title: A randomised, placebo-controlled trial comparing the effects of tapentadol and oxycodone on gastrointestinal and colonic transit in healthy humans.
abstract: BACKGROUND
  Tapentadol is a mu-opioid receptor agonist and norepinephrine reuptake inhibitor. In clinical trials, tapentadol provided somatic pain relief comparable to mu-opioids such as oxycodone, with significantly less gastrointestinal adverse effects. The acute effects of tapentadol on gastrointestinal and colonic transit are unclear.
  
  
  OBJECTIVE
  To compare acute effects of oral tapentadol and oxycodone on gastric, small bowel and colonic transit of solids in 38 healthy human subjects.
  
  
  METHODS
  In a randomised, parallel-group, double-blind, placebo-controlled study of the effects of identical-appearing tapentadol immediate release (IR), 75 mg t.d.s., or oxycodone IR, 5 mg t.d.s., for 48 h, we measured gastric (GE), small bowel (SBT measured as colonic filling at 6 h) and colonic transit by validated scintigraphy. Drug was commenced on the evening before the start of the transit test. The primary endpoints were overall colonic transit (geometric centre, GC) at 24 h and GE half-time (t1/2 ). ancova of transit data included gender or BMI as covariates. Adverse effects were summarised.
  
  
  RESULTS
  At the doses tested, oxycodone and tapentadol significantly delayed GE t1/2 and SBT, but not overall colonic transit, compared to placebo. Transit profiles in all regions were not significantly different between oxycodone and tapentadol at the doses tested. Both oxycodone and tapentadol were associated with nausea and central effects attributable to central opiate effects.
  
  
  CONCLUSIONS
  Tapentadol significantly delayed gastric emptying t1/2 and small bowel transit, similar to oxycodone. These data suggest that acute administration of tapentadol may not have significant advantages over standard mu-opioids, in terms of the potential to avoid upper gastrointestinal motor dysfunction.
authors.affiliation: Clinical Enteric Neuroscience Translational and Epidemiological Research (C.E.N.T.E.R.), Mayo Clinic, Rochester, MN, USA.
authors.forename: I D
authors.initials: ID
authors.lastname: Jeong
authors.forename: M
authors.initials: M
authors.lastname: Camilleri
authors.forename: A
authors.initials: A
authors.lastname: Shin
authors.forename: J
authors.initials: J
authors.lastname: Iturrino
authors.forename: A
authors.initials: A
authors.lastname: Boldingh
authors.forename: I
authors.initials: I
authors.lastname: Busciglio
authors.forename: D
authors.initials: D
authors.lastname: Burton
authors.forename: M
authors.initials: M
authors.lastname: Ryks
authors.forename: D
authors.initials: D
authors.lastname: Rhoten
authors.forename: A R
authors.initials: AR
authors.lastname: Zinsmeister
mesh_terms: D000328:Adult; D000701:Analgesics, Opioid / Q000008:administration & dosage / Q000009:adverse effects*; D004311:Double-Blind Method; D005260:Female; D005772:Gastrointestinal Transit / Q000187:drug effects*; D006801:Humans; D008297:Male; D009325:Nausea / Q000139:chemically induced; D010098:Oxycodone / Q000008:administration & dosage / Q000009:adverse effects*; D010636:Phenols / Q000008:administration & dosage / Q000009:adverse effects*; D017450:Receptors, Opioid, mu / Q000819:agonists; D000077432:Tapentadol
chemical_list: D000701:Analgesics, Opioid; D010636:Phenols; D017450:Receptors, Opioid, mu; D010098:Oxycodone; D000077432:Tapentadol