Generic Name, Examples of Brand Names. Oxycodone, acetaminophen, Endocet, Percocet, Tylox. Hydrocodone, acetaminophen, Lortab, Norco.
Combination Drug Products :
Nonsteroidal Anti-Inflammatory Drugs (NSAIDs) :
American Geriatrics Society 2012 Beers Criteria Update Expert Panel. American Geriatrics Society updated Beers Criteria for potentially inappropriate medication use in older adults. J Am Geriatr Soc. 2012 Apr;60(4):616-31.
Acetaminophen (ah-see-tah-MIN-oh-fen) can relieve mild-to-moderate pain caused by some common conditions such as arthritis and low back pain. Acetaminophen may also be much safer for older adults than other pain relievers if you use the right amount.
At higher doses (available with a prescription), they are effective in reducing inflammation. Inflammation can cause pain. NSAIDs block the body’s production of certain substances that cause the inflammation. NSAIDs may be useful and necessary if taken for a very brief amount of time (a few days).
Click on each medication type below to see more information.
One of these, mexilitine, is helpful in controlling persistent pain, especially nerve pain and pain caused by touch. Common side effects include nausea and tremors (shaking). Serious side effects can occur in patients with heart disease. Muscle Relaxants :
There are other effective medications available that your healthcare provider can offer. Your healthcare provider and pharmacist will explain how the medication works and discuss any precautions or side effects with you.
DISCLAIMER: This information is not intended to diagnose health problems or to take the place of medical advice or care you receive from your physician or other healthcare provider. Always consult your healthcare provider about your medications, symptoms, and health problems.
They may also have serious side effects, and if used, should be approached with caution. These include calcitonin, botulinum toxin, glucosamine, chondroitin, and cannabinoids. Glucosamine and chondroitin are both dietary supplements used to support joint health. Calcitonin helps strengthen bones.
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Corticosteroids are strong medications that are very effective in reducing inflammation. They are especially useful for short-term treatment of severe pain associated with many different inflammatory conditions. When used for short periods, corticosteroids have few side effects. When used for longer periods, for the dose may be changed to every other day instead of daily, to reduce the likelihood of side effects.
The most common side effects of opioid use are drowsiness and constipation. The constipation typically does not go away with time, so many older adults may need a laxative. Opioids can also cause dizziness, upset stomach, confusion, and falls. Antidepressants :
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Any time you consider starting or stopping a medication, whether it is prescription or over-the-counter, always consult your healthcare provider or pharmacist first. Acetaminophen.
Corticosteroids, or glucocorticoids, are anti-inflammatory drugs. They are similar to hormones produced naturally in the body by the adrenal glands (triangle shaped glands located at the top of your kidneys). Corticosteroids have been used for more than 50 years to treat many medical conditions, such as rheumatoid arthritis and asthma.
Research has shown that some medications used for depression—called tricyclic antidepressant medications (TCAs)—seem to be helpful in controlling persistent pain. These medicines are especially helpful for pain caused by damage to nerves. When used to treat pain, TCAs are prescribed in much smaller doses than when used to treat depression. As with any medication, side effects can occur. You should not take TCAs if you:
Dual Mechanism Drugs :
If you have pain that is limited to a small area, you may get a great deal of relief from using medications that are put directly on the skin, such as a medicated patch. Placing the medication onto the skin where the pain is also helps avoid side effects that come from taking medications by mouth.
Muscle relaxant drugs are sometimes used when muscle spasms are contributing to the pain. However, many of them are not very effective or have too many side effects. Muscle relaxant drugs should be started at a low dose. If needed, they can be increased gradually to avoid possible side effects such as dizziness, low blood pressure, or stomach upset.
Research has also shown that older adults with persistent pain often become depressed. There are many medications available to treat depression, and unless it is treated, it may be difficult to control pain. If you feel depressed, it is very important to discuss this with your doctor. Anticonvulsants :
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People who take corticosteroids for a long time may develop osteoporosis (weakening of the bones). Your healthcare provider may want you to take calcium and vitamin D as well as another medication to prevent osteoporosis. Opioids :
Medications that contain acetaminophen.
Acetaminophen can cause problems if you:
However, even short-term use of NSAIDs can cause indigestion, bleeding, and easy bruising. Longterm use of NSAIDs is generally discouraged for older persons, because of risks of serious medical complications, including heart problems, stomach ulcers, and kidney problems. Risk of heart disease, including heart failure and heart attack, has been shown with high doses of NSAIDs, so it is important for your provider to carefully evaluate your risk and potential benefits. Corticosteroids :
Deciding to use opioid medications should be based on a careful evaluation of risk and benefits. Some people still believe that there is a high risk of addiction with these medications. However, the risk is small for older adults when the medication is taken specifically to fight pain, there is no prior history of substance abuse, and there is careful monitoring of the benefits and adverse effects.
You may have some skin reaction (itchiness or soreness) where the patch was placed. Other medicines applied to the skin (such as creams like menthol or capsaicin) may sometimes be helpful, but you should check with your healthcare professional first in order to avoid side effects.
Antiarrhythmic agents are medications usually used to treat irregular heart rhythms.
Even if they can be obtained without a prescription, you should always inform your healthcare provider if you are already taking any of these medications or if you wish to take any of them.
TCAs have some risky side effects and should be used very carefully in older patients. They can make you feel very sleepy and can make it difficult to think clearly. TCAs may also affect your balance and cause constipation. Some TCAs have more side effects than others.
Anticonvulsants can interact with other medications, so make sure your healthcare provider knows all medications you take, even over-the-counter medications. Common side effects include: Antiarrhythmic Agents :
These medications are called “dual mechanism” because they act like an opioid drug and as an antidepressant. If you take these medications, you need to be regularly checked by your healthcare provider for side effects linked to both types of pain medicines. For instance, tramadol may be constipating (like an opioid drug) and it also must be stopped gradually (like an antidepressant). Other Medications :
This is not a complete list. Many other brands and prescription medications use acetaminophen as an active ingredient. Sometimes acetaminophen is listed as “APAP” on prescription bottles and labels. Also, some brands listed above have products that do not contain acetaminophen. Check your medicine before you take it to see if it contains acetaminophen, and talk to your healthcare provider or pharmacist if you are not sure if your medicines contain acetaminophen.
Many medications contain more than one active ingredient. Not knowing the ingredients in each medication you take can be dangerous. For example, if you take Tylenol for a headache while you are taking a cold medication that contains acetaminophen, you may be getting too much acetaminophen. Sources:
You should not take more than 3,000 milligrams of acetaminophen per day, unless under the care of a healthcare provider. Do not take more than one medicine at a time that contains acetaminophen in order to make sure not to take the wrong amount. Many prescription and over-the-counter medicines contain acetaminophen, including the following:
Common side effects occurring with corticosteroids taken by mouth include:
You should not suddenly stop taking muscle relaxants. These medications must be slowly decreased to avoid side effects. Muscle relaxants have been helpful for some patients with: Skin Preparations :
AGS Panel on the Pharmacological Management of Persistent Pain in Older Persons. Pharmacological Management of Persistent Pain in Older Persons. American Geriatrics Society. J Am Geriatr Soc 2009; 57:
Anticonvulsants are drugs that are normally used to control seizures in people who have epilepsy. They have been found to offer good pain relief with some types of stubborn nerve pain.
NSAIDs are medications used to block pain. They are available both over-the-counter and with a prescription. If you are taking an NSAID on your own, it is important to let your healthcare provider know about this.
A variety of other medications have been tried for pain relief, but there is not enough good proof that they are really effective or useful for older people.
Pain medicines that contain opioid analgesics (also referred to as narcotics) can be used for treating persistent moderate-to-severe pain that impacts function and does not respond well to other medications and treatments.
Sometimes corticosteroids are given as a shot to try to target at the site of pain. This is one way to lower the common side effects, but still provide pain relief.
This guide will help you learn about prescription and non-prescription (over-the-counter) pain medications. This listing of pain medications is designed to give brief information and examples of commonly used medications.