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  • 7/31/2019 Recent FDA Approval for Diabetic Neuropathy

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    Management Specialist: Recent FDA Approval For Diabetic Neuropathy

    /drrobertzhang.blogspot.com/2012/09/recent-fda-approval-for-diabetic.html[9/6/2012 12:28:34 PM]

    Pain Management Spec ia l is t

    Thursday, September 6, 2012

    Posted by Dr. Robert Zhang at 9:17 AM

    Rec ent FDA Approval For Diabet ic Neuropathy

    Tapentadol has been on the market for some time and I have to admit that this is my opioid of choice in

    many situations not exclusive to neuropathy pain. Without getting into much of the pharmacologic details,

    the distinctions that Tapentadol has over other opioids is that it works not only as a narcotic pain killer, but

    it also effects chemicals in the brain and spinal cord that contribute to pain generation, sensitivity and

    maintenance. Certain antidepressants affect the same chemicals and therefore have been shown to benefit

    painful neuropathy and other chronic pain conditions. A medication called Tramadol, although being less

    potent has similar mechanisms to Tapentadol.

    In my practice, I use both Tramadol and Tapentadol often. The reason being is that it is better to attack pain

    through multiple fronts rather than relying strictly on the narcotic pain relief properties of medications, such

    as Oxycodone. Studies have shown that Tramadol produces less of a euphoria (high) and addiction potential,

    than other narcotic pain killers. Tapentadol is marketed as producing less euphoria although the word is still

    out on that. In head to head comparisons with Oxycodone, Tapentadol was less likely to produce many side

    effects, including constipation which tends to be one of the biggest problems with being on pain

    medications.

    Although I do believe in Tapentadol, I feel that patients should be aware that at the end of the day it is a

    narcotic and as such has addiction and abuse potential. With the recent FDA approval for diabetic

    neuropathy I am fearful that many providers will start using it much more often. Other medications such as

    Neurontin and Lyrica are also approved for the diabetic neuropathy and in my experience these medications

    are used ubiquitously among diabetic patients and not always in the proper doses or frequency.

    Unlike Lyrica or Neurontin, Tapentadol has abuse and dependence potential and if stopped abruptly will

    likely cause withdrawal symptoms. Just because the medication has FDA approval does not mean it is right

    for everyone. Patients should definitely inquire more from their doctors about the short and long term

    negatives of being on this medication before starting it.

    Nucynta

    Tapentadol

    Neurontin

    Tramadol

    Oxycodone

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    Dr. Robert Z hang

    Dr. Robert Yu-Fan Zhangis an Interventional PainManagement Specialist w

    extended expertise intreating back pain, head and neckpain, and cancer pain. He is boardcertified in anesthesiology andfellowship trained in interventional pa

    management. After graduating fromAlbert Einstein College of Medicine, hcompleted his residency at Yale NewHaven Hospital and pain managemenfellowship at University of California o

    San Francisco Mount Zion Hospital.

    After practicing as an attending forKaiser Permanente in California, henow serves as the Director of Pain

    Management at Queens MedicalAssociates. Dr. Zhang has extensiveexperience in a variety of interventionincluding epidurals, facet therapies,nerve blocks, neurolytic procedures,

    and radiofrequency ablation.

    View my complete profile

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  • 7/31/2019 Recent FDA Approval for Diabetic Neuropathy

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    Management Specialist: Recent FDA Approval For Diabetic Neuropathy

    /drrobertzhang.blogspot.com/2012/09/recent-fda-approval-for-diabetic.html[9/6/2012 12:28:34 PM]

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