When it comes to managing moderate to severe pain, opioid medications like Nucynta (tapentadol) and Oxycodone are two frequently prescribed options. While both are effective pain relievers, they differ in their mechanisms, side effect profiles, and potential risks.
If you’re deciding between these two medications, this article breaks it down clearly to help guide your decision.
What Is Nucynta?
Nucynta is the brand name for tapentadol, a centrally acting opioid analgesic that works through two mechanisms: μ-opioid receptor agonism and norepinephrine reuptake inhibition. Because of this dual action, Nucynta is believed to provide pain relief with potentially fewer gastrointestinal side effects compared to traditional opioids.
Nucynta is often prescribed for moderate to severe acute pain and, in its extended-release form, for chronic pain and neuropathic pain from diabetic peripheral neuropathy.
What Is Oxycodone?
Oxycodone is a well-known opioid used to treat moderate to severe pain. It binds directly to the μ-opioid receptors in the brain and spinal cord to block pain signals. Oxycodone has been available since the early 20th century and is available in both immediate-release and extended-release formulations (e.g., OxyContin).
Because of its long history and widespread use, Oxycodone is one of the most studied opioids in terms of efficacy, tolerance, and misuse potential.
Effectiveness: How Do They Compare?
Both medications are effective for managing moderate to severe pain, but they work slightly differently in the body. Nucynta’s additional norepinephrine reuptake inhibition may make it more effective in certain types of pain, such as neuropathic or nerve-related pain.
A randomized clinical trial found that tapentadol ER was non-inferior to oxycodone CR in pain relief for patients with chronic low back pain, while offering a better gastrointestinal tolerability profile.
Additionally, a meta-analysis also found that patients on tapentadol ER experienced 50% fewer gastrointestinal adverse events (e.g., nausea, constipation) compared to those on oxycodone CR.
Side Effects
Common Side Effects of Nucynta:
- Nausea
- Dizziness
- Sleepiness
- Vomiting
- Fatigue
Common Side Effects of Oxycodone:
- Constipation
- Drowsiness
- Nausea
- Lightheadedness
- Dry mouth
While side effects vary by person, Nucynta has shown a slightly more tolerable side effect profile in clinical studies. According to a study, constipation occurred in 25% of oxycodone users versus only 11% in those taking Nucynta.
Risks and Dependency Potential
Both drugs are Schedule II controlled substances, meaning they have a high potential for abuse and dependence. However, some evidence suggests that Nucynta may have a lower abuse potential due to its unique dual mechanism and less euphoric effect.
A 2015 review noted that tapentadol showed lower “likability” and “drug high” scores in recreational drug users compared to oxycodone. This suggests that Nucynta may be less appealing for misuse, although it still carries addiction risk.
That said, Oxycodone remains one of the most abused prescription opioids in the United States, contributing significantly to the opioid epidemic. According to the CDC, nearly 49,860 people died from opioid overdoses in 2019, and oxycodone was among the most commonly involved substances.
Bottom Line
There’s no one-size-fits-all answer, but here’s a quick comparison:
| Factor | Nucynta | Oxycodone |
| Pain Relief | Effective, especially for neuropathic pain | Effective for general and chronic pain |
| Side Effects | Fewer GI issues (nausea, constipation) | More likely to cause constipation |
| Abuse Potential | Lower, but still present | Higher abuse potential |
| FDA Approval | 2008 | 1950s (longer history) |
| Cost & Availability | May be more expensive or less available | Widely available, generic versions exist |
If you or your doctor are concerned about tolerance, constipation, or opioid dependence, Nucynta may be a safer bet, especially for nerve-related pain. However, for acute pain or when cost is a major factor, oxycodone remains a reliable and accessible option.
Still unsure which pain management option is right for you? At Premiere Addiction Recovery, a drug rehab in Florida, we’re committed to providing accurate, research-backed insights to help patients and healthcare providers make informed decisions.
Have questions or need guidance? Contact us today and we’re here to support your journey toward safer pain relief.
