Medications

Many different drugs are used to treat cancer pain. If you are already taking pain medicine for another problem, tell your doctor how often you are taking it and how well it works.

The key to controlling cancer pain is to take your medicine on a regular schedule. Do not wait until your pain gets bad. Pain is easier to control when you treat it just after it starts. Painkilling drugs work to control cancer pain in most people.

Nonprescription medicines

Be careful when taking nonprescription medicines. Talk with your doctor before you take these medicines, especially if you have a fever or have had kidney or liver disease, gastrointestinal bleeding, or a stomach ulcer. And don't take more than the label says, unless your doctor tells you to do so.

Medicines you can buy without a prescription may be enough to relieve your pain at times. These medicines include:

• Acetaminophen, such as Tylenol.
• Anti-inflammatory drugs, such as ibuprofen and aspirin, which also reduces swelling.

Prescription medicines

People who have cancer pain often need stronger medicines that their doctors prescribe. Be sure to follow your doctor's orders when you take these stronger medicines. If you still have pain, call your doctor.

Prescription medicines may be used alone or with other medicines. Depending on your pain, some of these medicines work better than others. Prescription medicines include:

• Opiate pain relievers, such as morphine, hydromorphone, oxycodone, methadone, fentanyl, and tramadol.
• Other medicines that may be used with opiate pain relievers. These medicines may be given to help your pain medicine work better or to treat your symptoms. Or they may be given for certain types of pain. These include:
  • Antidepressants, to relieve pain and help you sleep.
  • Anticonvulsants, to help control nerve pain like burning and tingling.
  • Local anesthetics, such as skin creams with capsaicin or lidocaine, to help relieve pain in the skin and surrounding tissues.
  • Anti-inflammatory drugs and corticosteroids (for example, prednisone or dexamethasone).
  • Bisphosphonates, such as pamidronate and zoledronic acid, to treat bone pain.

Ways medicine is given

Medicines for cancer pain are usually given by mouth. When a person is having trouble swallowing or faster pain relief is needed, medicine can be taken in other ways, such as:

• By mouth. This includes pills, capsules, liquids, and medicines that dissolve on the tongue or under the tongue.
• With needles, such as a shot (injection) or into a vein (IV). A person with an IV may be able to use a (PCA) pump, which lets him or her control pain medicines.
• With a pain pump, also called an infusion pump. This kind of pump is placed under your skin to deliver pain medicine directly to your spine.
• Using skin patches. These have medicine in the patch that is absorbed into the body through the skin.
• With rectal suppositories. Medicine in capsules or pills are put inside the rectum and absorbed into the body.
• Into the spine. Medicine can be put into the area around the spinal cord, such as with spinal anesthesia or an epidural.
• Through the nose. Medicine in a nasal spray can be absorbed into the body quickly.

Medical marijuana also may help relieve cancer pain. It is available as marijuana cigarettes or as dronabinol, which is made from an active ingredient of marijuana. Dronabinol is available as a capsule.