Nucynta and oxycodone both are FDA-approved prescription opioid drugs (differences between Tapentadol and other pain meds) widely used to treat severe or acute pain. They are also used for pain that is not relieved by non-opioids or when the patient cannot tolerate various other options medications. Both analgesics are classified as narcotics and have a high risk of dependence and abuse. (Know differences between Tapentadol and other pain meds)

The effects of Nucynta are not fully understood. There are some studies which suggest that Nucynta, a mu-receptor (pain receptor) agonist and norepinephrine reuptake inhibitor, may have analgesic properties. Also, Oxycodone works by binding to μ-receptors in the brain, blocking or weakening pain signals and relieving pain.

Because both drugs are so powerful, they are generally used for pain relief in situations where milder (non-narcotic) pain medications are intolerable or ineffective. Although both drugs are used to treat severe pain, there are many differences, which we will discuss below.

Major Differences between Tapentadol and other pain meds

Nucynta (Tapentadol) is an opioid (narcotic) pain reliever (analgesic). It is a brand-name medication available in immediate-release tablets and extended-release tablets. The extended-release tablets are called Nucynta ER. The initial dose is 50 mg to 100 mg, administered every 4 to 6 hours, depending on your pain-needs. The dose may be adjusted by your doctor; the maximum dose is 600 mg per day. If you like to buy Nucynta online, there are many online pharmacy sites.

Oxycodone is a generic opioid analgesic (Oxycodone IR stands for immediate release) under the brand name OxyContin, which is an extended-release tablet. Dosage varies, but the typical dose of immediate-release oxycodone tablets is 5 to 15 mg every 4 to 6 hours, depending on the need for pain.

Common Differences between ‌Nucynta & oxycodone


Nucynta    Oxycodone
Drug class    Opioid (narcotic) analgesic Opioid (narcotic) analgesic
Brand/generic status    Brand Brand and generic
What is the generic/brand name?    Generic: Tapentadol    Brand: OxyIR (immediate-release), Oxycontin (long-acting)
What form(s) does the drug come in? Immediate-release tablet

Extended-release tablet

Immediate-release tablet

Immediate-release capsule

Extended-release tablet

Oral solution

What is the standard dosage? About 50 mg to 100 mg given every 4 to 6 hours as required. The dose may be adjusted by the pharmacist as needed. Maximum 700 mg of the dose per day can be given on the first day of treatment    Immediate-release tablet:

About 5 to 15 mg every 5 to 6 hours as required 

Extended-release tablet:

About 20 mg every 11-12 hours

How long is the typical treatment? Short-term, may be used for the longer duration based on condition treated (such as chronic pain)    Short-term, may be used on longer term based on condition treated (such as chronic pain)
Who typically uses the medication? Adults Adults

Which is the more effective drug: Nucynta or Oxycodone?

In a study comparing an immediate-release formulation of Nucynta with an immediate-release formulation of oxycodone in patients with moderate to severe acute low back pain, both drugs were found to be equally safe and effective for low back pain and associated lower extremity pain.

A study comparing the potential for abuse in patients taking Nucynta and oxycodone found that Nucynta had a lower potential for abuse. The only way to determine which drug will work best for you is for your doctor to investigate your condition, medical history, and other medications you are taking. Both of these drugs are available online. You can buy Nucynta on sale as well as on various online pharmacy sites. (Know differences between Tapentadol and other pain meds)

Comparison of coverage and cost between Nucynta and Oxycodone

If you are receiving opioid painkillers for the first time, you are likely to be given a small dose. Coverage varies by Nucynta company. Nucynta 50 mg, 30 tablets is usually a copay of about $250, but can be purchased for as low as $211 with a Single Care Discount.

Oxycodone is usually covered by insurance and Medicare. The copay for 30 5mg tablets is about $100, but can be as low as $36 with a SingleCare coupon at participating pharmacies.

Common side effects of Nucynta and Oxycodone

The most common side effects of Nucynta are nausea, vomiting, drowsiness, dizziness, constipation, dry mouth and itching. Severe respiratory depression (slowed breathing and not getting enough oxygen) can occur, which can be life-threatening.

Side effects have been reported in more than 3% of patients when oxycodone is used, but the exact percentage has not been reported. The most common side effects are nausea, vomiting, headache, constipation, insomnia, dizziness, itching (pruritus), weakness, and drowsiness. Some serious side effects may also include respiratory arrest (stopping to breathe), respiratory depression, cardiac arrest (sudden loss of breathing, heart function, or consciousness), low blood pressure, and/or shock.

Because of the serious risks, it is very important that if you take Nucynta or Oxycodone, you do so exactly as directed and do not take additional doses. You should also check for respiratory depression, especially when starting the medication or changing the dose.

Nucynta vs oxycodone: drug interactions

Concomitant use of Nucynta or oxycodone with other drugs that suppress the central nervous system, including benzodiazepines or other opioids, may cause hypotension, respiratory depression, deep sedation, coma, and/or death. Therefore, concomitant use should be avoided. However, if there is no other option, the lowest dose of each drug should be used for the shortest period of time and the patient should be monitored closely, especially at the beginning of the treatment and during changes of the dose of medicine.

Taking Nucynta or oxycodone with medications that increase 5-hydroxytryptamine also increases the risk of 5-hydroxytryptamine syndrome (a life-threatening condition caused by an excessive buildup of 5-hydroxytryptamine). These medicines include antidepressants such as 5-hydroxytryptamine reuptake inhibitors, muscle relaxants, MAOIs (MAOIs should not be used within 14 days of Nucynta or oxycodone), and triamcinolone, which is used to treat migraines.

Interactions may occur if you take oxycodone with certain drugs that are metabolized by enzymes called CYP3A4 or CYP2D6. These drugs are called enzyme inhibitors and include macrolide antibiotics, azole antifungals, and protease inhibitors. When these drugs are mixed with oxycodone, the concentration of opioids increases and can be very dangerous. These drugs have interactions with oxycodone, but not with Nucynta. You can purchase Nucynta at discounted prices from various online pharmacy sites.

Other drugs, known as enzyme inducers, have the opposite effect of inhibitors, lowering opioid levels, which can reduce their effectiveness and cause withdrawal symptoms. Inducers may affect Nucynta and oxycodone.