Clinical presentation

Tapentadol poisoning may be asymptomatic. If symptoms do occur, prominent features include:

• respiratory effects
  • respiratory depression, which includes reduced minute volume, and reduced respiratory rate or apnoea; respiratory depression is more likely with co-ingestion of other sedatives
  • aspiration pneumonitis, pulmonary oedema
• central nervous system effects
  • sedation
  • agitation
  • seizures—rare
• cardiovascular effects—tachyarrhythmias (eg sinus tachycardia, ventricular tachycardia), hypertension

The risk of serotonergic toxidrome is low unless tapentadol is co-ingested with a serotonergic agent, particularly a monoamine oxidase inhibitor.