Many different types of medicines can be used along with (or instead of) opioids to help relieve cancer pain. Some of these medicines relieve pain or increase the effect of opioids. Others lessen the side effects of opioids. Table 2 shows the classes of non-opioid drugs that your doctor might prescribe to help you get the best pain relief with as few side effects as possible.
Table 2. Other medicines commonly used to relieve cancer pain
DRUG CLASS |
GENERIC NAME |
ACTION |
SIDE EFFECTS |
Antidepressants |
amitriptyline (Elavil), nortriptyline (Pamelor), |
Used to treat tingling or burning pain from damaged nerves. Nerve injury can be caused by surgery, radiation therapy, chemotherapy, or the cancer itself. |
Dry mouth, sleepiness, constipation. Drop in blood pressure with dizziness or fainting when standing. Blurred vision, trouble passing urine. Patients with heart disease may have an irregular heartbeat. |
Antihistamines |
hydroxyzine (Atarax, Vistaril), |
Help control nausea and help people sleep. Help control itching. |
Drowsiness, dry mouth and nose, irritability, restlessness, nervousness, trouble passing urine |
Anti-anxiety drugs |
diazepam (Valium), |
Used to treat muscle spasms that often go along with severe pain. Also lessen anxiety. |
Drowsiness. May cause urinary incontinence (loss of bladder control). |
Stimulants and amphetamines |
caffeine, |
Increase the pain-relieving action of opioids and reduce the drowsiness they cause. |
Irritability, rapid heartbeat, decreased appetite |
Anti-convulsants |
carbamazepine (Tegretol), clonazepam (Klonopin), gabapentin (Neurontin), phenytoin (Dilantin) |
Help to control tingling or burning from nerve pain caused by the cancer or cancer therapy. |
Liver problems, low red and white blood cell counts. Gabapentin may cause sleepiness and dizziness. |
Steroids |
dexamethasone (Decadron), prednisone |
Help relieve bone pain, pain caused by spinal cord and brain tumors, and pain caused by inflammation. Increase appetite. |
Fluid build-up in the body, increased blood sugar, stomach irritation, confusion. changes in behavior, trouble sleeping. |
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