications to control the pain. I would have to pretty much agree with the order of pain relief of the different medications. I am currently on 150mg ER Nucynta 2 times a day. I find that it takes about 45-60 minutes for the pain relief to kick in. However when it does my pain is completely gone for 4 to 6 hours. Something interesting I found about it was that the longer I took it the better it worked. the first few weeks I had my doubts but by the second months prescription I was sold. I credit this effect to the NRI part of the medication. However the Euphoria that many people talk about and some seek with Opioid medications is another story. The Nucynta; at least in my opinion; has a noticeable ceiling effect. It took messing with the dose of Nucynta a bit in order to find the right dose to remove my pain. However, regardless of the dose all that I ever experienced was a mild Euphoria that really lasts no more than an hour; the pain relief continues however. I would put at the top of the list for pain relief effectiveness but below Vicodin for Euphoria. (standard opioid, hydrocodone, oxycodone, morphine, hydromorphone have no ceiling effect at all. The more you take the higher one gets as well as risking their lives at very high doses due to respiratory depression.) For someone like me who is actually looking for something that controls pain without a considerable cognitive effect (a healthcare worker doesn't last very long if they are walking around the hospital looking and or acting high) Nucynta is a bit of a miracle drug. The fact that it has been scheduled a class II seems pretty unfortunate as it will scare MD's and patients away from its use.

    Those just looking for a high are much better off sticking with your standard opioids.
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    #5
    Bluelighter Ohayou's Avatar
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    What is Nucynta exactly? Sounds like a brand name to me.
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    #6
    Bluelighter Starshowers's Avatar
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    Quote Originally Posted by Ohayou View Post
    What is Nucynta exactly? Sounds like a brand name to me.
    http://en.wikipedia.org/wiki/Tapentadol
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    #7
    The immediate release Nucynta came out in 2009. The ER came out in Aug 2011 so its going to be a while before any generics hit the market, at least in the US.
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