Latest Pain Management Medications
NCBI Bookshelf. A service of the National Library of Medicine, National Institutes of Health.
StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2026 Jan-.
Pain Management Medications
Authors
Daniel A. Queremel Milani1; Donald D. Davis2.
Affiliations
1 Universidad de Los Andes, Bogotá, Colombia
2 Wellstar Atlanta Medical Center
Last Update: July 3, 2023.
Continuing Education Activity
Analgesics are medications used in the management and treatment of pain. They include several classes of
medications (acetaminophen, nonsteroidal anti-inflammatory drugs, antidepressants, antiepileptics, local anesthetics,
and opioids). This activity reviews the indications, actions, and contraindications for all the drug classes listed before
as valuable agents in the treatment of pain and other specific disorders. This activity will highlight the mechanism of
action, adverse event profile, and other key factors (e.g., off-label uses, dosing, monitoring) pertinent for members of
the interprofessional healthcare team in the management of patients with acute and chronic pain and related
conditions.
4/16/2026, 1:43:23 PM
,Latest Pain Management Medications
Objectives:
Outline the indication for naloxone administration.
Describe the common physical exam findings associated with nonsteroidal anti-inflammatory drug (NSAID)
toxicity.
Identify the most common adverse events associated with acetaminophen therapy.
Review the importance of improving care coordination among the interprofessional team to pain control
medication choices for patients with acute and chronic pain.
Access free multiple choice questions on this topic.
Indications
According to the International Association for the Study of Pain (IASP), pain is defined as an unpleasant experience
(sensory and/or emotional) related to a potential or confirmed tissue damage or described in such terms.[1] Currently,
the debate is ongoing whether or not this definition should be modified.[2][3][4] Nonetheless, the classification for
pain management medications is stable; categories are nonopioid analgesic agents and opioid analgesic agents.
Nonopioid analgesic agents
4/16/2026, 1:43:23 PM
,Latest Pain Management Medications
Acetaminophen (paracetamol): Mild to moderate pain, moderate to severe pain (as adjunctive therapy to
opioids), and temporary reduction of fever. Acetaminophen should not be used for neuropathic pain since there
is no documented effect.[5][6][7]
Nonsteroidal anti-inflammatory drugs (NSAIDs): These drugs are used for mild-to-moderate pain, pain
associated with inflammation, and temporary reduction of fever. Similar to the previous medication, NSAIDs
have no evidence for the management of neuropathic pain. Some NSAIDs have other non-pain-related
indications (eg., aspirin use for secondary prevention of myocardial infarction), which will not be covered in
this review.[7][8]
Antidepressant medications: Selective serotonin and norepinephrine reuptake inhibitors (SNRIs), particularly
duloxetine, and tricyclic antidepressants (TCAs), especially amitriptyline, have demonstrated efficacy in a
variety of neuropathic pain conditions. Thus they are recommended as the first line of treatment.
[9] Furthermore, besides their respective indications for psychiatric disorders such as major depressive disorder
and generalized anxiety disorder, these medications are indicated for other pathologies such as fibromyalgia and
chronic musculoskeletal pain. Also, antidepressants are recommended as a prophylactic treatment for migraine
and tension-type headaches (amitriptyline). Both of the pharmacological groups seem to be more effective in
patients with depressive symptoms and pain as comorbidity than in those patients with pain alone.[7][9]
Antiepileptic medications: Several antiepileptic drugs are also known for their analgesic properties through
their mechanism of action of lowering neurotransmitter release or neuronal firing. The most common
antiepileptics used for pain treatment are gabapentin and pregabalin.[7]
4/16/2026, 1:43:23 PM
, Latest Pain Management Medications
Gabapentin: Postherpetic neuralgia in adults and neuropathic pain.
Pregabalin: Neuropathic pain associated with diabetic peripheral neuropathy or spinal cord injury,
postherpetic neuralgia, and fibromyalgia.
Oxcarbazepine and carbamazepine: trigeminal or glossopharyngeal neuralgia
Local anesthetics: Lidocaine is among the most commonly used medications in this drug class, which is FDA
approved for postherpetic neuralgia and recommended for peripheral neuropathic pain.[7][10]
Opioid Agents
Opioids are a broad class of medications with structural resemblance to the natural plant alkaloids found in opium,
which was originally derived from the resin of the opium poppy, Papaver somniferum.[11] They are recognized as the
most effective and widely used drugs in treating severe pain.[12] Opioids have been among the most controversial
analgesics, particularly because of their potential for addiction, tolerance, and side effects.[13] Although opioids have
indications for acute and chronic pain treatment, the Center for Disease Control and Prevention's guidelines
recommends that only if the expected benefits for both pain and function outweigh the risks, clinicians should
prescribe opioids at the lowest effective dose and for the shortest expected duration to treat the pain severe enough to
require opioids.[14][15][16][17]
Mechanism of Action
Nonopioid analgesic agents
4/16/2026, 1:43:23 PM
NCBI Bookshelf. A service of the National Library of Medicine, National Institutes of Health.
StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2026 Jan-.
Pain Management Medications
Authors
Daniel A. Queremel Milani1; Donald D. Davis2.
Affiliations
1 Universidad de Los Andes, Bogotá, Colombia
2 Wellstar Atlanta Medical Center
Last Update: July 3, 2023.
Continuing Education Activity
Analgesics are medications used in the management and treatment of pain. They include several classes of
medications (acetaminophen, nonsteroidal anti-inflammatory drugs, antidepressants, antiepileptics, local anesthetics,
and opioids). This activity reviews the indications, actions, and contraindications for all the drug classes listed before
as valuable agents in the treatment of pain and other specific disorders. This activity will highlight the mechanism of
action, adverse event profile, and other key factors (e.g., off-label uses, dosing, monitoring) pertinent for members of
the interprofessional healthcare team in the management of patients with acute and chronic pain and related
conditions.
4/16/2026, 1:43:23 PM
,Latest Pain Management Medications
Objectives:
Outline the indication for naloxone administration.
Describe the common physical exam findings associated with nonsteroidal anti-inflammatory drug (NSAID)
toxicity.
Identify the most common adverse events associated with acetaminophen therapy.
Review the importance of improving care coordination among the interprofessional team to pain control
medication choices for patients with acute and chronic pain.
Access free multiple choice questions on this topic.
Indications
According to the International Association for the Study of Pain (IASP), pain is defined as an unpleasant experience
(sensory and/or emotional) related to a potential or confirmed tissue damage or described in such terms.[1] Currently,
the debate is ongoing whether or not this definition should be modified.[2][3][4] Nonetheless, the classification for
pain management medications is stable; categories are nonopioid analgesic agents and opioid analgesic agents.
Nonopioid analgesic agents
4/16/2026, 1:43:23 PM
,Latest Pain Management Medications
Acetaminophen (paracetamol): Mild to moderate pain, moderate to severe pain (as adjunctive therapy to
opioids), and temporary reduction of fever. Acetaminophen should not be used for neuropathic pain since there
is no documented effect.[5][6][7]
Nonsteroidal anti-inflammatory drugs (NSAIDs): These drugs are used for mild-to-moderate pain, pain
associated with inflammation, and temporary reduction of fever. Similar to the previous medication, NSAIDs
have no evidence for the management of neuropathic pain. Some NSAIDs have other non-pain-related
indications (eg., aspirin use for secondary prevention of myocardial infarction), which will not be covered in
this review.[7][8]
Antidepressant medications: Selective serotonin and norepinephrine reuptake inhibitors (SNRIs), particularly
duloxetine, and tricyclic antidepressants (TCAs), especially amitriptyline, have demonstrated efficacy in a
variety of neuropathic pain conditions. Thus they are recommended as the first line of treatment.
[9] Furthermore, besides their respective indications for psychiatric disorders such as major depressive disorder
and generalized anxiety disorder, these medications are indicated for other pathologies such as fibromyalgia and
chronic musculoskeletal pain. Also, antidepressants are recommended as a prophylactic treatment for migraine
and tension-type headaches (amitriptyline). Both of the pharmacological groups seem to be more effective in
patients with depressive symptoms and pain as comorbidity than in those patients with pain alone.[7][9]
Antiepileptic medications: Several antiepileptic drugs are also known for their analgesic properties through
their mechanism of action of lowering neurotransmitter release or neuronal firing. The most common
antiepileptics used for pain treatment are gabapentin and pregabalin.[7]
4/16/2026, 1:43:23 PM
, Latest Pain Management Medications
Gabapentin: Postherpetic neuralgia in adults and neuropathic pain.
Pregabalin: Neuropathic pain associated with diabetic peripheral neuropathy or spinal cord injury,
postherpetic neuralgia, and fibromyalgia.
Oxcarbazepine and carbamazepine: trigeminal or glossopharyngeal neuralgia
Local anesthetics: Lidocaine is among the most commonly used medications in this drug class, which is FDA
approved for postherpetic neuralgia and recommended for peripheral neuropathic pain.[7][10]
Opioid Agents
Opioids are a broad class of medications with structural resemblance to the natural plant alkaloids found in opium,
which was originally derived from the resin of the opium poppy, Papaver somniferum.[11] They are recognized as the
most effective and widely used drugs in treating severe pain.[12] Opioids have been among the most controversial
analgesics, particularly because of their potential for addiction, tolerance, and side effects.[13] Although opioids have
indications for acute and chronic pain treatment, the Center for Disease Control and Prevention's guidelines
recommends that only if the expected benefits for both pain and function outweigh the risks, clinicians should
prescribe opioids at the lowest effective dose and for the shortest expected duration to treat the pain severe enough to
require opioids.[14][15][16][17]
Mechanism of Action
Nonopioid analgesic agents
4/16/2026, 1:43:23 PM
