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Tramadol, Tapentadol and Soma are primarily FDA approved Schedule II and Schedule IV medications prescribed for moderate to severe pain. Though the exact mechanism is not clear, Tapentadol and Tramadol are believed to work by inhibiting the serotonin reuptake, i.e. blocking the pathways involved in the transmission of pain. Soma works on the GABA receptors for the analgesic effect. Along with being pain relievers, they also have sedative effects for additional relaxation and pain relief for the patient.

While Tapentadol and Tramadol are controlled substances, Soma is a generic medication.

What are these Medications used for?

Tapentadol medicine is a centrally-acting synthetic analgesic that acts two ways- firstly, by its mu-opioid receptor activity and secondly, by its adrenaline reuptake inhibition. In simple words, it has the potential of an opioid analgesic without any of its adverse reactions, which makes it an important reliever for neuropathic pain, i.e. nerve damage-related pain. Tramadol, being structurally similar to Tapentadol, is less potent than Tapentadol. It is used in cases of fibromyalgia and for post-surgery pain relief. Soma is a skeletomuscular relaxant used for mild injuries.

A comparison of their use criteria

Tapentadol and Tramadol are used in severe cases of pain not responding well to other analgesics. They are usually used for post surgeries and other severe injuries. Soma, in comparison, is a less severe medication used for the relief of musculoskeletal pain. It is more commonly used in sprains, ligament sprains and other muscle injuries. You will need to use it in addition to rest and therapy for it to be completely effective.

Let’s look at the pro-drug angle.

It is worthwhile to mention that while Soma and Tramadol are pro-drugs, Tapentadol is not. A pro-drug is a drug that, on its own, is not very effective. It gets converted into a pharmacologically active drug after its metabolism. Pro-drugs are advantageous in being abuse-deterrent, but in the process, their effectiveness takes a back seat.

Tapentadol 100mg, on the other hand, is not a pro-drug. Meaning, it does not require metabolic activation to start working. That makes it suitable for faster pain relief and better for chronic, neuropathic, and nociceptive pain like sports injuries or arthritis.

But does that make it an ideal drug? The answer is no.

The unwanted side effects

While taking painkillers, we often tend to ignore the treatment goals along with the length of treatment. Painkillers, when used for a long term, lead to addiction or over-consumption, causing further complications. Not to mention, these have drug interactions or react with foods and beverages. This can lead to a range of complications from mild to moderate, leading up to the death of the person.

A detailed discussion

Soma 350mg is available in tablet forms. Tapentadol and Tramadol are available in tablet, extended-release tablet, injection and patch form. When consumed incorrectly (either broken or crushed), the extended-release tablet form acts in increased concentrations leading to overdosing symptoms. Dizziness, increased heart rate and sometimes heart stroke could occur in the worst-case scenario.

Additionally, Tapentadol on being used in pregnant mothers results in the baby having serious withdrawal symptoms like hyperactivity, tremors, discomfort with weight gain issues, and, if discontinued, suddenly. Likewise, when accidentally consumed by children, Tramadol may lead to difficulties in breathing, loss of consciousness, and a host of other complications lethal to them.

Side-effects in Soma, though comparatively less, are still present. Soma tends to accumulate in alarming concentrations in breast milk when consumed on a long term basis by lactating mothers. Nausea, vomiting, agitation and headaches are some of the common side effects you may expect with these three medications. Tapentadol, not a pro-drug, will permanently damage your liver or kidneys if you have any liver/kidney infection or consume more than required.

A few words about allergies and drug interactions

Tapentadol and Soma on being taken with anti-depressants can lead to serotonin toxicity. Tramadol tends to react with around 72 drugs. The most severe reaction occurs when taken in combination with anti-seizure medications leading to suicidal behaviour.

Allergies to these medications can rarely occur. Potential allergic reactions to any of these medicines may result in blisters throughout the skin and present with hives and breathing difficulties. Tramadol, Tapentadol and Soma all three have sedative effects. Consuming them with grapefruits or alcohol may cause unconsciousness or drowsiness effects.

Better to be safe than sorry

Though they may seem scary, these catastrophes can be avoided to a great extent with proper care and precautions.  Most medications react only when misused or overused. It’s okay if you have missed a dose. Do not take an extra dose to make up for the missed one. Also, stop taking them gradually after the course is over. Do not consume them for a prolonged period or abruptly stop the course. It will worsen the withdrawal symptoms.

Before using a medicine, always make it a point to read the instruction leaflet inside the medicine packet. It contains detailed instructions on the usage, storage and possible drug interactions. Reading it will give you an idea of whether or not to use it without any expert consultation. Confiding with your practitioner in the first place will give him an idea of what not to advise you. This will save you a lot of drug-related allergy risks in future.

As Tapentadol, Tramadol and Soma have sedative effects, they can make you sleepy. Do not drive or handle heavy machinery after using these medications. Immediately discard the medication if it has turned yellowish or looks soggy. After you have used them, store them in a cool, dry place away from children and pets for the safety of the household.


It is a fact that painkillers are extremely beneficial medications that benefit a lot of people. Tapentadol Tramadol and Soma have been FDA approved despite the associated risks. It is because their lists of pros outweigh their cons. It is up to the users to use the drug with discretion. It will lessen the incidence of drug-related addictions and complications. Additionally, it will encourage medicine companies to keep researching and making even better analgesic medications for the betterment of mankind.

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