DRUG TREATMENTS FOR FIBROMYALGIA

Drug treatments for fibromyalgia image drugs images

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

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