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Review
, 33 (11), 1965-1969

The Role of Tapentadol as a Strong Opioid in Cancer Pain Management: A Systematic and Critical Review

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Review

The Role of Tapentadol as a Strong Opioid in Cancer Pain Management: A Systematic and Critical Review

Sebastiano Mercadante. Curr Med Res Opin.

Abstract

Aim: The aim of this review was to assess the role of tapentadol given at medium-high doses in opioid-tolerant patients for cancer pain management in place of step-3 analgesics.

Methods and results: A systematic literature search was performed out of which six studies and one secondary analysis provided data regarding tapentadol used as a step-3 analgesic for this review. Tapentadol, when used at ≥60 mg of oral morphine equivalents in opioid-tolerant patients with cancer pain, or passing from step-2 doses to ≥60 mg of oral morphine equivalents, was well tolerated and effective and could be considered as a flexible drug to be used for the management of moderate-to-severe cancer pain. The limited occurrence of gastrointestinal adverse effects may be a great advantage in the context of a disease like cancer, where multiple causes contribute to nausea, vomiting, or constipation; however, studies of tapentadol given at doses equivalent to step-3 level have some weaknesses, as data from prospective observational studies are poorly generalizable due to a small number of participants, controlled studies do not clearly show a superiority of tapentadol with respect to other opioids, and the sample size is often small.

Conclusions: More studies are necessary to confirm the role of tapentadol in cancer patients requiring strong opioids for their pain.

Keywords: Tapentadol; cancer pain; palliative care; strong opioids.

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