|
|
Table 7. Adjuvant Medications With Possible Analgesic Activity
Class
|
Drug
|
Daily Dose Rangea
|
Studies Conducted in:
|
|
|
|
Cancer Patients
|
Noncancer Patients
|
Antidepressants |
amitriptyline (Elavil) |
10–25 mg every day |
[197,198] |
[199] |
desipramine (Norpramin) |
10–150 mg every day |
[200] |
[201] |
maprotiline (Ludiomil) |
25 mg bid–50 mg tid |
|
[202] |
duloxetine (Cymbalta) |
20 mg bid–30 mg bid |
|
[203] |
nortriptyline (Pamelor, Aventyl) |
10–100 mg every day |
|
[204] |
venlafaxine (Effexor) |
37.5–225 mg every day |
[205,206] |
[207] |
Anticonvulsants |
carbamazepine (Tegretol) |
100 mg tid–400 mg tid |
|
[208] |
valproate (Depacon) |
500 mg tid–1,000 mg tid |
|
[209] |
gabapentin (Neurontin) |
100 mg tid–1,000 mg tid |
[210,211] |
[212] |
clonazepam (Klonopin) |
0.5 mg bid–4 mg bid |
[213] |
|
lamotrigine (Lamictal) |
25 mg bid–100 mg bid |
|
[214] |
pregabalin (Lyrica) |
150 mg divided into 2 or 3 doses; increase to 300 mg starting at day 3–7; if needed, increase to 600 mg 7 days later |
|
[215] |
Local anesthetics |
mexiletine (Mexitil) |
100 mg bid–300 mg tid |
|
[216] |
lidocaine patch (Lidoderm) |
5% patch contains 700 mg; one patch, 12 hours on, 12 hours off |
|
[217] |
Corticosteroids |
dexamethasone (Decadron) |
See text |
|
|
prednisone |
See text |
|
|
Bisphosphonates |
clodronate |
See text |
|
|
pamidronate (Aredia) |
See text |
|
|
zoledronic acid (Zometa) |
See text |
[218] |
|
NSAIDs |
See the Dosing Recommendations for Acetaminophen and NSAIDs table |
|
|
|
Miscellaneous |
baclofen (Lioresal) |
5 mg tid–20 mg tid |
|
[219] |
calcitonin (Calcimar) |
100–200 IU (subcutaneous or
intranasal) |
|
|
clonidine (Catapres) |
0.1 mg bid–0.3 mg bid |
|
[220] |
methylphenidate (Ritalin) |
2.5 mg bid–20 mg bid |
[221] |
[222] |
ketamine (Ketalar) |
See NMDA Receptor Antagonists section |
|
|
bid = twice a day; tid = three times a day.
|
aStarting doses should incorporate the lowest possible dose.
|
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