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You may be prescribed other medicines to take along with your regular painkillers. Some of these are described here:
Commonly used NSAIDs are ibuprofen (Brufen®), diclofenac sodium (Voltarol®) and celecoxib (Celebrex®). NSAIDs can help to reduce pain, inflammation and swelling. They are especially good at treating pain in skin, muscle or bone. Since people vary in the way these drugs work for them, it is often worth trying a few different ones to find what suits you best. Check with your doctor, nurse or pharmacist before taking them, in case they interact with other medicines you are taking or are not suitable for you. You can tell if any other medicines or tablets you buy from the pharmacy (eg cold cures) contain aspirin or ibuprofen by checking the ingredients on the packet. Check with the pharmacist if you are not sure.
NSAIDs can cause indigestion and may irritate the lining of the stomach (sometimes causing bleeding). Because of this it is important to take them after a meal or snack. Your doctor may prescribe an additional tablet to help protect your stomach.
People who have pain from cancer that has spread to the bone may find drugs called bisphosphonates| helpful. As well as helping to reduce pain, bisphosphonates can also strengthen the bones that are affected. Bisphosphonates may be given as a drip into a vein, usually once a month, or as tablets.
When pain is caused by a tumour pressing on or damaging a nerve, steroid drugs| may help to relieve this pressure and so reduce pain. They may be given alone or with other painkillers. Commonly used steroids are dexamethasone and prednisolone. They may increase your appetite and generally make you feel better.
Steroids may make you put on weight and have a slightly higher risk of getting infections. The levels of sugar in your blood may also change temporarily. Tell your doctor or nurse if you become very thirsty and start going to the toilet to pass urine more often, as this may be due to an increase in your blood sugar levels.
Some people find that steroids make them feel agitated or irritable because they make the mind more active. Steroids can make it more difficult to sleep, but this is less of a problem if they are taken as a single dose in the morning. The side effects disappear gradually once the treatment is over. Steroids can also cause indigestion and may irritate the lining of the stomach (sometimes causing bleeding), so it is important to take them after a meal or snack. Your doctor may prescribe additional tablets to help to protect your stomach.
Low doses of anti-epileptic drugs such as gabapentin (Neurontin®), or low dose antidepressants such as amitriptyline, can help to reduce pain caused by pressure on a nerve. This type of pain is called neuropathic pain. The medicines may take up to 7–10 days to control pain. It is important not to stop taking them if they don't work straight away. They are often given for several months along with other painkillers. In a few cases other drugs not normally thought of as painkillers may also be tried.
If antidepressants are being used for depression they may take several weeks to have any effect on mood.
When pain is due to an underlying infection, you are likely to be given antibiotics to treat the infection.
If muscle spasms are making pain worse, you may be given a drug to relax the muscles, such as diazepam or baclofen (Lioresal®).
If you are taking several different drugs you may find it helpful to draw up a chart, listing:
Your doctor, nurse or pharmacist can help you to do this, or they may be able to give you a chart to fill in this information. Make sure it has space for you to tick off each dose as you take it.
You may find it easier to have your drugs arranged in a container (called a pill-reminder or dosette box) that is labelled with the times to take them. Then at any time during the day you can check that you are up-to-date.
The aim is to make things as simple as possible. If you find it is difficult to remember to take medicines several times a day, talk this over with your doctor. There may be other types of the same drug that have the same effect but can be taken less often.
You may find it useful to keep a diary of how well your pain and other symptoms are being controlled. This will help your medical team too. They will be able to see whether the doses of any of your drugs need changing. If you don't want to bother writing a full diary, just make a note if your pain comes back before your next dose of medicine is due, and when you need to take extra doses of painkillers.
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