Lincomycin Injection and Tapentadol Hydrochloride

• Generic Name: lincomycin
• Dosage Forms: injection, solution
• Other Brand Names: Lincocin, Lincorex, L-Mycin, Bactramycin

Treatment of serious infections caused by susceptible staphylococci, Streptococcus pneumoniae, and other streptococci. Because of more potent antibacterial activity, clindamycin usually preferred when a lincosamide antibiotic indicated for treatment of these infections.

Reserve for treatment of serious infections when less toxic alternatives cannot be used (e.g., penicillin-allergic patients or other patients for whom a penicillin is inappropriate). Has been associated with potentially fatal colitis (see Superinfection/Clostridium difficile-associated Diarrhea and Colitis [CDAD] under Cautions); consider nature of the infection and suitability of less toxic alternatives (e.g., erythromycin).

May be used concomitantly with other anti-infectives when indicated.

Certain infections may require incision and drainage or other indicated surgical procedures in addition to anti-infective treatment; use of lincomycin does not eliminate need for surgical procedures when indicated.

Do not use for treatment of meningitis because of inadequate CNS penetration following parenteral administration.

• Generic Name: tapentadol
• Dosage Forms: n.a.
• Other Brand Names: Nucynta, Nucynta ER

Conventional tablets or oral solution: Relief of acute pain that is severe enough to require an opiate analgesic and for which alternative treatment options (e.g., nonopiate analgesics, opiate-containing fixed combinations) have not been, or are not expected to be, adequate or tolerated.

Extended-release tablets: Management of pain (including neuropathic pain associated with diabetic peripheral neuropathy) that is severe enough to require long-term, daily, around-the-clock use of an opiate analgesic and for which alternative treatment options (e.g., nonopiate analgesics, immediate-release opiates) are inadequate or not tolerated. Not indicated for as-needed (“prn”) use.

In symptomatic treatment of acute pain, reserve opiate analgesics for pain resulting from severe injuries, severe medical conditions, or surgical procedures, or when nonopiate alternatives for relieving pain and restoring function are expected to be ineffective or are contraindicated. Use smallest effective dosage for shortest possible duration since long-term opiate use often begins with treatment of acute pain. Optimize concomitant use of other appropriate therapies. (See Managing Opiate Therapy for Acute Pain under Dosage and Administration.)

Generally use opiates for management of chronic pain (i.e., pain lasting >3 months or past the time of normal tissue healing ) that is not associated with active cancer treatment, palliative care, or end-of-life care only if other appropriate nonpharmacologic and nonopiate pharmacologic strategies have been ineffective and expected benefits for both pain relief and functional improvement are anticipated to outweigh risks.

If used for chronic pain, opiate analgesics should be part of an integrated approach that also includes appropriate nonpharmacologic modalities (e.g., cognitive-behavioral therapy, relaxation techniques, biofeedback, functional restoration, exercise therapy, certain interventional procedures) and other appropriate pharmacologic therapies (e.g., nonopiate analgesics, analgesic adjuncts such as selected anticonvulsants and antidepressants for certain neuropathic pain conditions).

Available evidence insufficient to determine whether long-term opiate therapy for chronic pain results in sustained pain relief or improvements in function and quality of life or is superior to other pharmacologic or nonpharmacologic treatments. Use is associated with serious risks (e.g., opiate use disorder, overdose). (See Managing Opiate Therapy for Chronic Noncancer Pain under Dosage and Administration.)