The Medical Letter on Drugs and Therapeutics
Nonopioid Drugs for Pain
March 7, 2022 (Issue: 1645)Nonopioid drugs can be used in the treatment of many nociceptive and neuropathic pain conditions. For severe pain, especially severe chronic cancer pain, use of opioids may be necessary. Noninvasive nonpharmacologic treatments, including...more
- NB Finnerup. Nonnarcotic methods of pain management. N Engl J Med 2019; 380:2440.
- AC Skelly et al. Noninvasive nonpharmacological treatment for chronic pain: a systematic review update [internet]. Rockville (MD): Agency for Healthcare Research and Quality (US); 2020 Apr. Report No.: 20-EHC009. Available at: https://bit.ly/3uwrh33. Accessed February 17, 2022.
- BT Saragiotto et al. Paracetamol for low back pain. Cochrane Database Syst Rev 2016; 6:CD012230.
- BR da Costa et al. Effectiveness and safety of non-steroidal anti-inflammatory drugs and opioid treatment for knee and hip osteoarthritis: network meta-analysis. BMJ 2021; 375:n2321.
- IM MacIntyre et al. Regular acetaminophen use and blood pressure in people with hypertension: the PATH-BP trial. Circulation 2022; 145:416.
- TK Choueiri et al. Analgesic use and the risk of kidney cancer: a meta-analysis of epidemiologic studies. Int J Cancer 2014; 134:384.
- Addendum: Warfarin-acetaminophen interaction. Med Lett Drugs Ther 2008; 50:45.
- S Alwan et al. Paracetamol use in pregnancy – caution over causal inference from available data. Nat Rev Endocrinol 2021 Dec 14 (epub).
- RA Moore et al. Overview review: comparative efficacy of oral ibuprofen and paracetamol (acetaminophen) across acute and chronic pain conditions. Eur J Pain 2015; 19:1213.
- SA Cooper et al. Analgesic efficacy of naproxen sodium versus hydrocodone/acetaminophen in acute postsurgical dental pain: a randomized, double-blind, placebo-controlled trial. Postgrad Med 2021 Dec 8 (epub).
- WTM Enthoven et al. Non-steroidal anti-inflammatory drugs for chronic low back pain. Cochrane Database Syst Rev 2016; 2:CD012087.
- GC Machado et al. Non-steroidal anti-inflammatory drugs for spinal pain: a systematic review and meta-analysis. Ann Rheum Dis 2017; 76:1269.
- Drugs for osteoarthritis. Med Lett Drugs Ther 2020; 62:57.
- S Motov et al. Comparison of intravenous ketorolac at three single-dose regimens for treating acute pain in the emergency department: a randomized controlled trial. Ann Emerg Med 2017; 70:177.
- FKL Chan et al. Gastrointestinal safety of celecoxib versus naproxen in patients with cardiothrombotic diseases and arthritis after upper gastrointestinal bleeding (CONCERN): an industry-independent, double-blind, double-dummy, randomised trial. Lancet 2017; 389:2375.
- FDA Drug Safety Communication: FDA strengthens warning that non-aspirin nonsteroidal anti-inflammatory drugs (NSAIDs) can cause heart attacks or strokes. July 9, 2015. Available at: https://bit.ly/3gLeYYD. Accessed February 17, 2022.
- Celecoxib safety revisited. Med Lett Drugs Ther 2016; 58:159.
- DK Li et al. Use of nonsteroidal antiinflammatory drugs during pregnancy and the risk of miscarriage. Am J Obstet Gynecol 2018; 219:275.
- In Brief: New warnings on NSAID use in pregnancy. Med Lett Drugs Ther 2020; 62:175.
- Inhibitors and inducers of CYP enzymes, P-glycoprotein, and other transporters. Med Lett Drugs Ther 2021 October 20 (epub). Available at: medicalletter.org/downloads/CYP_PGP_Tables.pdf.
- AK Chang et al. Effect of a single dose of oral opioid and nonopioid analgesics on acute extremity pain in the emergency department: a randomized clinical trial. JAMA 2017; 318:1661.
- A Liampas et al. Pharmacological management of painful peripheral neuropathies: a systematic review. Pain Ther 2021; 10:55.
- C Weng et al. Efficacy and safety of duloxetine in osteoarthritis or chronic low back pain: a systematic review and meta-analysis. Osteoarthritis Cartilage 2020; 28:721.
- JJ van den Driest et al. No added value of duloxetine for patients with chronic pain due to hip or knee osteoarthritis: a cluster randomized trial. Arthritis Rheumatol 2022 January 6 (epub).
- R Aiyer et al. Treatment of neuropathic pain with venlafaxine: a systematic review. Pain Med 2017; 18:1999.
- H Gupta et al. Milnacipran for the treatment of fibromyalgia. Health Psychol Res 2021; 9:25532.
- NB Finnerup et al. Pharmacotherapy for neuropathic pain in adults: a systematic review and meta-analysis. Lancet Neurol 2015; 14:162.
- N Majdinasab et al. A comparative double-blind randomized study on the effectiveness of duloxetine and gabapentin on painful diabetic peripheral neuropathy. Drug Des Devel Ther 2019; 13:1985.
- S Derry et al. Pregabalin for neuropathic pain in adults. Cochrane Database Syst Rev 2019; 1:CD007076.
- S Mathieson et al. Trial of pregabalin for acute and chronic sciatica. N Engl J Med 2017; 376:1111.
- In Brief: Respiratory depression with gabapentinoids. Med Lett Drugs Ther 2020; 62:81.
- KE Evoy et al. Abuse and misuse of pregabalin and gabapentin: a systematic review update. Drugs 2021; 81:125.
- M Zhou et al. Oxcarbazepine for neuropathic pain. Cochrane Database Syst Rev 2017; 12:CD007963.
- AS Afonso et al. Combination therapy for neuropathic pain: a review of recent evidence. J Clin Med 2021; 10:3533.
- Ziconotide (Prialt) for chronic pain. Med Lett Drugs Ther 2005; 47:103.
- TR Deer et al. Intrathecal therapy for chronic pain: a review of morphine and ziconotide as firstline options. Pain Med 2019; 20:784.
- CJ Derry et al. Caffeine as an analgesic adjuvant for acute pain in adults. Cochrane Database Syst Rev 2014; 12:CD009281.
- Orphengesic Forte – an old analgesic combination returns. Med Lett Drugs Ther 2020; 62:180.
- DK Patten et al. The safety and efficacy of low-dose naltrexone in the management of chronic pain and inflammation in multiple sclerosis, fibromyalgia, Crohn's disease, and other chronic pain disorders. Pharmacotherapy 2018; 38:382.
- J Park and HJ Park. Botulinum toxin for the treatment of neuropathic pain. Toxins (Basel) 2017; 9:260.
- SP Cohen et al. Consensus guidelines on the use of intravenous ketamine infusions for chronic pain from the American Society of Regional Anesthesia and Pain Medicine, the American Academy of Pain Medicine, and the American Society of Anesthesiologists. Reg Anesth Pain Med 2018; 43:521.
- Cannabis and cannabinoids. Med Lett Drugs Ther 2019; 61:179.
- ZTlido – a new lidocaine patch for postherpetic neuralgia. Med Lett Drugs 2019; 61:41.
- Capsaicin patch (Qutenza) for postherpetic neuralgia. Med Lett Drugs Ther 2011; 53:42.
- DM Simpson et al. Capsaicin 8% patch in painful diabetic peripheral neuropathy: a randomized, double-blind, placebo-controlled study. J Pain 2017; 18:42.
The Medical Letter is a subscriber-funded nonprofit organization that publishes critical appraisals of new prescription drugs and comparative reviews of drugs for common diseases.