Like other opioids, tapentadol can cause an overdose if it is taken in large quantities or combined with other illicit substances.[1]
Signs and symptoms of a tapentadol overdose include respiratory depression, extreme sedation, slowed heart rate, low blood pressure, pinpoint pupils, gastrointestinal issues and unresponsiveness.[1,2] Breathing can slow to the point that it stops altogether.[3]
Immediate medical attention is necessary. Call 911 if tapentadol overdose is suspected and administer naloxone if you have it available.[4]
How to Avoid Overdose
Only take tapentadol as directed by your doctor. Do not exceed the recommended dose or take it more frequently than prescribed.
Avoid taking tapentadol in combination with substances like alcohol, benzodiazepines and other opioids that may increase the risk of overdose.[5]
Signs & Symptoms of Tapentadol
Symptoms that indicate a tapentadol overdose include the following:[2,6]
Respiratory Depression
Tapentadol-induced respiratory depression is characterized as slow, shallow or difficulty breathing. This symptom is one of the most dangerous and can be life-threatening. It requires urgent medical intervention.
Extreme Sedation
Taking too much tapentadol can lead to profound drowsiness and sedation. The person may appear excessively sleepy, have difficulty staying awake or exhibit extreme lethargy. They may also lose consciousness entirely.
Slowed Heart Rate
Tapentadol can cause a slowing of the heart rate, leading to bradycardia. It can be manifested as a slow heartbeat or irregularity. Dizziness, lightheadedness or fainting are all possible symptoms of the issue.
Hypotension
An overdose of tapentadol may cause a drop in blood pressure. It can cause symptoms like dizziness, blurred or distorted vision, confusion or even loss of consciousness.
Gastrointestinal Issues
Tapentadol can cause gastrointestinal issues, such as nausea, constipation or even paralytic ileus where the normal movement in the bowels is disrupted.
Lack of Responsiveness
In severe cases of tapentadol poisoning, the person may become unconscious or unresponsive. This is a medical emergency.
How Much Tapentadol Can Make You Overdose?
Varying amounts of tapentadol can trigger an overdose, depending on various factors, such as tolerance, weight, metabolism, other substances in the system and a person’s overall health.
Even a small amount of tapentadol over the prescribed dosage can cause an overdose. If alcohol is used with the drug, the risk of overdose is higher.
Tapentadol is recommended not to exceed a maximum daily dose of 600 milligrams for adults.[5] Additionally, taking a prescribed dose too soon after the last one can create an accumulation of tapentadol in the system that can overwhelm the body.
If you feel your prescribed dose isn’t working, speak to your doctor. Do not increase your dose on your own or take it with another substance.
What to Do if You Are Experiencing Overdose Symptoms
If you believe someone you are with is experiencing a tapentadol overdose, call 911.
Tell the operator you believe someone has overdose on tapentadol. Give any details you have about what they took and when.
If you have naloxone (Narcan) available, administer it to the person. This is a nasal spray that can immediately reverse the effects of an opioid overdose. There is no disadvantage to giving it if the person isn’t overdosing, so err on the side of caution and administer it if an opioid overdose is even suspected.
Monitor the person’s condition until professional help arrives. Do not move the person unless instructed by the operator. You may be asked to check for vital signs, noting the quality and pace of the breathing and their heart rate.
Using MAT for OUD
A tapentadol overdose is usually a sign of OUD. While you may recover from one overdose, it’s likely that another will occur if you don’t get help.
Medication for Addiction Treatment (MAT) is a proven treatment method for OUD.[7] Suboxone is a common choice in MAT. It combines buprenorphine (which helps to manage opioid withdrawal symptoms and cravings) and naloxone (which serves as a deterrent to misusing the medication).[8]
At Bicycle Health, we offer Suboxone via our telehealth MAT services. Our virtual platform removes obstacles to treatment like lack of local providers and transportation issues.[9,10] No matter where you live, we can meet with you, get you a Suboxone prescription you can pick up locally and set you up with counseling services.
We place a high priority on privacy and confidentiality for those seeking help. And we offer a comprehensive treatment experience that includes medication management, therapy and support services. Our holistic approach addresses physical, emotional and social aspects of recovery to help people in crisis and their families lay a strong foundation for long-term success.
Call now to learn more about your treatment options with Bicycle Health. We can often get you started right away. With the help of MAT, a better future in recovery is around the corner.
Reviewed By Peter Manza, PhD
Peter Manza, PhD received his BA in Psychology and Biology from the University of Rochester and his PhD in Integrative Neuroscience at Stony Brook University. He is currently working as a research scientist in Washington, DC. His research focuses on the role ... Read More
- Channell JS, Schug S. Toxicity of tapentadol: a systematic review. Pain Management. 2018;8(5):327-339. doi:https://doi.org/10.2217/pmt-2018-0027
- Schiller EY, Goyal A, Mechanic OJ. Opioid overdose. StatPearls. Published January 2023. Accessed September 22, 2023. https://www.ncbi.nlm.nih.gov/books/NBK470415/
- Palkovic B, Marchenko V, Zuperku EJ, Stuth EAE, Stucke AG. Multi-level regulation of opioid-induced respiratory depression. Physiology (Bethesda). 2020;35(6):391-404. doi:10.1152/physiol.00015.2020
- Hanson, B.L., Porter, R.R., Zöld, A.L. et al. Preventing opioid overdose with peer-administered naloxone: findings from a rural state. Harm Reduct J 17, 4 (2020). https://doi.org/10.1186/s12954-019-0352-0
- Singh DR, Nag K, Shetti AN, Krishnaveni N. Tapentadol hydrochloride: A novel analgesic. Saudi J Anaesth. 2013;7(3):322-326. doi:10.4103/1658-354X.115319
- Alshehri FS. Tapentadol: A Review of Experimental Pharmacology Studies, Clinical Trials, and Recent Findings. Drug Des Devel Ther. 2023;17:851-861. Published 2023 Mar 21. doi:10.2147/DDDT.S402362
- Information about Medication-Assisted Treatment (MAT). US Food & Drug Administration. https://www.fda.gov/drugs/information-drug-class/information-about-medication-assisted-treatment-mat. May 2023. Accessed May 2023.
- Suboxone: Rationale, Science, Misconceptions. The Ochsner Journal. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5855417/. 2018. Accessed June 2023.
- Molfenter T, Brown R, O’Neill A, Kopetsky E, Toy A. Use of telemedicine in addiction treatment: Current practices and organizational implementation characteristics. Int J Telemed Appl. 2018;2018:3932643. Published 2018 Mar 11. doi:10.1155/2018/3932643
- Fast N, van Kessel R, Humphreys K, Ward NF, Roman-Urrestarazu A. The evolution of telepsychiatry for substance use disorders during COVID-19: A narrative review. Curr Addict Rep. 2023;10(2):187-197. doi:10.1007/s40429-023-00480-9
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