4 Adjuvant Medications for Pain
Learn how adjuvant medications may help with neuropathic pain, how treatment choices depend on individual circumstances, and what safety effects to monitor.
What adjuvant medicines can do
are drugs developed for other purposes that can also help manage certain kinds of pain. They are especially useful for some conditions, including pain described as burning or electric-shock-like.
The best option depends on the pain condition, other health factors, expected benefits, and potential adverse effects. The choice should reflect the person’s circumstances rather than treating every case alike.
Medication options for
Possible options for include , , and selected topical medicines. Guidelines include amitriptyline, duloxetine, gabapentin, and pregabalin among possible initial medication options.
Duloxetine is an SNRI, and amitriptyline is a tricyclic antidepressant. Using either medicine for pain does not mean that the person must have depression.
Choosing and using topical treatments
may be considered for localized when a person wants to avoid oral treatment or cannot tolerate it. Whether it is suitable depends on the clinical situation and local guidance.
Local burning or irritation can occur with topical treatments. Follow the instructions for the specific product. For a , remove it if irritation or burning occurs, and do not reapply until the irritation subsides.
Medication safety and monitoring
Gabapentin and pregabalin can cause serious breathing problems in people with risk factors, including people who also use opioids. Combining a gabapentinoid with an opioid can increase sedation and the risk of serious breathing problems.
Review other medicines that may cause sedation, and monitor for unusual sleepiness, confusion, or slow or difficult breathing. These effects warrant serious attention.
Reassessing treatment
After starting an adjuvant pain medicine, reassess whether pain is controlled and whether it affects daily activities or sleep. Review adverse effects and whether treatment is still needed.
Considering pain and its effects on function, sleep, and well-being helps determine whether the medicine is providing meaningful benefit.