Just like other μ-opioid agonists, tapentadol could lead to spasms of your sphincter of Oddi, and it is hence discouraged to be used in people with biliary tract disease such as both acute and Long-term pancreatitis. People who are speedy or ultra fast metabolizers with the CYP2C9, CYP2C19, and CYP2D6 enzymes might not react adequately to tapentad