Adult Dosing
Moderate to severe acute pain (Nucynta)
- 50-100 mg PO then q4-6 hrs PRN
- If pain control is not achieved within first hour of first dose, additional dose may be given
- Doses should not exceed 700 mg on the first day or 600 mg/day thereafter
Note:
- Individualize dosing regimen according to severity of pain, previous experience with similar drugs and facilities for monitoring
Moderate to severe chronic pain (Nucynta ER)
- 50 mg PO bid, may increase by 50 mg bid q3 days
- Max: 500 mg/24hrs
Diabetic peripheral neuropathy pain (Nucynta ER)
- 50 mg PO bid may increase by 50 mg bid q3 days
- Max: 500 mg/24hrs
Notes:- Individualize dosing regimen according to severity of pain, previous experience with similar drugs and facilities for monitoring
- Refer package insert for conversion
- Do not cut, crush, chew or dissolve and should be swallowed wholly
- Taper dose gradually to discontinue
Pediatric Dosing
- Safety and effectiveness in pediatric patients have not been established
[Outline]
See Supplemental Patient Information
- Respiratory depression have occurred in geriatric, debilitated patients and in those suffering from conditions accompanied by hypoxia, hypercapnia, or upper airway obstruction, in whom even moderate therapeutic doses may significantly decrease pulmonary ventilation
- Administer drug under careful medical supervision at the least effective dose in patients with decreased respiratory reserve, provide treatment for respiratory depression as with any mu-opioid agonist-induced respiratory depression
- Respiratory depression, CNS depression, hypotension, profound sedation, coma or death have occurred on concomitant use with mu-opioid agonist analgesics, general anesthetics, phenothiazines, other tranquilizers, sedatives, hypnotics, or other CNS depressants (including alcohol)
- Increase in cerebrospinal fluid pressure with retention of carbon dioxide have occurred, avoid use in patients susceptible to the effects of raised cerebrospinal fluid pressure
- May hamper clinical course of patients with head injury due to effects on pupillary response and consciousness
- Misuse, abuse and addiction have occurred; crushing, chewing, snorting or injecting the product have lead to overdose and fatal death, carefully monitor patients for signs of abuse and addiction
- Safety and efficacy is not established in patients with seizure disorder, prescribed with utmost care in such patients
- Avoid concomitant use with serotonergic drugs and those impairing metabolism of serotonin as fatal serotonin syndrome have occurred
- Gradually taper dose to avoid abrupt withdrawal symptoms
- Higher serum concentrations have occurred in patients with hepatic impairment
- Spasm of the sphincter of oddi has occurred with use of the drug and should be used with caution in patients with biliary tract disease and acute pancreatitis
- Monitor neonates from mothers treated with the drug, for respiratory depression
Cautions: Use cautiously in:
- Severe renal impairment
- Hepatic impairment
- Shock
- Arrhythmias
- Hypovolemia
- Pulmonary impairment
- Hypoxia
- Hypercapnia
- Asthma
- Chronic obstructive pulmonary disease
- Cor pulmonale
- Severe obesity
- Sleep apnea
- Hypothyroidism or myxedema
- Kyphoscoliosis
- Adrenal insufficiency
- Central nervous system (CNS) depression
- History of/risk of seizures
- Coma
- Head injury
- Intracranial lesions
- Preexisting increased intracranial pressure
- Biliary tract disease
- Acute pancreatitis
- Delirium tremens
- Toxic psychosis
- Acute alcoholism
- Acute abdomen
- Substance abuse
- GI motility disorder
- Prostatic hypertrophy
- Urethral stricture
Supplemental Patient Information
- Advise patients to avoid engaging in potentially dangerous activities such as driving, operating machinery and other activities requiring mental alertness
Pregnancy Category:C
Breastfeeding: Possibly unsafe; Manufacturer advises to avoid use during breastfeeding
Pricing data from www.DrugStore.com in U.S.A.
- Nucynta 50 MG TABS [Bottle] (JANSSEN)
20 mg = $65.99
30 mg = $98.97
Warning: This pricing information is subject to change at the sole discretion of DS Pharmacy. For the most current and up-to-date pricing information, please visit drugstore.com.
