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Medications for Fibromyalgia Pain Relief

Understanding fibromyalgia

Fibromyalgia is a complicated health issue. It seems to change the way your brain registers pain. It’s marked by pain in your muscles, bones, tendons, and nerves. Fibromyalgia may be caused by several factors. These can include genetics, infections, injury, and stress. Women tend to develop it more often than men. People with arthritis also seem to be more likely to get fibromyalgia.

There’s no cure for fibromyalgia, but medications and other treatments can help ease symptoms. Here’s a list of prescription and over-the-counter (OTC) drugs that may help relieve your fibromyalgia pain.

Approved drugs

Pregabalin (Lyrica)

The Food and Drug Administration (FDA) approved the first drug to treat fibromyalgia in 2007. That drug was pregabalin (Lyrica). This medication works by affecting chemicals in your brain that may play a role in fibromyalgia. It blocks the activity of certain nerve cells that send pain signals through your body.

The more common side effects of this drug can include:

  • sleepiness
  • dizziness
  • weight gain
  • dry mouth
  • trouble concentrating

Duloxetine (Cymbalta)

Duloxetine (Cymbalta) was first approved by the FDA to treat depression and anxiety. The FDA approved it to treat fibromyalgia in 2008. Fibromyalgia and depression often go hand in hand. This drug may treat both conditions at once.

This drug works by changing the levels of certain chemicals in your brain. These chemicals include serotonin and norepinephrine. Changing the levels of these chemicals may help control pain in your body.

The more common side effects of this drug can include:

  • sleepiness
  • nausea
  • loss of appetite

This drug may cause suicidal thoughts. If you have these thoughts, call your doctor right away.

Milnacipran HCI (Savella)

Milnacipran HCI (Savella) is the newest fibromyalgia drug. It was approved in 2009. It was also the first drug made just to treat fibromyalgia.

This drug is not prescribed to treat depression, but it works like drugs that do treat depression. Milnacipran HCI changes the levels of serotonin and norepinephrine in your brain. This may help relieve pain.

The more common side effects of this drug can include:

  • nausea
  • insomnia, or trouble falling or staying asleep
  • heart issues such as palpitations and high blood pressure

Off-label drugs

What is off-label drug use?
Off-label drug use means that a drug that’s been approved by the FDA for one purpose is used for a different purpose that has not been approved. However, a doctor can still use the drug for that purpose. This is because the FDA regulates the testing and approval of drugs, but not how doctors use drugs to treat their patients. So, your doctor can prescribe a drug however they think is best for your care.

Your doctor may give you other drugs for fibromyalgia that aren’t approved to treat the condition. These are called off-label drugs.

For fibromyalgia, common off-label drugs include:

People with fibromyalgia often have trouble sleeping. Sometimes, doctors may give drugs that are used to improve sleep to people with fibromyalgia. These off-label sleep medications include:

  • amitriptyline (Elavil), which is used for depression, sleep, and nerve pain
  • cyclobenzaprine (Flexeril), which helps with sleep and restlessness
  • gabapentin (Neurontin), which helps with sleep and nerve pain

Experts are researching new ways to treat fibromyalgia. These are also off-label uses. Some of these experimental treatments include:

  • Cannabinoids, which are medications made from marijuana. These drugs have been helpful for people with fibromyalgia, according to a review in the British Journal of Clinical Pharmacology.
  • Low-dose naltrexone (Revia), which is normally used to treat alcoholism and opioid addiction. This drug has been helpful for some people with fibromyalgia, according to a study in Clinical Rheumatology.

Not all drugs that are used to help with pain and sleep are safe for people with fibromyalgia, however. For example, opioids should not be used to treat fibromyalgia, according to the American College of Rheumatology (ACR). Research shows that these drugs do not help much. And in fact, they may increase feelings of pain or make the pain last longer.

The ACR also says that certain sleeping pills should not be used to treat fibromyalgia. These include zolpidem (Ambien), diazepam (Valium), or alprazolam (Xanax). These drugs come with the risk for addiction. They may also cause people with fibromyalgia to have additional pain.

Over-the-counter drugs

Other treatments
In some cases, doctors suggest other treatments with your medication to help you cope with your fibromyalgia symptoms. Psychological treatments, sleep, and exercise that includes gentle stretching may help. So may relaxation techniques such as acupuncture, massage, and yoga.

Some over-the-counter (OTC) drugs may also provide pain relief from fibromyalgia. Nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (Advil) can help. Some people may also get relief from acetaminophen (Tylenol).

However, these drugs treat the pain triggers only. That means that they may not work as well as medications approved for fibromyalgia. OTC painkillers may be most helpful for people with fibromyalgia who also have arthritis.

Get more information: 7 natural remedies for fibromyalgia »

Keep fighting

Finding relief from fibromyalgia pain can be a challenge. It may take both drugs and other treatments to help you feel better. It may also take time to find the best combination that works for you. The key is to keep working with your doctors to find the right approach.

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