There are several broad classes of pain medication available. These are:
Over-the-counter medication
Opioids
Neuropathic agents
Others
Types of pain medication
Over-the-counter pain medication
You may already know these medications. We generally prescribe these for mild to moderate pain. They work together with stronger pain killers to manage pain.
Examples of over-the-counter medication include:
- Paracetamol (brand names include Panadol)
- NSAIDs (non-steroidal anti-inflammatory drugs) such as:
- Ibuprofen (brand names include Nurofen, Advil)
- Diclofenac (brand names include Voltaren)
- Celecoxib (brand names include Celebrex)
Opioids
We use opioids in post-operative acute pain and more persistent cancer pain. These are strong pain killers. They are also complex medications with both short-term and long-term side effects. It is important to use these medications right. Your medical practitioner or pain specialist would guide you on their use. They will describe the appropriateness and risks and benefits of these medications.
Examples of opioids include:
Morphine (brand names include Ordine, Sevredol)
Oxycodone (brand names include Endone, Oxynorm)
Buprenorphine (brand names include Norspan)
Tapentadol (brand names include Palexia)
Common side effects include:
Constipation
Nausea and vomiting
Drowsiness
Dry mouth
Physical dependence and withdrawals
Breathing issues
More information about Opioids
We use neuropathic agents to target neuropathic or nerve-related pain. Neuropathic pain arises from problems with the nerves. These problems include damaged or irritated nerves. They also include problems with the nerves' ability to send pain messages to the brain.
Neuropathic pain can result from the cancer itself. It can also result from treatment such as chemotherapy, radiotherapy, and surgery. Nerves are slow to heal. As a result, damage from earlier surgeries or treatments can add to neuropathic pain.
Neuropathic pain is complex. We may not be able to explain the pain even after examinations and investigations. The management of neuropathic pain can be challenging. It may be a long-term pain. As a result, traditional pain relievers may not be effective.
Common descriptors for neuropathic pain include burning, tingling, electric shocks, or pins-and-needles. The pain can be in one area or described as “shooting” pain down the arm or leg. It could also be numbness or tingling in the fingers or toes. This could lead to decreased function in the hands or feet.
Examples of neuropathic agents include:
Pregabalin (brand names include Lyrica)
Gabapentin (brand names include Gabacor, Neurotin)
Amitriptyline (brand names include Endep, Entrip)
Duloxetine (brand names include Duloxecor, Cymbalta)
You may recognise these medications from their other uses. Pregabalin and Gabapentin are also classed as anti-epileptic medications. Amitriptyline and Duloxetine are also classed as anti-depressant medications. these drugs fall in these other categories. There is proof though that they are beneficial in the treatment of neuropathic pain.
Common side effects include:
Drowsiness
Dry mouth
Feet swelling
Heart palpitations
Agitation
Local anaesthetics
Local anaesthetics relate to neuropathic agents as they target similar types of pain. They are a group of drugs that work by numbing the area of your skin that is painful. A local anaesthetic can reduce some types of pain. This is pain that has a burning, shooting, stinging, or tingling sensation. The area of skin may also have an increased sensitivity to touch, heat and/or cold.
We usually prescribe local anaesthetics for you to apply on your skin either as a gel, cream, spray, or patch.
The most common example of a local anaesthetic is Lignocaine (also known as Lidocaine). Brand names include Xylocaine, Nervoderm, and Versatis.
Lignocaine is available in various preparations. We prescribe it in the form of a patch.
Download the Lignocaine Patch fact sheet
Living with neuropathic pain
Neuropathic agents are for medium-term to long-term use. Your hospital or outpatient clinic may have prescribed them to you. If so, your pain specialist or GP will continue to manage the medication dose.
Treatment for neuropathic pain supports the function and quality of your life. As a result, we may refer you to specialists that can help you achieve these goals. These specialists include physiotherapists, occupational therapists, and psychologists. This is part of a multi-disciplinary approach to your treatment. In this approach we get input from allied health and the medical team. This will help achieve the best outcome for you.
Find out more about Pain Management Strategies.
Others
There are other classes of medication that we sometimes use to manage your pain.
Ketamine infusion therapy
Ketamine is a complex medication. We use it for post-operative acute pain and more persistent cancer pain. It is a strong pain-relieving medication. It works by targeting pain-sensing nerves, interrupting their pain signals to the brain. It resets these pain signals altogether when we give it via an intravenous infusion. This means that there are longer lasting benefits even after we stop the infusion.
Download the Ketamine Infusion fact sheet