Tapentadol no longer working.. any alternatives?

[taxi_maicon]

I've been using Tapentadol for chronic nerve pain for the last 5 years. It has worked wonders for me, and helped eradicate any pain I had previously been experiencing. However, I guess as is standards with most pain meds, its efficacy has dropped quite dramatically over the last 6 months or so, meaning I now notice the pain a lot more again. I'm in need of an alternative.

Has anyone experienced similar problems, and what alternatives, opioids or otherwise, are there to try and manage my pain going forward?

Cheers!

Brian

[OSTEOARTHRITISRA]

Hi id speak to doc and make an appointment maybe asap There are alternatives and everyone different wot suites ,and the the side effects are different as well ,not sure if you have tryed different meds in past

There's is

Codiene

Paracetamol (helps other pain meds work better )

Pregablin could be your alternative

Or gabepentin

Usually one ot the other Pregablin can be good if can take to it

Tramadol but is a bit similar to tapentadol

Fentynal patch low dose along side other meds

And antidepressant is sleep effected

Sometimes a cocktail of drugs low dose alongside your main med Pregablin etc

I'd phone doc to discuss the alternatives

Everyone is different though and upto doc wot to prescibe

Maybe asap so pain does not get out of control

[Onslow729 in reply to OSTEOARTHRITISRA]

I would think the author of the question will find this very helpful.

It’s a mine field when it comes to controlling Nerve Pain.

The major factor being the Side Effects of the drugs.

Mainly making the patient a zombie !

[Onslow729]

Good morning.

I used to take Tapentadol for many years and like you they didn’t seem to be working as well as they first did.

Personally I put this down to the fact that my Diabetic Neuropathy/ Nerve Pain was actually getting worse.

The Pain Clinic changed the medication to Oxycodone 30 mg twice a day.

During really bad times I was given 35 mg twice a day and even 40 mg.

But although 35 and 40 mg may help to control the pain more it left me on a more confused and forgetful position.

I very quickly became a zombie especially with the 40 mg medication living in my own world.

Ok it’s maybe less pain but honestly didn’t give me a life !

Due to the long term effects of taking Opioids long term I really need to stop but I don’t get offered an alternative.

Here in the United Kingdom Tapentadol are no longer available on the NHS so only available by private prescription.

Hope this helps.

[FolkSing in reply to Onslow729]

You can get Tapentadol on the NHS, it depends on your GP.

[Onslow729 in reply to FolkSing]

I had an appointment with the Pain Clinic in Broomfield Hospital in Chelmsford a couple of months ago.

I was fortunate to see the senior Pain Consultant who I have go to know well over the last 10 years.

He informed me that ‘NICE’ had removed Tapendolol from their list approved list under the NHS so they are now only available via Private Prescription.

[CharlieJ22 in reply to Onslow729]

I picked up.my monthly prescription meds last Thursday, including my tapentadol. I think you may have misinterpreted. A lot of CCGs class tapentadol as a "black drug" meaning unsuitable for general practice. This means only a pain management consultant can prescribe it in the 1st instance.

To the original poster, I recently changed pharmacy and the 1st time I got tapentadol from them it was Tapentadol Mylan, which is Tapentadol Phosphate, rather than my usual Palexia SR which is Tapentadol Hydrochloride. The Tapentadol Mylan wasn't as effective as the Palexia. So my GP changed the prescription to specifically Palexia and the difference is very noticeable. It's worthwhile checking which version you used to have and if its recently changed.

[Defenders]

Hi, are you in the UK or US? I’m on Gabapentin for nerve pain, it now doesn’t touch my pain. Our meds in the UK are all generic. There is a stark difference between all generic makes. I’ve managed to get my pharmacy to send the same make each month. I now see a difference in these? Is Tapentadol good for pain, it may treat my pain?

[taxi_maicon]

Thanks for the info guys, some really good points in there. OSTEOARTHRITISRA I'm taking Pregabalin as well as Tapentadol. For years I was doing OK with these 2 meds. I must have some weird dopamin effects cos I ended up feeling alert/awake and proactive... then all of a sudden the same dosage of Tapentadol can occasionally trigger a confused state. I'm curious to try Oxycontin/Oxycodone as I'm sure this would initially have a similar effect to the good years taking Tapentadol. But from you saying it made you introverted and lacking focus etc, makes me worried I might experience the same.

My GP says they cant prescribe Tapentadol now, and that it has to be approved by a pain clinic instead. Wouldn't even know where to start with this!

Does anyone know of any non-opioid meds that might work in a similar way?

Defenders I'm in the UK. I would recommend Tapentadol for your pain, it worked really well for me for nearly 4 years. I just don't know where to turn now...

[PainConcernHelpline Moderator Community Champion Pain Concern in reply to taxi_maicon]

Hi There,

Neuropathic pain can be really difficult to manage and conventional medications are often ineffective.

You said you were unsure where to turn and I wondered if you have ever asked your GP for a referral to a pain clinic? They are best placed to advise on neuropathic meds and will also look at your pain in a more holistic way, including physiotherapy and pain psychology.

Pain Concern have a leaflet which explains what neuropathic pain is as well as explaining ways of treating it : painconcern.org.uk/product/...

We also run a two hour pain education session via teams. It is free to join and open to anyone in the UK who has pain, as well as their carers. It covers pain science, managing activity, sleep, stress and flare ups and can help people to understand how pain works and what they can do about it. The facilitators have lived experience of pain too. Here are the details of how to join :

Call or text us on: 07421 125 638

Email us: [e-mail]

If you would like further support you can also call or email our helpline. If you do call, please leave a short message and some one will ring you back:

Call 0300 123 0789

Email [e-mail]

Best wishes

Pain Concern moderator

[CharlieJ22 in reply to taxi_maicon]

Ask your GP for a referral to the pain clinic.

[OSTEOARTHRITISRA]

I i think we are all similar in a way ,I waa getting no where ,bit stable now although do get some bad days ,I got tapentadol halted ,and pregabalin increased same time ,then tramadol halted after that and pregabalin increased again now 600mg a day ,with Paracetamol and fentynal low dose and dehydracodine when needed dose help a bit now and if any sleep issiuese a sleep med when needed ,the pregablin 200mg 3 times a day or 400mg at night and 200mg day all with docs approval and all treatments prescribed everyone different though specifically with side effects,.ines vary day to day ,acceptance is important a normal level is now 3 to 6 anything above docs advice or increased meds or tools ,hope you find right levels and treatment

[taxi_maicon]

Has anyone tried Carisoprodol? I've heard its a pain medication but not an opioid, and is good at treating nerve pain. I'm wondering if this may be a good alternative to Tapentadol?