Pain is often controlled with short-acting pain medication. These medications typically last from two to four hours and are good for acute pain that is expected to be short lived. In situations where pain is more chronic in nature, long-acting pain medications are often used. These medications require less frequent dosing and provide better analgesia over the long term. Used appropriately, long-acting pain medications can be an effective part of a pain management plan.
Types of Pain Medication
There are three main types of pain medication: aspirin/non-steroidal anti-inflammatory drugs (NSAIDs), acetaminophen and opioid narcotics. Certain medications from other drug classes (like antidepressants) are sometimes used for pain control, but are not designed as pain medication. Aspirin and NSAIDs are very effective pain relievers but few come in long-acting formulations. Acetaminophen is a non-narcotic analgesic medication that only recently became available in formulations marketed to last up to eight hours. Opioid narcotic medications are among the most effective pain medications available and also have the widest range of long-acting formulations. Of note is that the definition of long-acting is variable across drugs and manufacturers. In some cases, formulations of drugs lasting eight hours are considered long-acting whereas in others, formulations lasting up to 24 hours or more are considered long-acting. Also, various abbreviations are used, mostly with prescription medications, to indicate they are long acting. Some include XR or ER or XL (extended release), CR (controlled release) and LA (long acting).
Long Acting Non-narcotics
Aside from long-acting acetaminophen, there are few true long-acting non-narcotic pain medications. One exception is celecoxib (Celebrex), which can be given as a single dose once per day or in a divided dose, with half in the morning and half in the evening. Another is tramadol (Ultram) extended release which is dosed once per day. Non-narcotic pain medications are most effective in treating mild to moderate pain over the long term. They are often used in treating arthritis or other musculoskeletal pain conditions.
Long Acting Narcotics
Some examples of long-acting opioid narcotic medications include oxycodone (Oxycontin), morphine (MS-Contin or Kadian), methadone (Dolophine), fentanyl (Duragesic), codeine (Codeine Contin) and oxymorphone (Opana ER). These medications are typically dosed once per day or in some cases (as with Duragesic), even less frequently. They provide long-acting analgesic properties and are most useful in the treatment of chronic pain.
- "Pharmacotherapeutics: A Primary Care Clinical Guide;" Debra S. Israel, Pharm.D., Ellis Quinn Youngkin, Ph.D., R.N.C., Jeanette F. Kissinger, Ed.D., R.N. and Kathleen J. Sawin, D.N.S., R.N.; 2005
- National Center for Biotechnology Information: Drug Class Review - Long-acting Opiod Analgesics