Tapentadol is a novel analgesic with combined opioid and adrenergic activity that was developed in an effort to fulfill some of the unmet needs in the management of acute pain and reduce the adverse effects of opioids. It may provide effective analgesic therapy for acute pain with both nociceptive and neuropathic components. Tapentadol immediate release (Tapentadol IR) was approved by the FDA in 2009 for the treatment of moderate to severe acute pain. It is the first new drug in the centrally acting analgesic class approved in the United States in more than 25 years. Tapentadol is listed in schedule II under the Controlled Substance Act (Drug Enforcement Administration 2009).