MedifocusHealth

• You are allergic to any medications
• You have previously experienced any serious side-effects from pain medications (e.g., gastrointestinal bleeding)
• You have a current or past history of stomach ulcers
• You are taking any other pain medications including herbal products or medications.

In general, the following pain medication treatment options are available in the management of cancer-related pain based upon the severity of the pain:

• Non-Steroidal Anti-Inflammatory Drugs - Mild cancer-related pain can usually be managed with a variety of pain medications that belong to the general family of drugs known as non-steroidal anti-inflammatory drugs (NSAIDs). Examples of NSAIDs that are available "over-the-counter" include:

  • aspirin (e.g., Bayer)
  • acetaminophen (e.g., Tylenol)
  • ibuprofen (e.g., Motrin)
  • naproxen (e.g., Aleve)

Some NSAIDs used for the treatment of pain, including cancer-related pain, are available by prescription only. Examples include diclofenac (e.g., Voltaren); indomethacin (Indocin); ketoprofen (e.g., Orudis); and Cox-2 inhibitors (e.g., Celebrex), among others.

• Narcotic (Opioid) Analgesics - If you are experiencing mild to moderate cancer-related pain, your doctor may prescribe a medication that belongs to a family of drugs known as narcotic analgesics. Examples include:

  • codeine
  • morphine
  • buprenorphine (e.g., Subutex; Suboxone)
  • fentanyl (e.g., Duragesic)
  • oxycodone (e.g., OxyNorm; OxyContin)
  • hydrocodone (e.g., Vicodin; Lortab)
  • hydromorphone (e.g., Dilaudid)

In some cases, combination pain medication tablets containing an NSAID plus a narcotic analgesic may be prescribed for the management of mild to moderate cancer-related pain. Examples of combination pain medication tablets include Percodan (aspirin plus oxycodone); Percocet (acetaminophen plus oxycodone); Co-codamol (acetaminophen plus codeine); and Co-codaprin (aspirin plus codeine)

As a general "rule of thumb", cancer patients with mild to moderate pain are usually started on "weaker" opioid-based medications (e.g., codeine) and, if necessary, are switched to stronger opioid medications (e.g., fentanyl, oxycodone, morphine).

Common side-effects of narcotic analgesics include constipation, lethargy, drowsiness, nausea/vomiting, and sleepiness. In addition, a major concern with the use of narcotic analgesics is the possibility of addiction to the medications. Be sure you notify your doctor if you have a current or past history of drug and/or alcohol abuse before taking narcotic analgesics. Also speak with your doctor about strategies that can be used to manage the side-effects of narcotic analgesics. For example, constipation may be managed by taking a stool softener (e.g., Colace; Senokot). If you experience drowsiness or sleepiness when you take your pain medication, you should avoid any activities that may pose a danger to yourself or others (e.g., driving a car; mowing the lawn).

• Adjuvant Pain Medications - Some drugs that are primary used to treat conditions other than pain also possess analgesic (pain-relieving) properties. These drugs are known as adjuvant pain medications and are sometimes prescribed, alone or in combination with other medications, for the management of cancer-related pain. Examples include:

  • anticonvulsants - This class of drugs is used primarily to treat seizures. Examples of anticonvulsants that may also be used to treat cancer pain include: gabapentin (e.g.,Neurontin); carbamazepine (e.g., Tegretol); phenytoin (e.g., Dilantin); and topiramate (e.g., Topamax)