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Nonopioid Drugs for Pain

   
The Medical Letter on Drugs and Therapeutics • 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....
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 physical and psychological therapies, have been shown to improve pain and function in patients with some common chronic pain conditions and are unlikely to cause serious harms. A multimodal approach to analgesic therapy can increase pain control while reducing opioid use and adverse effects.
Med Lett Drugs Ther. 2022 Mar 7;64(1645):33-40 | Show Full IntroductionHide Full Introduction

Comparison Table: Some Nonopioid Analgesics for Pain (online only)

   
The Medical Letter on Drugs and Therapeutics • March 7, 2022;  (Issue 1645)
...
View the Comparison Table: Some Nonopioid Analgesics for Pain
Med Lett Drugs Ther. 2022 Mar 7;64(1645):e40-3 | Show Full IntroductionHide Full Introduction

Drugs for Osteoarthritis

   
The Medical Letter on Drugs and Therapeutics • April 20, 2020;  (Issue 1596)
Many different drugs are used for treatment of osteoarthritis pain, but none of them prevent progression of the disease. Nonpharmacologic approaches including weight management, exercise, tai chi, physical...
Many different drugs are used for treatment of osteoarthritis pain, but none of them prevent progression of the disease. Nonpharmacologic approaches including weight management, exercise, tai chi, physical therapy, assistive devices, and total joint arthroplasty can also be used. The American College of Rheumatology (ACR) has published new guidelines for the management of osteoarthritis of the hip, hand, and knee.
Med Lett Drugs Ther. 2020 Apr 20;62(1596):57-62 | Show Full IntroductionHide Full Introduction

Some Drugs for COVID-19

   
The Medical Letter on Drugs and Therapeutics • April 6, 2020;  (Issue 1595)
The severity and rapid spread of COVID-19 (caused by SARS-CoV-2) have raised questions about the use of some drugs in patients with the disease and whether currently available drugs could be effective in...
The severity and rapid spread of COVID-19 (caused by SARS-CoV-2) have raised questions about the use of some drugs in patients with the disease and whether currently available drugs could be effective in treating it. Definitive answers are lacking, but some recommendations can be made. For additional information on specific drugs, see our table Some Drugs Being Considered for Treatment of COVID-19.
Med Lett Drugs Ther. 2020 Apr 6;62(1595):49-50 | Show Full IntroductionHide Full Introduction

Table: Treatments Considered for COVID-19 (online only)

   
The Medical Letter on Drugs and Therapeutics • April 6, 2020;  (Issue 1595)
...
View the Table: Treatments Considered for COVID-19
Med Lett Drugs Ther. 2020 Apr 6;62(1595):e1-289 | Show Full IntroductionHide Full Introduction

Some Drugs for COVID-19

   
The Medical Letter on Drugs and Therapeutics • April 6, 2020;  (Issue 1919)
The severity and rapid spread of COVID-19 (caused by SARS-CoV-2) have raised questions about the use of some drugs in patients with the disease and whether currently available drugs could be effective in...
The severity and rapid spread of COVID-19 (caused by SARS-CoV-2) have raised questions about the use of some drugs in patients with the disease and whether currently available drugs could be effective in treating it. Definitive answers are lacking, but some recommendations can be made. For additional information on specific drugs, see our table Some Drugs Being Considered for Treatment of COVID-19.
Med Lett Drugs Ther. 2020 Apr 6;62(1919):1 | Show Full IntroductionHide Full Introduction

Drugs for Gout

   
The Medical Letter on Drugs and Therapeutics • March 11, 2019;  (Issue 1567)
Drugs for gout reduce the pain and inflammation of acute flares and lower serum urate levels in order to prevent recurrent flares, development of tophi, and joint...
Drugs for gout reduce the pain and inflammation of acute flares and lower serum urate levels in order to prevent recurrent flares, development of tophi, and joint damage.
Med Lett Drugs Ther. 2019 Mar 11;61(1567):33-7 | Show Full IntroductionHide Full Introduction

Nonopioid Drugs for Pain

   
The Medical Letter on Drugs and Therapeutics • February 12, 2018;  (Issue 1540)
Nonopioid drugs can be used in the treatment of many nociceptive and neuropathic pain conditions. Use of opioids for pain will be reviewed in a future...
Nonopioid drugs can be used in the treatment of many nociceptive and neuropathic pain conditions. Use of opioids for pain will be reviewed in a future issue.
Med Lett Drugs Ther. 2018 Feb 12;60(1540):24-32 | Show Full IntroductionHide Full Introduction

Comparison Table: Some Nonopioid Analgesics for Pain (online only)

   
The Medical Letter on Drugs and Therapeutics • February 12, 2018;  (Issue 1540)
...
View the Comparison Table: Some Nonopioid Analgesics for Pain
Med Lett Drugs Ther. 2018 Feb 12;60(1540):e32-5 | Show Full IntroductionHide Full Introduction

Drugs for Migraine

   
The Medical Letter on Drugs and Therapeutics • February 13, 2017;  (Issue 1514)
An oral nonopioid analgesic may be sufficient for treatment of mild to moderate migraine without severe nausea or vomiting. A triptan is the drug of choice for treatment of moderate to severe migraine. Use...
An oral nonopioid analgesic may be sufficient for treatment of mild to moderate migraine without severe nausea or vomiting. A triptan is the drug of choice for treatment of moderate to severe migraine. Use of a triptan early in an attack when pain is still mild to moderate in intensity improves headache response and reduces recurrence rates.
Med Lett Drugs Ther. 2017 Feb 13;59(1514):27-32 | Show Full IntroductionHide Full Introduction

Drugs for Osteoarthritis

   
The Medical Letter on Drugs and Therapeutics • September 1, 2014;  (Issue 1450)
Many different drugs are used for treatment of osteoarthritis pain, but none of them prevent progression of the disease. Many nonpharmacologic approaches are available as well, including weight...
Many different drugs are used for treatment of osteoarthritis pain, but none of them prevent progression of the disease. Many nonpharmacologic approaches are available as well, including weight management, exercise, physical therapy, assistive devices, and total joint arthroplasty. New guidelines for the management of osteoarthritis have recently been published.
Med Lett Drugs Ther. 2014 Sep 1;56(1450):80-4 | Show Full IntroductionHide Full Introduction

Drugs for Migraine

   
The Medical Letter on Drugs and Therapeutics • December 1, 2013;  (Issue 136)
Treatment of migraine in the emergency department, which may involve use of intravenous drugs, is not discussed...
Treatment of migraine in the emergency department, which may involve use of intravenous drugs, is not discussed here.
Treat Guidel Med Lett. 2013 Dec;11(136):107-12 | Show Full IntroductionHide Full Introduction

Drugs for Pain

   
The Medical Letter on Drugs and Therapeutics • April 1, 2013;  (Issue 128)
Pain can be acute or chronic. The two major types of chronic pain are nociceptive pain and neuropathic pain. Nociceptive pain can be treated with nonopioid analgesics or opioids. Neuropathic pain is less...
Pain can be acute or chronic. The two major types of chronic pain are nociceptive pain and neuropathic pain. Nociceptive pain can be treated with nonopioid analgesics or opioids. Neuropathic pain is less responsive to opioids and is often treated with adjuvant drugs such as antidepressants and antiepileptics. Combining different types of analgesics may provide an additive analgesic effect without increasing adverse effects.
Treat Guidel Med Lett. 2013 Apr;11(128):31-42 | Show Full IntroductionHide Full Introduction

Drugs for Rheumatoid Arthritis

   
The Medical Letter on Drugs and Therapeutics • May 1, 2012;  (Issue 117)
Disease-modifying anti-rheumatic drugs (DMARDs) are now used early in the treatment of rheumatoid arthritis (RA) to achieve clinical remission, prevent irreversible damage to joints, and minimize...
Disease-modifying anti-rheumatic drugs (DMARDs) are now used early in the treatment of rheumatoid arthritis (RA) to achieve clinical remission, prevent irreversible damage to joints, and minimize toxicity associated with nonsteroidal anti-inflammatory drugs (NSAIDs) and corticosteroids. DMARDs (Table 1) generally do not have an immediate analgesic effect, but over time can control symptoms and have been shown to delay and possibly stop progression of the disease. NSAIDs have immediate analgesic and antiinflammatory effects, but may not affect the disease process. Oral corticosteroids can relieve joint symptoms and control systemic manifestations, but their chronic use can cause many complications. Judicious use of intra-articular corticosteroids can rapidly decrease inflammation in acute joints with few, if any, adverse effects.
Treat Guidel Med Lett. 2012 May;10(117):37-44 | Show Full IntroductionHide Full Introduction

Drugs for Migraine

   
The Medical Letter on Drugs and Therapeutics • February 1, 2011;  (Issue 102)
Drugs for treatment of migraine are listed in Table 2 on page 9. Drugs for prevention of migraine are listed in Table 3 on page 10. Treatment of migraine in the emergency room, which may involve use of...
Drugs for treatment of migraine are listed in Table 2 on page 9. Drugs for prevention of migraine are listed in Table 3 on page 10. Treatment of migraine in the emergency room, which may involve use of intravenous drugs, is not included here.
Treat Guidel Med Lett. 2011 Feb;9(102):7-12 | Show Full IntroductionHide Full Introduction

Drugs for Pain

   
The Medical Letter on Drugs and Therapeutics • April 1, 2010;  (Issue 92)
Pain can be acute or chronic. Chronic pain has been broadly classified into two types: nociceptive and neuropathic. Nociceptive pain can be treated with nonopioid analgesics or opioids. Neuropathic pain is less...
Pain can be acute or chronic. Chronic pain has been broadly classified into two types: nociceptive and neuropathic. Nociceptive pain can be treated with nonopioid analgesics or opioids. Neuropathic pain is less responsive to opioids; adjuvant medicines such as antidepressants and anticonvulsants are often used to treat neuropathic pain. Combining different types of analgesics may provide an additive analgesic effect without increasing adverse effects.
Treat Guidel Med Lett. 2010 Apr;8(92):25-34 | Show Full IntroductionHide Full Introduction

A Fixed-Dose Combination of Sumatriptan and Naproxen for Migraine

   
The Medical Letter on Drugs and Therapeutics • June 16, 2008;  (Issue 1288)
The FDA has approved an oral, fixed-dose combination (Treximet - GlaxoSmithKline) of the selective serotonin receptor agonist ("triptan") sumatriptan (Imitrex) and the nonsteroidal anti-inflammatory drug...
The FDA has approved an oral, fixed-dose combination (Treximet - GlaxoSmithKline) of the selective serotonin receptor agonist ("triptan") sumatriptan (Imitrex) and the nonsteroidal anti-inflammatory drug (NSAID) naproxen sodium (Anaprox, and others) for acute treatment of migraine attacks.
Med Lett Drugs Ther. 2008 Jun 16;50(1288):45-6 | Show Full IntroductionHide Full Introduction

Drugs for Migraine

   
The Medical Letter on Drugs and Therapeutics • March 1, 2008;  (Issue 67)
Some drugs for treatment of migraine attacks are listed in table 2 on page 18. Drugs for prevention of migraine are listed in table 3 on page 20. Treatment of migraine in the emergency room, which may involve...
Some drugs for treatment of migraine attacks are listed in table 2 on page 18. Drugs for prevention of migraine are listed in table 3 on page 20. Treatment of migraine in the emergency room, which may involve use of intravenous drugs, is not included here.
Treat Guidel Med Lett. 2008 Mar;6(67):17-22 | Show Full IntroductionHide Full Introduction

A Diclofenac Patch (Flector) for Pain

   
The Medical Letter on Drugs and Therapeutics • January 14, 2008;  (Issue 1277)
Diclofenac epolamine patch 1.3% (Flector Patch - Alpharma), a topical formulation of the nonsteroidal anti-inflammatory drug (NSAID) diclofenac, has been approved by the FDA for topical treatment of acute pain...
Diclofenac epolamine patch 1.3% (Flector Patch - Alpharma), a topical formulation of the nonsteroidal anti-inflammatory drug (NSAID) diclofenac, has been approved by the FDA for topical treatment of acute pain due to minor strains, sprains and contusions. It is the first topical NSAID patch approved in the US. A diclofenac patch has been used in Europe since 1993. Diclofenac sodium (Voltaren, and others) is available in the US as an oral tablet, in a 1% gel for treatment of osteoarthritis (to be reviewed in a future issue), in a 3% gel (Solaraze) for treatment of actinic keratoses, and in an ophthalmic formulation.
Med Lett Drugs Ther. 2008 Jan 14;50(1277):1-2 | Show Full IntroductionHide Full Introduction

Drugs for Pain

   
The Medical Letter on Drugs and Therapeutics • April 1, 2007;  (Issue 56)
Pain can be acute or chronic. Chronic pain has been broadly classified into two types: nociceptive and neuropathic. Nociceptive pain is generally treated with nonopioid analgesics and opioids. Antidepressants...
Pain can be acute or chronic. Chronic pain has been broadly classified into two types: nociceptive and neuropathic. Nociceptive pain is generally treated with nonopioid analgesics and opioids. Antidepressants and anticonvulsants have been used to treat neuropathic pain. Combining two different types of analgesics may nprovide an additive analgesic effect without increasing adverse effects.
Treat Guidel Med Lett. 2007 Apr;5(56):23-32 | Show Full IntroductionHide Full Introduction

Drugs for Migraine

   
The Medical Letter on Drugs and Therapeutics • September 1, 2004;  (Issue 25)
Drugs for treatment of migraine attacks are listed in the table on page 64. All of the oral drugs are most effective if taken early in an attack when the pain is mild (H Christoph-Diener et al, Neurology 2004;...
Drugs for treatment of migraine attacks are listed in the table on page 64. All of the oral drugs are most effective if taken early in an attack when the pain is mild (H Christoph-Diener et al, Neurology 2004; 63:520). Drugs for prevention of migraine are listed in the table on page 65. Treatment of migraine in the emergency room, which may involve use of intravenous drugs, is not included here.
Treat Guidel Med Lett. 2004 Sep;2(25):63-6 | Show Full IntroductionHide Full Introduction

Drugs for Pain

   
The Medical Letter on Drugs and Therapeutics • July 1, 2004;  (Issue 23)
Three types of analgesic drugs are available: non-opioids, including aspirin, other nonsteroidal anti-inflammatory drugs (NSAIDs) and acetaminophen; opioids; and adjuvant drugs that are not usually thought of...
Three types of analgesic drugs are available: non-opioids, including aspirin, other nonsteroidal anti-inflammatory drugs (NSAIDs) and acetaminophen; opioids; and adjuvant drugs that are not usually thought of as analgesics, such as antidepressants, which can act as adjuvants when given with NSAIDs or opioids, or have analgesic activity of their own in some types of pain. Combining two different types of analgesics may provide an additive analgesic effect without necessarily increasing adverse effects.
Treat Guidel Med Lett. 2004 Jul;2(23):47-54 | Show Full IntroductionHide Full Introduction

Drugs for Pain

   
The Medical Letter on Drugs and Therapeutics • August 21, 2000;  (Issue 1085)
Three types of analgesic drugs are available: first, non-opioids, including aspirin, other nonsteroidal anti-inflammatory drugs (NSAIDs) and acetaminophen; second, opioids; and third, drugs not usually thought...
Three types of analgesic drugs are available: first, non-opioids, including aspirin, other nonsteroidal anti-inflammatory drugs (NSAIDs) and acetaminophen; second, opioids; and third, drugs not usually thought of as analgesics, which act as adjuvants when given with NSAIDs or opioids, or have analgesic activity of their own in some types of pain. Non-opioids can be given concurrently with opioids for an additive analgesic effect.
Med Lett Drugs Ther. 2000 Aug 21;42(1085):73-8 | Show Full IntroductionHide Full Introduction

Drugs for Pain

   
The Medical Letter on Drugs and Therapeutics • August 14, 1998;  (Issue 1033)
Three types of analgesic drugs are available: first, non-opioids, including aspirin, other nonsteroidal anti-inflammatory drugs (NSAIDs) and acetaminophen; second, opioids; and third, some drugs not usually...
Three types of analgesic drugs are available: first, non-opioids, including aspirin, other nonsteroidal anti-inflammatory drugs (NSAIDs) and acetaminophen; second, opioids; and third, some drugs not usually thought of as analgesics, which act as adjuvants when given with NSAIDs or opioids, or have analgesic activity of their own in some types of pain.
Med Lett Drugs Ther. 1998 Aug 14;40(1033):79-84 | Show Full IntroductionHide Full Introduction

Acetaminophen, Nsaids and Alcohol

   
The Medical Letter on Drugs and Therapeutics • June 21, 1996;  (Issue 977)
An advertising war between manufacturers of over-the-counter (OTC) analgesics has led some patients to ask their physicians about the safety of taking these products if they also drink...
An advertising war between manufacturers of over-the-counter (OTC) analgesics has led some patients to ask their physicians about the safety of taking these products if they also drink alcohol.
Med Lett Drugs Ther. 1996 Jun 21;38(977):55-6 | Show Full IntroductionHide Full Introduction

Drugs for Pain

   
The Medical Letter on Drugs and Therapeutics • January 8, 1993;  (Issue 887)
Three types of analgesic drugs are available in the USA: first, aspirin, other nonsteroidal anti-inflammatory drugs (NSAIDs) and acetaminophen; second, opioids; and third, drugs not usually thought of as...
Three types of analgesic drugs are available in the USA: first, aspirin, other nonsteroidal anti-inflammatory drugs (NSAIDs) and acetaminophen; second, opioids; and third, drugs not usually thought of as analgesics, which act as adjuvants when given with NSAIDs or opioids, or have analgesic activity of their own in some types of pain. (American Pain Society, Principles of analgesic Use, 3rd ed, Skokie, illinois: American pain society, 1992).
Med Lett Drugs Ther. 1993 Jan 8;35(887):1-6 | Show Full IntroductionHide Full Introduction

Ibuprofen vs. Acetaminophen in Children

   
The Medical Letter on Drugs and Therapeutics • December 15, 1989;  (Issue 807)
Since the implication of aspirin in Reye's syndrome, acetaminophen (Tylenol; and others) has become the standard drug for symptomatic treatment of fever and pain in children. Ibuprofen, a nonsteroidal...
Since the implication of aspirin in Reye's syndrome, acetaminophen (Tylenol; and others) has become the standard drug for symptomatic treatment of fever and pain in children. Ibuprofen, a nonsteroidal anti-inflammatory drug (NSAID) available for many years in tables (Mortin; Advil; and others), has now become available in a suspension. The suspension will be sold by presecription for treatment of fever or arthritis in children.
Med Lett Drugs Ther. 1989 Dec 15;31(807):109-10 | Show Full IntroductionHide Full Introduction

Flurbiprofen

   
The Medical Letter on Drugs and Therapeutics • April 7, 1989;  (Issue 789)
Flurbiprofen (Ansaid - Upjohn), a nonsteroidal anti-inflammatory drug (NSAID) available in some countries since 1977, was recently approved by the US Food and Drug Administration for treatment of rheumatoid...
Flurbiprofen (Ansaid - Upjohn), a nonsteroidal anti-inflammatory drug (NSAID) available in some countries since 1977, was recently approved by the US Food and Drug Administration for treatment of rheumatoid arthritis and osteoarthritis. Flurbiprofen is a fluorinated phenylalkanoic acid derivative structurally related to ibuprofen (Motrin;and others).
Med Lett Drugs Ther. 1989 Apr 7;31(789):31-2 | Show Full IntroductionHide Full Introduction

Diclofenac

   
The Medical Letter on Drugs and Therapeutics • December 2, 1988;  (Issue 780)
Diclofenac sodium (Voltaren - Geigy), a nonsteroidal anti-inflammatory drug (NSAID) available in some countries since 1974, was recently introduced in the USA for treatment of rheumatoid arthritis,...
Diclofenac sodium (Voltaren - Geigy), a nonsteroidal anti-inflammatory drug (NSAID) available in some countries since 1974, was recently introduced in the USA for treatment of rheumatoid arthritis, osteoarthritis and ankylosing spondylitis. It is being promoted as 'The number one prescribed antiarthritic in the world.'
Med Lett Drugs Ther. 1988 Dec 2;30(780):109-11 | Show Full IntroductionHide Full Introduction