Pain Medications

Medicines can often help control chronic pain. Many different drugs, both prescription and nonprescription, are used to treat chronic pain. All these medicines can cause side effects and should be taken exactly as they are prescribed. In some cases, it may take several weeks before medicines work to reduce pain. It is important to let your health professional know all medicines you are taking (including herbal and other complementary medicines) to avoid dangerous drug interactions.

Medicines used for pain control include short- and long-acting opioid medications, non-opioid pain medications, muscle relaxants, antidepressants, and anticonvulsant medications. Although not approved by the US Food and Drug Administration (FDA) for pain control, antidepressants and anticonvulsant medications do have pain-relieving properties, especially in patients with pain emanating from the nervous system (i.e., neuropathic pain). These antidepressant and anticonvulsant medications are called adjuvant medications.

Non-opioid pain relieving medications include acetaminophen and the non-steroidal anti-inflammatory agents (NSAIDs), such as aspirin or ibuprofen. Opioid pain medications are either short or long acting. For constant pain, long-acting opioids are a better choice. Sometimes other medications, such as steroids, anti-hypertensive medications, oral local anesthetics, and others, are used for pain control.

The WHO guidelines suggest steps for pain control. For mild pain, the guidelines suggest using non-opioid pain relievers with or without an adjuvant medication (that is, medications that do have pain relieving properties not approved by the FDA for pain control). If pain persists, the guidelines suggest adding a mild opioid to the above therapy. If pain still persists after the addition of mild opioids, the guidelines suggest going to a strong opioid.

The WHO guidelines group cancer-related pain by severity into mild, moderate, and severe pain and suggest matching the strength of pain medications to the severity of the pain complaint of the patient.

The WHO suggests non-opioid medications such as the NSAIDs and adjuvant medications (antidepressants and/or anticonvulsant medications) for mild to moderate cancer pain and weak to moderate strength opioids such as acetaminophen with codeine and hydrocodone (such as Vicodin, Lortab, or Norco) in combination with non-opioid and adjuvant medications for moderately severe cancer pain.

Potent opioids such as morphine, together with non-opioids and adjuvant medications, are used for strong and severe cancer-related pain. Approximately 50% to 80% of patients dying of cancer, depending on the type of pain, should have their pain well controlled using these WHO guidelines.

We have list the pain medication here. Because information about pain medications is constantly changing, the following list of medications is by no means comprehensive. Never use this information to treat yourself. It is no substitute for the experience and knowledge of your physician.

NonSteroidal Anti-Inflammatory Drugs (NSAIDs):

  • Aspirin (Ecotrin, ASA)

  • Diclofenac (Voltaren)

  • Diflunisal (Dolobid)
  • Celecoxib (Celebrex – a cox-2 inhibitor)
  • Etodolac (Lodine)
  • Ibuprofin (Advil, Nuprin, Motrin, etc.)
  • Indomethacin (Indocin)
  • Ketorolac (Toradol (only use for up to five days.))
  • Oxaprozin (Daypro)
  • Piroxicam (Feldene)
  • Sulindac (Clinoril)

 

Opioid-Like Drugs (Narcotics):
  • Butorphanol Tartrate (Stadol)
  • Nalbuphine (Nubain)
  • Pentazocine Lactate (Talwin) (a category of drugs called opioid agonist-antagonists. They  probably should not ever be used.)
  • Codeine Phosphate (Codeine)
  • Fentanyl Citrate (Fentanyl)
  • Hydromorphone (Dilaudid)
  • Morphine Sulfate (MS Contin, Noxamol)
  • Oxycodone (Oxyir, Roxicodone, Oxycontin, Percocet)
  • Buprenorphine (Subutex, Suboxone)
  • Propoxyphene Napsylate (Darvon – N)
  • Methodone
  • Hydrocodone (Vicodin)

 

Opioid – Containing Combination Drugs:
  • Hydrocodone/Acetaminophen (Anexsia)
  • Propoxyphene/APAP (Darvocet)
  • Butalbital/ASA/Caffiene/Codiene (Fiorinal with Codeine)
  • Butalbital/APAP/Caffiene/Codiene (Fioricet with Codeine)
  • Hydrocodne/Acetaminophen (Lortab)
  • Hydrocodone/APAP (Norco)
  • Oxycodone/Aspirin (Percodan)
  • Hydrocodone/Acetaminophen (Lorcet)
  • Carisoprodol plus Codeine (Soma with Codeine)
  • Oxycodone/Acetaminophen (Tylox)
  • Hydrocodone/Acetaminophen (Vicodin)
  • Hydrocodone/Ibuprofen (Vicoprofen)

 

Other Analgesics:
  • Acetaminophen (Tylenol, Panadol, Tempra, etc.)
  • Tramadol (Ultram)

 

Anesthetics/Sedatives:
  • Fentanyl Citrate (Fentanyl)
  • Ketamine (Ketalar)
  • Diphenhydramine (Sufentanil, Sleepinal)

 

Local Anesthetics:
  • Bupivacaine (Marcaine, Bupivac)
  • Lidocaine (Xylocaine)
  • Mepivacaine (Carbocain)

 

Anxiolytics/Hypnotics (used when anxiety disorders and/or sleep disturbance is present):
  • Lorazepam (Ativan)
  • Temazepam (Restoril)
  • Alprazolam (Xanax)
  • Midazolam Hydrochloride (Versed)
  • Oxzaepam (Serax)
  • Diphenhydramine Hydrochloride (Benadryl)
  • Chlordiazepoxide (Librium)
  • Clonazepam (Klonopin)
  • Clorazepate Dispotassium (Tranxene)
  • Flurazepam (Dalmane)
  • Buspirone (Buspar)
  • Zolpidem (Ambien)
  • Zaleplon (Sonata)
  • Eszopiclone (Lunesta)
Anti-epileptics (Anticonvulsants):
  • Carbamazepine (Tegretol)
  • Clonazepam (Klonopin)
  • Topiramate (Topomax)
  • Gabapentin (Neurontin)
  • Phenytoin (Dilantin)
  • Valproic Acid (Depakene/Depakote)
  • Tiagabine (Gabitril)
  • Pregabalin (Lyrica)
  • Diazepam (Valium)
  • Lamotrigine (Lamictal)
  • Levetiracetam (Keppsa)
  • Oxcarbazepine (Trileptal)

Pregabalin is related to gabapentin and is approved to treat neuropathic pain, specifically diabetic peripheral neuropathy and postherpetic neuralgia. It is currently under review by the FDA for the adjunctive treatment of partial seizures and may have potential for treating CRPS.

Anti-depressants:
  • Fluoxentine Hydrochloride (Prozac)
  • Paroxetine (Paxil)
  • Sertraline Hydrochloride (Zoloft)
  • Amitriptyline (Elavil)
  • Desipramine (Norpramin)
  • Venlafaxine (Effexor)
  • Doxepin (Sinequan)
  • Bupropion Hydrochloride (Wellbutrin)
  • Nefazodone (Serzone)
  • Trazadone (Desyrel)

 

Muscle Relaxants
  • Baclofen (Lioresal)
  • Carisoprodol (Soma)
  • Methocarbamol (Robaxin)
  • Tizanidine (Zanaflex)
  • Cyclobenzaprine (Flexeril)
  • Dantrolene Sodium (Dantrium)
  • Diazepam (Valium)
  • Quinine Sulfate (Quinaam)

 

Trans-dermal Patches and Ointments May Contain:
  • Catapres (Clonidine)
  • Ketamine (Ketalar)
  • Capsaicin (Zostrix)
  • Fentanyl Citrate (Fentanyl – local anesthetic)

Differnet Pain use different medications, for more pain medication information, please go to pain medication directory

1 comment

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  1. tramault says:
    03/05/2009 at 2:44 am

    Narcotics can be addictive, so your family doctor will be careful about prescribing them. For many people with severe chronic pain, these drugs are an important part of their therapy. If your doctor prescribes narcotics for your pain, be sure to carefully follow his or her directions. Tell your doctor if you are uncomfortable with the changes that may go along with taking these medicines, such as inability to concentrate or think clearly. Do not drive when taking these medicines.

    When you’re taking narcotics, it’s important to remember that there is a difference between “physical dependence” and “psychological addiction.” Physical dependence on a medicine means that your body gets used to that medicine and needs it to work properly. When you don’t have to take the pain medicine any longer, your doctor can help you slowly and safely decrease the amount of medicine until your body no longer “needs” it.

    Psychological addiction is the desire to use a drug whether or not it’s needed to relieve pain. Using a narcotic this way can be dangerous and may not help your pain. If you have a psychological addiction to a narcotic, your doctor may give you another drug to help with your psychological problems. Or your doctor might recommend that you talk to a counselor. Your doctor might also change the medicine that you are addicted to by lowering the dose, changing to another drug or stopping the medicine altogether.

    Narcotic drugs often cause constipation (difficulty having bowel movements). If you are taking a narcotic medicine, it’s important to drink at least 6 to 8 glasses of water every day. Try to eat 2 to 4 servings of fresh fruits and 3 to 5 servings of vegetables every day. Be sure to tell your doctor if constipation becomes a problem for you. He or she may suggest taking laxatives to treat or prevent it.