Tapentadol vs Tramadol: Which One Is Better for Pain Relief?

Suffering from body pain is not easy; it can disrupt daily life, limit mobility, and affect overall well-being. In 2023, 24.3% of adults experienced chronic pain, and 8.5% had pain so severe that it limited their life or work activities [1]. These numbers highlight why finding the right pain relief medication is crucial. Two popular pain medications available in the market today are Tapentadol and Tramadol. But how do they compare?

While both are used to manage moderate to severe pain, they differ in several ways. Some find Tramadol effective for long-term use, while others prefer the faster action of Tapentadol. If you are struggling with pain, this blog will help you understand the key differences, effectiveness, and safety profiles of these two medications. So, let us look into the Tapentadol vs Tramadol comparative analysis to help you understand the right pain medication for you.

Understanding Tapentadol And Tramadol

Before we get into understanding which among Tapentadol and Tramadol is the best treatment option for you, let us have a look into what they are.

What is Tapentadol?

Tapentadol is an opioid pain medication for moderate to severe body pain. It is available under various brand names, including Aspadol, Tapaday, and Nucynta.

Tapentadol is available in two formulations-

• Immediate-Release (IR)
• Extended-Release (ER) Tablets.

The Tapentadol IR tablets are designed for moderate acute pain, providing quick relief within 30 minutes. This formulation is often prescribed for post-surgical pain, injury-related pain, or pain that requires rapid management. The Aspadol 100 mg is one of the widely used IR options and also preferable for beginners. On the other hand, the Tapentadol ER tablets are formulated for moderate to severe chronic pain that requires long-lasting relief. The Aspadol 200 mg is a popular ER option, often recommended for chronic conditions like neuropathic pain, arthritis, and lower back pain.

What Is Tramadol?

Tramadol is also a widely used pain medication that is prescribed for moderate to severe pain. It was patented in 1972 and marketed under the name Tramal in 1977 by the pharmaceutical company Grünenthal GmbH [2]. Tramadol is also available under the brand name Ultram and has two formulations- Immediate (IR) and Extended release (ER) tablets.

Tapentadol Vs Tramadol- Key Similarties

The key similarities between Tapentadol and Tramadol are listed below.

Centrally Acting Analgesics

Both Tapentadol and Tramadol work by affecting the central nervous system (CNS) to alter pain perception, making them effective for moderate to severe pain relief.

Dual Mechanism of Action

These medications relieve pain through two pathways- binding to opioid receptors to block pain signals and inhibiting norepinephrine reuptake, which enhances their pain-relieving effects. This dual action makes them more effective than traditional opioids alone [3].

Used for Moderate to Severe Pain

Tapentadol and Tramadol are prescribed for a variety of pain conditions, including post-surgical pain, nerve pain (neuropathy), musculoskeletal pain, and chronic conditions like arthritis or fibromyalgia.

Available In IR And ER Forms

Both medications come in immediate-release (IR) and extended-release (ER) formulations. IR versions work quickly, making them ideal for acute pain, while ER versions provide long-lasting relief for chronic pain conditions, reducing the need for frequent dosing.

Risk Of Dependence And Withdrawal

Like other opioid-based medications, Tapentadol and Tramadol carry a risk of dependence and withdrawal symptoms if used for a long time or misused. This is why they should only be taken under a doctor’s supervision.

Prescription-Based Medications

Neither Tapentadol nor Tramadol is available over the counter (OTC). Due to their potential for misuse, they require a doctor’s prescription for purchase.

Differences Between Tramadol And Tapentadol

The potential differences between Tramadol and Tapentadol are listed below.

Potency and Strength

Tapentadol is stronger than Tramadol, offering more effective pain relief at lower doses. Tramadol is generally used for mild to moderate pain, while Tapentadol is preferred for moderate to severe pain.

Onset of Action

Tapentadol works faster than Tramadol. Tramadol needs to be metabolized into its active form in the liver, which can delay its effects, whereas Tapentadol provides quicker pain relief.

Prescription Regulations

Tapentadol is classified as a stronger controlled substance in many countries, meaning it may have stricter prescription regulations. Tramadol is more widely available but still requires a doctor’s prescription.

Duration in the Body

Another key point of comparison is how long each drug stays in the system. Tapentadol has a relatively short half-life of around 4 hours, which means it is cleared from the body quickly. Despite this, it can still be detected in urine for up to 3 days after use, depending on individual factors like metabolism and dosage. For those looking for detailed detection windows and elimination timelines, here is a breakdown on how long Tapentadol stays in the system.

Tramadol, by contrast, has a longer half-life of about 6 hours and also produces an active metabolite that can linger. As a result, it may remain detectable in the body for 4 to 5 days, making it slightly longer-lasting than Tapentadol in terms of presence in the system.

Effectiveness And Pain Relief Comparison

For short-term pain relief, such as after surgery or injury, Tapentadol IR works more quickly and effectively than Tramadol IR. Tramadol may take longer to work and may be less effective for severe pain. On the other hand, Tapentadol ER is a better choice for chronic pain conditions like arthritis, lower back pain, and neuropathic pain. Tramadol ER can help with milder chronic pain but may not be as effective for severe cases.

For managing Neuropathic pain, both medications are effective, but Tapentadol is more effective due to its stronger opioid activity and norepinephrine reuptake inhibition.

A 2018 study on the analgesic effects of Tapentadol and Tramadol in cancer patients suggests that Tapentadol offers better pain control than the combined effects of Tramadol with Paracetamol [4].

Side Effects And Safety Profile

Both Tapentadol and Tramadol can cause side effects. Understanding these can help in choosing the right medication. The common side effects of Tapentadol include-

• Drowsiness
• Dizziness
• Nausea
• Constipation
• Dry mouth

The common side effects of Tramadol are-

• Nausea
• Dizziness
• Drowsiness
• Constipation
• Sweating
• Headache

Risk of Dependence and Addiction

Tapentadol has a higher potential for dependence since it has stronger opioid activity. It should be used with caution, especially for long-term pain management. Tramadol is considered less addictive, but long-term use can still lead to dependence and withdrawal symptoms if stopped suddenly.

Withdrawal Symptoms

Both Tramadol and Tapentadol can cause withdrawal symptoms if discontinued suddenly, such as-

• Anxiety
• Irritability
• Sweating
• Muscle pain
• Insomnia

Tramadol Vs Tapentadol- Drug Interactions

Tramadol interacts with antidepressants, seizure medications, and certain painkillers, increasing the risk of serotonin syndrome and seizures. Whereas Tapentadol has fewer drug interactions, making it a safer choice for those on multiple medications.

Which One Is Better For You?

The choice between Tapentadol and Tramadol depends on the severity of pain, individual health conditions, and medication tolerance. Tapentadol is stronger and faster-acting, while Tramadol is milder and has a lower risk of dependence.

When To Choose Tapentadol?

Tapentadol is a better choice if-

• You have moderate to severe pain that does not respond well to weaker painkillers.
• You need fast-acting pain relief, as Tapentadol works quicker than Tramadol.
• You have chronic pain conditions such as arthritis, back pain, and neuropathic pain that require long-term pain management.
• You need a stronger alternative to Tramadol, especially if Tramadol has not worked for you.

When To Choose Tramadol?

Tramadol is a better option if-

• You have mild to moderate pain and do not need a very strong opioid.
• You are looking for a lower addiction risk compared to stronger opioids.
• You prefer a gradual pain relief effect, as Tramadol works slower but lasts longer.

Alternatives And Other Considerations

While Tapentadol and Tramadol are effective pain management options, there are other alternatives that may be better suited for specific conditions. Two notable substitutes for Tramadol and Tapentadol include Carisoprodol and Pregabalin. They work differently from opioids but can be beneficial for body pain.

Carisoprodol (Soma Pill) for Muscle Pain

Carisoprodol is a muscle relaxant that helps to manage acute musculoskeletal pain by relaxing muscles. They help in reducing discomfort caused by strains, sprains, or injuries. The Carisoprodol pain medication is commonly available under the brand names Pain O Soma and Soma Dol. Available in numerous dosage strengths, the Soma Dol 350 mg is often recommended as a starting dose to assess tolerance and effectiveness.

Carisoprodol is typically used for short-term pain relief and is not intended for long-term treatment due to its potential for dependency.

Pregabalin (Nervigesic) for Nerve Pain

Pregabalin is a neuropathic pain medication that helps relieve pain caused by nerve damage, fibromyalgia, and diabetic neuropathy. It works by calming overactive nerve signals, making it an effective alternative for individuals who do not respond well to opioids.

The Nervigesic tablets are available in three main dosage strengths- 75mg, 150mg, and 300mg. The Nervigesic 75 mg is a suitable starting dose to minimize side effects while assessing effectiveness. This dosage strength can be later gradually increased based on the severity of the condition. The highest available dosage strength if Nervigesic 300 mg, which must be taken only after consulting a doctor.

Tapentadol Vs Tramadol- Our Final Thoughts

Both Tapentadol and Tramadol are effective for pain medications, but the best choice depends on the severity of pain, individual health conditions, and medication tolerance. Tapentadol is a stronger opioid analgesic that provides faster and more potent pain relief. This makes Tapentadol a better option for moderate to severe chronic pain conditions such as arthritis and neuropathic pain.

On the other hand, Tramadol is a milder analgesic that works well for mild to moderate pain with a lower risk of dependency, making it a suitable option for people looking for a less potent alternative.