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If you have ever had a bad reaction to tapentadol, you shouldn't take this medicine. Unless your doctor tells you otherwise, you shouldn't use it while you're pregnant or nursing. If you have any of the following side effects while taking tapentadol: rash, hives, or itching on your skin; swelling of your face, lips, tongue, or throat, which can make it hard to breathe or swallow; unusual hoarseness; or trouble breathing.