Non-Opioid Drug Products for Pain Management The list that follows below is intended for informational purposes only and not intended to be either complete or to be used as guidance for opioid substitution. Clinicians have reported favorable experience with many drug and non-drug interventions for pain and headache. Not all of these observations are equally well supported by the best available evidence, and not all conditions or patients respond equally well to the same dose of the same agent. Competencies in the safe and effective diagnosis and treatment of painful conditions are complex skill sets. Appropriate clinical expertise should be sought in the individualized decision making required for optimal pain assessment and treatment. Therapeutic Class Generic Name Brand Name(s) FDA-Labeled Pain Indication Off-Label Pain Use Analgesics and Antipyretics, Miscellaneous Acetaminophen Tylenol® Headache, musculoskeletal pain - Acetaminophen injection Ofirmev® Mild to moderate pain, moderate to severe pain (adjunct) - Acetaminophen/ aspirin Excedrin® Back and Body Headache, musculoskeletal pain - Acetaminophen/ aspirin/caffeine Excedrin® (various products) Headache - Angiotensin-Converting Enzyme Inhibitors (ACE-I) Enalapril Vasotec® - Migraine prophylaxis Lisinopril Prinivil®, Zestril® - Migraine prophylaxis Anticonvulsants Carbamazepine Carbatrol®, Epitol®, Tegretol®, Tegretol XR® Trigeminal Neuralgia - Divalproex sodium Depakote®, Depakote ER® Migraine prophylaxis - Gabapentin Gralise®, Horizant®, Neurontin® Postherpetic neuralgia Diabetic peripheral neuropathy, fibromyalgia, postoperative pain (preemptive), chemotherapy-induced peripheral neuropathy Lacosamide Vimpat® - Diabetic peripheral neuropathy Lamotrigine Lamictal®, Lamictal ODT®, Lamictal XR® - Migraine prophylaxis, neuropathic pain, trigeminal neuralgia
Nonsteroidal Anti-inflammatory Drugs (NSAIDs) Diclofenac sodium Cambia®, Voltaren®, Voltaren XR®, Zipsor®, Zorvolex® Acute pain, ankylosing spondylitis, osteoarthritis, rheumatoid arthritis Acute gout, biliary colic, renal colic Diclofenac sodium gel Voltaren Gel® Osteoarthritis - Diclofenac sodium injection Dyloject® Acute pain Biliary colic, migraine headache, myalgia, renal colic Diclofenac sodium topical solution Pennsaid® Osteoarthritis - Diclofenac/ misoprostol Arthrotec® Osteoarthritis and rheumatoid arthritis in patients at high risk of developing NSAID-induced gastric and duodenal ulcers and their complications Dental pain, inflammatory disorder Diflunisal Dolobid® Mild to moderate pain, osteoarthritis, rheumatoid arthritis Backache, dysmenorrhea, soft tissue injury Etodolac Lodine®, Lodine XL® pain, juvenile rheumatoid arthritis, osteoarthritis, rheumatoid arthritis - Fenoprofen Nalfon® Mild to moderate pain, osteoarthritis, rheumatoid arthritis Migraine headache, tendinitis Flurbiprofen Ansaid® Osteoarthritis, rheumatoid arthritis Ankylosing spondylitis, dental pain, dysmenorrhea, migraine headache, throat pain Nonsteroidal Anti-inflammatory Drugs (NSAIDs) Ibuprofen Motrin® Headache, migraine headache, osteoarthritis, pain, primary dysmenorrhea, rheumatoid arthritis -
Ibuprofen injection Caldolor® Mild to moderate pain, moderate to severe pain (adjunct) - Ibuprofen/famotidine Duexis® Ostearthritis, rheumatoid arthritis - Indomethacin Indocin®, Tivorbex® Acute gout, ankylosing spondylitis, mild to moderate pain, osteoarthritis, rheumatoid arthritis Dysmenorrhea, headache, post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis prophylaxis, ureteric colic Ketoprofen Orudis® Mild to moderate pain, osteoarthritis, primary dysmenorrhea, rheumatoid arthritis Soft tissue injury Ketorolac Toradol® Acute pain (short-term treatment) Headache, postoperative pain, renal colic Ketorolac injection Toradol® injection Acute pain (short-term treatment) Headache, regional anesthesia, renal colic Ketorolac nasal spray Sprix® Acute pain (short-term treatment) - Meclofenamate Meclomen® Ankylosing spondylitis, gout, juvenile chronic arthritis, menorrhagia, mild to moderate pain, osteoarthritis, primary dysmenorrhea, rheumatoid arthritis - Mefenamic acid Ponstel® Dysmenorrhea, low back pain, mild to moderate pain - Meloxicam Mobic®, Vivlodex® Polyarticular juvenile rheumatoid arthritis, Acute gout, postoperative dental pain, primary dysmenorrhea
osteoarthritis, rheumatoid arthritis Nabumetone Relafen® Osteoarthritis, rheumatoid arthritis Soft tissue injury Naproxen Anaprox DS®, EC Naprosyn®, Naprosyn®, Naprelan® Acute gout, acute tendinitis, ankylosing spondylitis, bursitis, mild to moderate pain, osteoarthritis, primary dysmenorrhea, rheumatoid arthritis Soft tissue injury, systemic lupus erythematosus Naproxen/ esomeprazole Vimovo® Ankylosing spondylitis, osteoarthritis, rheumatoid arthritis - Oxaprozin Daypro® Juvenile rheumatoid arthritis, osteoarthritis, rheumatoid arthritis Bursitis, tendinitis, procedure-associated dental pain Piroxicam Feldene® Osteoarthritis, rheumatoid arthritis Acute gout, dental pain, dysmenorrhea, pain, postoperative pain, soft tissue injury Salsalate Disalcid® Osteoarthritis, rheumatoid arthritis - Sulindac Clinoril® Acute gout, ankylosing spondylitis, osteoarthritis, rheumatoid arthritis, shoulder pain -