The following article features coverage from PAINWeek 2017 in Las Vegas, Nevada. Click here to read more of MPR‘s conference coverage.

The term “multigesic agent” was proposed by study authors who presented a commentary at Pain Week 2017 to describe analgesics with different mechanisms of actions, side effect profiles, and abuse potentials than conventional opioids.        

During the commentary, the authors discussed the 4 “atypical opioids” that have been recently developed, which include buprenorphine, cebranopadol, tapentadol, and tramadol. They explained, “These agents rely on unique and possibly synergistic mechanisms of action and do not work like conventional opioids, yet they are often categorized as “opioids,” which can be misleading in that they have different attributes than conventional opioids.” Because of this, use of the term “multigesic agent” is proposed so that this subset of analgesic products can be accurately described as well as differentiated from conventional opioids. 

Although each of the 4 “multigesic” agents has a different mechanism of action, each involve an opioid and nonopioid component. The 4 agents have not only been found to effectively relieve pain, but are also well tolerated and have a decreased risk of adverse events compared to conventional opioids. The authors added, “Although studies are needed for confirmation, it is easy to rationalize why multigesics may be less well liked by abusers than conventional opioids.” 

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Additionally, each of the multigesic agents possesses unique properties that differentiate them from traditional opioid products. For example, no ceiling effect exists for buprenorphine in regards to pain control but one does exist in terms of respiratory depression. Cebranopadol, unlike conventional opioids, does not cause sedation. Lastly, tramadol can cause respiratory depression, but only at doses higher than conventional opioids.

The authors concluded, “Multigesics as a new term will help categorize an important new type of analgesic product and differentiate it from conventional opioids.” 

Read more of MPR‘s coverage of PAINWeek 2017 by visiting the conference page.


  1. Pergolizzi JP, LeQuant J, Taylor R, Raffa R. The Introduction of a New Term: Multigesics. NEMA Research Group. Naples, FL, USA.