Pain Control

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Other types of pain medicine

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. These drugs are often started at low doses and increased over time. 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 (brand) name

    Action

    Side effects

    Antidepressants

    amitriptyline (Elavil),
    imipramine (Tofranil), nortriptyline (Pamelor), desipramine,
    duloxetine (Cymbalta), venlafaxine (Effexor)

    Used to treat tingling or burning pain from damaged nerves. Nerve injury (and nerve pain) can be caused by surgery, radiation, chemo, or the cancer itself.

    Dry mouth, blurred vision, trouble passing urine, sleepiness, constipation, Drop in blood pressure with dizziness or fainting when standing. May cause irregular heartbeat, especially in patients with heart disease.

    Antihistamines

    hydroxyzine (Atarax, Vistaril),
    diphenhydramine (Benadryl)

    Can 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),
    lorazepam (Ativan)

    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,
    dextroamphetamine (Dexedrine),
    methylphenidate (Ritalin), modafinil (Provigil)

    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), pregabalin (Lyrica)

    Help to control tingling or burning from nerve pain caused by the cancer or cancer treatment.

    Liver problems, low red and white blood cell counts. Gabapentin and pregabalin 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.

    Increased appetite and thirst. Fluid build-up in the body, increased blood sugar, stomach irritation, confusion. Changes in behavior, trouble sleeping.


Last Medical Review: 08/29/2013
Last Revised: 08/29/2013