Other types of drugs used in pain control

Some drugs are prescribed with painkillers to help control pain. These are often known as adjuvant drugs. They work in different ways. Below are some of the drugs used.

  • Bisphosphonates strengthen bones affected by cancer and reduce bone pain.
  • Denosumab injections reduce bone pain and the risk of fractures if cancer has spread to the bones.
  • Steroid tablets can reduce swelling and pain caused by a tumour pressing on a part of the body.
  • Anti-epileptic and anti-depressant drugs can reduce pain caused by nerve damage.
  • Antibiotics can help if pain is caused by an infection.
  • Muscle relaxants can be given if muscle spasms are making pain worse.

You may have other medicines that are not mentioned here.

It may take a while to find the drugs that work best for you. Talk to your doctor or nurse if you are still in pain or have side effects.

Adjuvant drugs

You may be prescribed other medicines to take with your painkillers. These are often known as adjuvant drugs.


Bisphosphonates

People who have pain from cancer that has spread to the bones may find drugs called bisphosphonates helpful. As well as helping to reduce pain, bisphosphonates can also strengthen the affected bones. You can have them as a drip into a vein, usually once a month, or as tablets. An example of this type of drug is zoledronic acid.


Denosumab

This is a treatment that reduces bone breakdown. It may be used to lower the risk of fractures and relieve bone pain if cancer has spread to the bones. You have it as an injection just under the skin every four weeks


Steroids

Steroids are usually given by mouth as tablets. They can reduce swelling and pain caused by a tumour pressing on a part of the body. There are many types of steroids. Usually people are given prednisolone or dexamethasone.


Anti-epileptic and anti-depressant drugs

Some anti-epileptic drugs (such as gabapentin, pregabalin or carbamazepine) and some low-dose anti-depressants (such as amitriptyline) can help reduce pain caused by nerve damage. This type of pain is called neuropathic pain. These medicines are usually taken by mouth as tablets or capsules.

The dose of these medicines may need to be gradually increased over a few days or weeks to control the pain. This means it’s important to continue taking them, even if they don’t work immediately.

Some people worry that if they are given anti-depressants for nerve pain, it’s because their doctor thinks they’re depressed. This is not the reason. Research has shown that low doses of anti-depressants are effective for nerve pain. Higher doses are needed to treat depression.

Some people find that the anti-depressant amitriptyline can make them feel sleepier or slightly ‘hungover’. If this happens to you, tell your doctor or nurse. Take the dose at night to stop you feeling drowsy during the day.


Antibiotics

When pain is caused by an infection, for example an infected wound, your doctor may prescribe antibiotics to treat the infection.


Muscle relaxants

If muscle spasms are making your pain worse, you may have a short course of a muscle relaxant drug. This could be diazepam (Valium®), baclofen (Lioresal®), hyoscine butylbromide (Buscopan®) or clonazepam (Rivotril®). They help relax the muscles.

You may have other medicines that are not mentioned here.

Ask your doctor or specialist nurse if you have any questions or are unsure about any of your prescribed medicines.

It is important you are as pain-free as possible. Sometimes, it may take a little while to find the drugs that suit you best and relieve your pain. Talk to your doctor or nurse if you are still in pain or side effects are bothering you.