Combination of Tapentadol Nasal Spray and Radiotherapy for Managing Moderate-to-Severe Pain from Lytic Bone Metastasis

Background: Tapentadol is known for its opioid-sparing effect, reducing adverse effects associated with opioids, particularly gastrointestinal issues. However, limitations in the oral formulation warrant exploration of alternatives like tapentadol nasal spray for enhanced efficacy and patient experience. Aims and Objectives: This study aimed to assess the safety of tapentadol nasal spray (45mg/dose, administered four times daily) along with radiotherapy in patients with lytic bony metastasis moderate to severe pain. Materials and Methods: 65 patients with lytic bony metastasis from solid tumours in 2023 were given local radiotherapy and tapentadol nasal spray (45mg/dose, administered four times daily). Results: Tapentadol nasal spray combined with radiotherapy demonstrated significant pain reduction. Sleep scores were significantly better with tapentadol nasal spray. The nasal route provided enhanced comfort, convenience, safety, and efficacy, offering rapid pain relief. Conclusion: Tapentadol nasal spray presents a favourable option for bone metastasis pain management along with radiotherapy, offering improved pain reduction, better sleep outcomes, and enhanced patient comfort. The nasal delivery method proves efficient and patient-friendly, marking a significant advancement in achieving early and sustained pain relief.