Guide to Controlling Cancer Pain

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Medicines used to relieve pain

The type of medicine and the way the medicine is given depend on the type and cause of pain. For example, chronic pain is best relieved by methods that deliver a steady dose of pain medicine over a long period of time, such as a patch that releases medicine through the skin or slow (extended)-release pills. On the other hand, breakthrough pain is best treated with medicines that work fast (quick release), and stay in the body only for a short time. Below is an overview of the types of medicines used to relieve pain.

Opioids or narcotics are the strongest pain relievers available.

For mild to moderate pain

Non-opioids: Acetaminophen (Tylenol) and non-steroidal anti-inflammatory drugs (NSAIDs), such as aspirin and ibuprofen (Advil, Motrin), are often used.

You can buy many of these over the counter (without a prescription). For others, you need a prescription. Check with your doctor before using these medicines. NSAIDs can slow blood clotting. This may be a problem if you’re having surgery or getting chemotherapy. NSAIDs and acetaminophen may also affect other parts of the body and may interact with other medicines.

For moderate to severe pain

Opioids (also known as narcotics): Morphine, fentanyl, hydromorphone, oxycodone, codeine and others

You need a written prescription for these medicines. Non-opioids may be used along with opioids for moderate to severe pain.

For breakthrough pain

Rapid-onset opioids: Fast-acting oral morphine; fentanyl in a lozenge, “sucker,” or under-the-tongue spray (These forms of fentanyl are absorbed from your mouth – they are not swallowed.)

You need a written prescription for these medicines. A short-acting opioid, which relieves breakthrough pain quickly, is often used with a long-acting opioid.

Many times the same opioid drug is used to treat both the chronic and the breakthrough pain, so be sure you know what you’re taking. For example, hydrocodone ER (Zohydro ER®) may be for your chronic pain and hydrocodone with acetaminophen (Lortab®) is for your breakthrough pain. Do not mix them up!

For tingling and burning pain

Antidepressants: Amitriptyline, nortriptyline, venlafaxine, and others

You need a prescription for these medicines. Antidepressants are prescribed to relieve certain types of pain. Taking an antidepressant does not mean that you’re depressed or have a mental illness.

Anti-convulsants (anti-seizure medicines): Carbamazepine, gabapentin, and others

You need a prescription for these medicines. Despite the name, anti-convulsants are not only used for convulsions (seizures), but also to control burning and tingling (nerve) pain.

For pain caused by swelling or pressure

Steroids: Prednisone, dexamethasone

You need a prescription for these medicines. They’re most often used to lessen swelling, which often causes pressure and pain.

Last Medical Review: 07/15/2015
Last Revised: 07/15/2015