Analgesic adjuvant

Short description: Medication used for other purposes that additionally has analgesic effects

An analgesic adjuvant is a medication that is typically used for indications other than pain control but provides control of pain in some painful diseases. For instance, caffeine has minimal analgesic effect on its own, but may have an adjuvant effect when given with paracetamol (acetaminophen).[1][2] Examples include:

* Anticonvulsants
* carbamazepine, gabapentin, pregabalin
* Antidepressants
* amitriptyline,[3] duloxetine, venlafaxine
* Antihistamines
* hydroxyzine, promethazine
* Stimulants
* caffeine, cocaine, dextroamphetamine, ephedrine

* carisoprodol
* cyclobenzaprine
* hyoscine (scopolamine)

The exact mechanism of the anticonvulsants carbamazepine, gabapentin, and pregabalin is unclear, but they are used to treat neuropathic pain with differing degrees of success.[4]

Antiemetics and medication to relieve constipation are two examples of non-adjuvant medication indications because these are used to treat side effects and adverse effects.[5]

## References

1. ↑ Zhang, W. Y. (2001). "A benefit-risk assessment of caffeine as an analgesic adjuvant". Drug Safety 24 (15): 1127–42. doi:10.2165/00002018-200124150-00004. PMID 11772146.
2. ↑ Derry, C. J.; Derry, S.; Moore, R. A. (2012). "Caffeine as an analgesic adjuvant for acute pain in adults". Prescriber 23 (7): 41. doi:10.1002/psb.895. PMID 25502052.
3. ↑ Bryson, HM; Wilde, MI (1 June 1996). "Amitriptyline. A review of its pharmacological properties and therapeutic use in chronic pain states". Drugs & Aging 8 (6): 459–476. doi:10.2165/00002512-199608060-00008. PMID 8736630.
4. ↑ Eardley, I; Whelan, P; Kirby, R; Schaeffer, A. "Drugs Used In The Treatment Of Interstitial Cystitis". Drug Treatment in Urology. John Wiley & Sons, 2008. p. 65.
5. ↑ "WHO Guidelines on the Pharmacological Treatment of Persisting Pain in Children with Medical Illnesses". World Health Organization. 2012. http://apps.who.int/iris/bitstream/10665/44540/1/9789241548120_Guidelines.pdf.

## External links

* WHO Guidelines on the Pharmacological Treatment of Persisting Pain in Children with Medical Illnesses, (2012), World Health Organization

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Analgesics (N02A, N02B)

Opioids|

| Opiates/opium|

* Codeine# (+paracetamol, +aspirin)
* Morphine# (+naltrexone)
* Opium
* Laudanum
* Paregoric

|

Semisynthetic|

* Acetyldihydrocodeine
* Benzylmorphine
* Buprenorphine (+naloxone)
* Desomorphine
* Diamorphine (heroin)
* Dihydrocodeine (+paracetamol)
* Dihydromorphine
* Ethylmorphine
* Hydrocodone (+paracetamol, +ibuprofen, +aspirin)
* Hydromorphinol
* Hydromorphone
* Nicocodeine
* Nicodicodine
* Nicomorphine
* Oxycodone (+paracetamol, +aspirin, oxycodone/ibuprofen

Synthetic|

* Alfentanil
* Alphaprodine
* Anileridine
* Butorphanol
* Carfentanil
* Dextromoramide
* Dextropropoxyphene
* Dezocine
* Fentanyl# (+fluanisone)
* Ketobemidone
* Levorphanol
* Lofentanil
* Meptazinol
* Methadone#
* Nalbuphine
* NFEPP
* Pentazocine
* Pethidine (meperidine)
* Phenadoxone
* Phenazocine
* Piminodine
* Piritramide
* Propiram
* Remifentanil
* Sufentanil
* Tapentadol
* Tilidine
* Tramadol

Paracetamol-type|

* Acetanilide‡
* Bucetin‡
* Butacetin‡
* Paracetamol (acetaminophen)#
* Parapropamol‡
* Phenacetin‡
* Propacetamol‡

NSAIDs|

| Propionates|

* Fenoprofen
* Flurbiprofen
* Ibuprofen#
* Ketoprofen
* Naproxen
* Oxaprozin

|

Oxicams|

* Meloxicam
* Piroxicam

Acetates|

* Diclofenac
* Indometacin
* Ketorolac
* Nabumetone
* Sulindac
* Tolmetin

COX-2 inhibitors|

* Celecoxib
* Etoricoxib
* Lumiracoxib
* Parecoxib
* Rofecoxib ‡
* Valdecoxib ‡

Fenamates|

* Meclofenamic acid
* Mefenamic acid

Salicylates|

* Aspirin (acetylsalicylic acid)# (+paracetamol/caffeine)
* Benorylate
* Diflunisal
* Ethenzamide
* Magnesium salicylate
* Salicin
* Salicylamide
* Salsalate
* Wintergreen (methyl salicylate)

Pyrazolones|

* Aminophenazone‡
* Ampyrone
* Metamizole (dipyrone)
* Nifenazone
* Phenazone
* Propyphenazone (+paracetamol/caffeine)

Others|

* Glafenine

Cannabinoids|

* Cannabidiol
* Cannabis
* Nabilone
* Nabiximols
* Tetrahydrocannabinol (dronabinol)

Ion channel
modulators|

| Calcium blockers|

* Gabapentin
* Gabapentin enacarbil
* Mirogabalin
* Pregabalin
* Ziconotide

|

Sodium blockers|

* Carbamazepine
* Lacosamide
* Local anesthetics (e.g., cocaine, lidocaine)
* Mexiletine
* Nefopam
* Tricyclic antidepressants (e.g., amitriptyline#)

* Nav1.7/1.8-selective: DSP-2230§
* Funapide§
* PF-05089771§

Potassium openers|

* Flupirtine

Myorelaxants|

* Carisoprodol
* Chlorzoxazone
* Cyclobenzaprine
* Mephenoxalone
* Methocarbamol
* Orphenadrine

Others|

* Analgesic adjuvant
* Analgecine
* Camphor
* Capsaicin
* Clonidine
* Ketamine
* Menthol
* Methoxyflurane
* Nefopam
* Proglumide
* Tricyclic antidepressants (e.g., amitriptyline#)

* #WHO-EM
* ‡Withdrawn from market
* Clinical trials:
* †Phase III
* §Never to phase III

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