"250mg once every 12hrs didn&#039;t do much for pain in er formulation for me but the 50mg worked quite well as a breakthrough pain medication when combined with 2/3 my typical dosage of oxycontin.  i found that pain relief duration at 50mg was about 4hrs.  i believe that the er formulation starts at 100mg and higher.  i am lethargic on nucynta er at the 250mg 2x a day dose compared to oxycontin 30mg 3x daily."