Opioid Pain Relievers In Migraine Treatment
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-Opioid Pain Relievers In Migraine Treatment
-Side Effects of Opioids
Opioid pain relievers are narcotics, and because they can cause physical dependence and have many side effects, they are used with great caution in migraine treatment. They are only prescribed to rescue those patients who experience moderate to severe migraines, and usually only after other migraine medications have been used without success. It’s important to note that there are currently no opioid drugs that are FDA-approved specifically for migraine relief. Most have general pain-relief indications. But many have been used in clinical trials and as an “off label” migraine therapy by physicians.
Opioids that may be prescribed for migraine treatment include butorphanol (Stadol), oxycodone (Oxycontin), morphine (Avinza, Kadian. MS Contin, MSIR, Oramorph, Rescudose, Roxanol), meperidine (Demerol), fentanyl (Actiq), levorphanol (Levo-Dromoran), propoxyphene (Darvon), and methadone (Diskets, Dolophine, Methadose). These drugs are available in either oral, suppository, injectable (i.e., intravenously or subcutaneously), or transdermal (i.e., skin patch) formulations. Butorphanol tartrate is available in a generic nasal spray form for faster pain relief. Codeine, the mildest opioid analgesic, is usually used in combination with acetaminophen or other nonopioid analgesics (Tylenol #3).
Side Effects of Opioids
Opioids related side effects include nausea, vomiting, forgetfulness, confusion, fatigue, constipation, and itching. They are sedatives, so should never be used before driving or operating machinery. Moreover, Opioids should not be taken with alcohol, and they must be used with caution in people with reduced liver or kidney function. Because opioids depress respiration (decrease breathing rate), they are not a good treatment choice for anyone suffering from lung problems such as chronic bronchial asthma, emphysema, or chronic obstructive pulmonary disease (COPD)
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