DRUG TREATMENTS FOR FIBROMYALGIA
Symptom |
Drug |
Comment |
Pain |
Acetaminophen (e.g. Tylenol) |
First line |
NSAID (e.g. Advil) |
First line (if also other condition such as osteoarthritis) |
|
Moderate to severe pain |
Tramadol |
Shown to improve pain & quality of life |
Codeine |
|
|
Pain, depression, sleep disturbance |
Amitriptyline |
Best choice Start 10mg at bedtime Could go to 25mg at bedtime Side effects: drowsiness, dry mouth, weight gain) |
Duloxetine |
Start 30mg – 60mg once daily Higher doses may not be better Response within 8 weeks Side effects: nausea, dry mouth, headache |
|
Pain, sleep disturbance |
Pregabalin |
Start 75mg BID Increase to 150mg BID after week Side effects: drowsiness, edema, weight gain |
Gabapentin |
Start 300mg at bedtime x 1 week Increase by 300mg/week to 1200-2400mg daily (divided TID) |
|
Sleep disturbance |
Nabilone |
Works as well as Amitriptyline for sleep disturbance but more side effects |