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 Morphine tapentadol is still considered the preferred opioid analgesic for moderate-to-severe pain because of familiarity, availability and cost, other opioids including tapentadol may be used where adverse effects of morphine are unacceptable .
 The place of tapentadol in palliative care is presently uncertain and should be used on specialist  More studies are needed tapentadol to determine long term safety and tolerability of tapentadol .
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