Why does nucynta (tapentadol) not show up on urine tox?

Synthetic opioid: Nucynta (tapentadol) is a synthetic opioid. Many synthetic opioids don't show up on standard toxicology screens and require specialized laboratory tests to check for.

Lets review your que: It is 99% excreted in the urine. Since it is the subclass of opiod, the opiod class may positive--exact med cannot be classified. It may also need to be specially tested for most urine drug screens I see have 6 categories tested--street drugs: marijuana, benzodiazepines, opiods, etc.

Nucenta: It can if the drug test is designed to test for it. Understand that urine tox come in many "flavors" that test for different things. Chances are your tox test did not test for nucynta (tapentadol). Dr R

It is unique: It is a unique compound that has features of narcotic and also an antidepressant. It is a synthetic compound called Tapentadol and isn't tested for in a routine 10 drug screen. But it can be tested for if specifically requested , or in a very comprehensive drug screen. It is a powerful and addictive and only used as prescribed by a qualified And lisenced doctor.