ANALGESICS

ANALGESICS FOR PAIN

Last update 12 May 2009

Pain gets in the way, interering with daily activities, disrupting sleep and generally reducing the quality of life for many people.

That's why medications to ease pain - analgesics - are among the most-used drugs for many forms of arthritis.

Unlike nonsteroidal anti-inflammatory drugs (NSAIDs), which target both pain and inflammation, analgesics are designed purely for pain relief.

For that reason, they may be safe for people who are unable to take NSAIDs due to allergies or stomach problems, for example.
They're also an appropriate, and possibly safer, choice for people whose arthritis causes pain but not inflammation.

The most commonly used analgesic, acetaminophen, is also the most widely available.

Because of its low cost, effectiveness and safety, rheumatologists recommend acetaminophen as a first-line option against osteoarth6tis (OA) pain.
Some people use acetaminophen in addition to an NSAID for added pain relief.
Always speak to your physician and pharmacist before combining any medications, even those available without a prescription.

For severe pain that isn't eased by acetaminophen, doctors sometimes prescribe analgesics containing an opioid, such as codeine or hydrocodone.

Sometimes these products also contain acetaminophen, such as oxycodone with acetaminophen (Percocet) or propoxyphene with acetaminophen (Darvocet).

If your doctor prescribes one of those for you, make sure you don't get a double dose of acetannnophen, which can be toxic.

Longer-actmg opioid analgesics are available, too.

Some of these come in pill forms, such as oxycodone (OxyContin).

Another option is transdermal fentanyl (Duragesic), a patch that delivers opioid medication through the skin.

NAME	DOSAGE	SPECIAL INSTRUCTIONS	POSSIBLE SIDE EFFECTS	BE AWARE
Acetaminophen Non-prescription: Anacin (aspirin-free), Excedrin caplets, Panadol, Tylenol Tylenol Arthritis	325 to 1,000 mg every 4 to 6 hours as needed, no more than 4,000 mg per day. 1,300 mg every 8 hours as needed. No more than 3,900 mg in 24 hours.	Do not use with any other product containing ascetaminophen. Do not use for more than 10 days for pain unless directed by a doctor	When taken as directed, acetaminophen is usually not associated with side effects	For acetaminophen -containing products- If you consume three or more alcoholic drinks a day, consult your doctor before taking this medication. Mixing acetaminophen with alcohol can cause liver damage
Acetaminophen with Codeine Phenaphen, Tylenol with Codeine #3	15 to 60 mg codeine every 4 hours as needed with codeine (150 to 600 mg acetaminophen)	Never take more of this drug than your doctor prescribes because high doses can slow down breathing	Constipation, dizziness, lightheadedness, nausea, sedation, shortness of breath, vomiting
<>Hydrocodone with acetaminaphon Dolacet, Hydrocet, Lorcet, Lortab, Vicodin	2.5 to 10 mg hydrocodone every 4 to 6 hours as needed (Acetaminophen portion of medication varies.)	Do not increase dose on your own because side effects increase and tolerance develops as dosage increases; do not stop abruptly unless advised to do so by your doctor; do not drive or operate heavy machinery until you know how your body reacts to this drug.	Constipation, drowsiness, nausea
Morphine sulfate Avinza Oramorph SR	30 mg per day in a single dose, to start. Doctor may increase dose as necessary. 30 to 100 mg every 12 hours.
Oxycodone OxyContin Roxicodone, OxyFAST OxylR (liquid)	10 mg every 12 hours. 5 mg every 6 hours as needed.
Oxycodone with acetaminophen Percocet, Endocet	5 mg oxycodone every 6 hours as needed. Acetaminophen portion of medication varies depending on whether you are taking pills or capsules.
Propoxyphene hydrochloride Darvan, PP- Cap	65 mg every 4 hours as needed. No more than 390 mg per day
Propoxyphene with acetaminophen Datvocet	50 to 100 mg propoxyphene (325 to 650 mg acetaminophen) every 4 hours as needed, not to exceed 600 mg propoxyphene per day.
Tramadol Ultram, Ultram-ER	50 to 100 mg every 4 to 6 hours as needed, not to exceed 300 mg per day.
Tramado with acetaminophen Ultracet	75 mg tramadol every 4 to 6 hours as needed for up to 5 days. No more than 300 mg per day).