Pain Medications from Discovery Health Channel

Pain Medications Written by James Broomfield, MD from Discovery Health Channel Last reviewed on 12/20/2006

Overview

Pain medication is taken in order to reduce the amount, duration, or awareness of pain.

What is the information for this topic?

Over-the-counter pain medicine Many pain medicines are available over the counter without a prescription. Common over-the-counter pain medicines include:

• acetaminophen

• nonsteroidal anti-inflammatory drugs (NSAIDs). Aspirin, ibuprofen, and naproxen are all NSAIDs.

Prescription pain medicine These are available only with a prescription from a healthcare professional. Examples include:

• anticonvulsants, which can relieve chronic nerve pain. Examples include phenytoin (i.e. Dilantin), carbamazepine (i.e. Tegretol), and gabapentin (i.e. Neurontin).

• antidepressants, which may relieve certain kinds of chronic pain. Common antidepressants include amitriptyline (i.e. Elavil), trazodone (i.e. Desyrel), and imipramine (i.e. Tofranil).

• capsaicin, a cream that can relieve skin pain caused by shingles, nerve problems, and other causes

• corticosteroids, such as prednisone, which can relieve pain from inflammation

• Cyclooxygenase 2 (COX-2) inhibitors such as celecoxib (i.e. Celebrex) and meloxicam (i.e. Mobic) are helpful for inflammatory pain such as from arthritis.

• narcotics, which are the most effective for moderate to severe pain. Common narcotics include morphine (i.e. Avinza, MS Contin), codeine, meperidine (i.e. Demerol), oxycodone (i.e. OxyContin), hydromorphone (i.e. Dilaudid) and methadone.

• sumatriptan (i.e. Imitrex) and naratriptan (i.e. Amerge), which can relieve the pain of a migraine headache

• tramadol (i.e. Ultram), which is used mainly for chronic pain

Side effects All medicines have potential side effects, including allergic reactions. Other common side effects of pain medicines include:

• stomach upset, gastrointestinal bleeding and kidney failure are potential side effects of NSAIDs and COX-2 inhibitors

• liver damage with high doses of acetaminophen, especially when it is used for long periods of time

• diabetes, osteoporosis, and increased risk of infection with long-term use of corticosteroids

• dizziness, drowsiness, and nausea with tramadol

• drowsiness and confusion with anticonvulsants, especially within the first 2 weeks of starting the medicine

• drowsiness, nausea, constipation, itchiness, urinary hesitancy and potential addiction with narcotics. Patients taking narcotics for more than 2 weeks may experience withdrawal if the narcotic dose is not gradually tapered.

• dry mouth, drowsiness, and constipation with antidepressants

• rarely, increased blood pressure with sumatriptan and naratriptan

Some people have severe pain that will not respond to over-the-counter pain medicines. These people should talk to a healthcare professional. First, the cause of the pain can be investigated, and possibly treated. If no cause can be found, or if the cause is not treatable, the healthcare professional can prescribe a medication or combination of medications to provide relief. In some persons, physical therapy or other non-medication forms of treatment may work better than medication. Pain specialists are available to help with the care of persons whose pain problems are especially difficult to manage.