Pain
"20  years in the evening for LUPUS (SLE), rheumatoid arthritis and now AVN (a vascular necrosis, from steroid use and the SLE).  I have been on Exalgo 16 mg, Nucynta 100 mg every 12 hrs for breakthrough pain. The Exalgo was sufficient. Nucynta takes pain away for a short time, and does make me sleepy, combined with the fatigue from lupus.  Once in a while I get headaches and jittery, don&#039;t know if it&#039;s from the Nucynta. (Better described like a painful spot in my head, instead of a headache)."