Disclosed is a pharmaceutical composition comprising a slow release tapentadol and at least one pharmaceutically acceptable carrier, and a second active agent, wherein the second active agent is a non-steroidal anti-inflammatory drug (NSAID) selected from the group consisting of Celecoxib, Diclofenac, Difiunisal, Etodolac, Fenoprofen, Flurbirofen, Ibuprofen, Indomethacin, Ketoprofen, Ketorolac, Mefenamic Acid, Meloxicam, Nabumetone, Naproxen, Oxaprozin, Piroxicam, Sulindac, Tolmetin, or a pharmaceutically acceptable salt thereof. The composition is preferably in a bilayer tablet.