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Analgesic Drugs for Fibromyalgia

Fibromyalgia is a complicated health issue. It changes the way your brain registers pain. It’s marked by pain in your muscles, bones, tendons, and nerves. Fibromyalgia may be caused by several factors. These can include genetics, infections, injury, and stress. Women tend to develop it more often than men. People with arthritis also seem to be more likely to get fibromyalgia. There’s no cure for fibromyalgia, but medications and other treatments can help ease symptoms. Here’s a list of prescription and over-the-counter drugs that may help relieve your fibromyalgia pain.

There's no cure-all pill for your fibromyalgia, but you've got lots of medicines to choose from in order to treat your symptoms. Some drugs ease the aches and pains, while others may boost your energy or improve your sleep. You may need to take more than one fibromyalgia medicine to find relief.

The FDA has approved three drugs to treat fibromyalgia: the antidepressants duloxetine (Cymbalta) and milnacipran (Savella), plus the anti-seizure medicine pregabalin (Lyrica). But your doctor may prescribe other drugs that aren't specifically approved for fibromyalgia. Medicines like these are sometimes called "off-label" medications. Each fibromyalgia drug has its own side effects, ranging from mild to serious. You and your doctor will work together to figure out the right medicine to keep your symptoms under control.

Medication use

Medication use in patients with fibromyalgia should always be combined with nonpharmacologic therapy. Japanese and German guidelines recommend that pediatric patients receive nonpharmacologic treatment.

The US Food and Drug Administration (FDA) have approved three drugs for use in fibromyalgia: pregabalin (Lyrica), duloxetine (Cymbalta), and milnacipran (Savella). Pregabalin is used to reduce pain and improve sleep. The antidepressants duloxetine and milnacipran, which are used to relieve pain, fatigue, and sleep problems, are generally used at lower doses than for treatment of depression.

Other anticonvulsants and antidepressants are often used off-label to treat fibromyalgia and there is evidence that many can decrease pain sensitivity. Corticosteroids and nonsteroidal anti-inflammatory drugs (NSAIDs) are useful only for management of coexisting inflammatory processes and are not recommended as first-line therapies. Pharmacologic and nonpharmacologic treatment of poor sleep is crucial for improving the patient's overall sense of well-being.

Several medications should be avoided or used carefully. Opioids, hypnotics, anxiolytics, and certain skeletal-muscle relaxants must be used with caution because of the potential for abuse and the risk of worsening fatigue and cognitive dysfunction.


Non-narcotic analgesics

Analgesics are painkillers which block the path of pain signals to the brain. Non-narcotic analgesics such as tramadol (Ultram) are not as strong or potentially addictive as narcotic analgesics.

Narcotic analgesics

Narcotic analgesics or opioids are used when all other medications have failed to treat the symptoms of fibromyalgia. They can potentially be addictive and are usually only prescribed for a short period. Oyxcodone (OxyContin) is a common opioid analgesic.

Pain control is essential to quality patient care. Analgesics ensure patient comfort, promote pulmonary toilet, and have sedating properties, which are beneficial for patients who experience pain.

Tramadol (Ultram, Ryzolt, Rybix)

Tramadol is a centrally acting analgesic indicated for moderately severe pain. This agent inhibits ascending pain pathways, altering the perception of and response to pain. Tramadol also inhibits reuptake of norepinephrine and serotonin.

Finding relief from fibromyalgia pain can be a true challenge. It may take both drugs and other treatments to help you feel better. It may also take time to find the best combination that works for you. The key is to keep working with your doctors to find the right approach.