Opioid Pain Relievers for Osteoarthritis

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Examples

Generic NameBrand Name
codeine 
hydrocodoneNorco, Vicodin
oxycodoneOxyContin, Roxicodone
tramadolRyzolt, Ultram

Opioids are available in pills, liquids, or suckers to take by mouth, and in shot, skin patch, and suppository form.

Opioids are also called opiates or narcotics.

How It Works

Opioid pain relievers suppress your perception of pain and calm your emotional response to pain. These drugs reduce not only the number of pain signals sent by the nervous system but also the brain's reaction to those pain signals.

Why It Is Used

Opioids are prescription medicines and are usually reserved for treatment of moderate to severe pain in people for whom acetaminophen, NSAIDs, exercise, and physical therapy have not worked.

How Well It Works

Opioids are effective in reducing osteoarthritis pain that has not been relieved by other medicines. Opioids are sometimes used along with nonsteroidal anti-inflammatory drugs (NSAIDs).footnote 1

Side Effects

All medicines have side effects. But many people don't feel the side effects, or they are able to deal with them. Ask your pharmacist about the side effects of each medicine you take. Side effects are also listed in the information that comes with your medicine.

Here are some important things to think about:

  • Usually the benefits of the medicine are more important than any minor side effects.
  • Side effects may go away after you take the medicine for a while.
  • If side effects still bother you and you wonder if you should keep taking the medicine, call your doctor. He or she may be able to lower your dose or change your medicine. Do not suddenly quit taking your medicine unless your doctor tells you to.

Call 911 or other emergency services right away if you have:

  • Trouble breathing.
  • Swelling of your face, lips, tongue, or throat.
  • Signs of an overdose, including:
    • Cold, clammy skin.
    • Confusion.
    • Severe nervousness or restlessness.
    • Severe dizziness, drowsiness, or weakness.
    • Slow breathing.
    • Seizures.

Call your doctor if you have:

  • Hives.
  • A fast, slow, or pounding heartbeat.
  • Increased sweating.
  • Redness or flushing of the face.

Common side effects of this medicine include:

  • Constipation.
  • Dizziness, lightheadedness, or feeling faint.
  • Drowsiness.
  • Nausea or vomiting.

See Drug Reference for a full list of side effects. (Drug Reference is not available in all systems.)

What To Think About

Opioid pain relievers are strong medicines. They can help you manage pain when you use them the right way. But if you misuse them, they can cause serious harm and even death. For these reasons, it is important to use them exactly as your doctor prescribes. But you can get addicted to opioids. The risk is higher if you have a history of substance use. Your doctor will monitor you closely for signs of misuse and addiction and to figure out when you no longer need to take opioids. If you are worried about addiction, talk with your doctor.

Opioids may be considered if other medicines and treatments have not controlled arthritis pain or are not safe for you. To make this decision, you and your doctor may consider:

Dry mouth is common with these medicines. To help with dry mouth, you can chew sugarless gum, suck on sugarless candy, or melt ice in your mouth. If you continue to have problems with dry mouth after a couple of weeks, call your doctor. Dry mouth can lead to tooth decay and gum disease.

Some of these medicines have acetaminophen in them. Check the labels on all the other nonprescription and prescription medicines you take. Many medicines have acetaminophen. Do not take two or more medicines with acetaminophen in them unless your doctor has told you to. Taking too much acetaminophen can be harmful. If you have questions about this, talk to your doctor or pharmacist.

Taking medicine

Medicine is one of the many tools your doctor has to treat a health problem. Taking medicine as your doctor suggests will improve your health and may prevent future problems. If you don't take your medicines properly, you may be putting your health (and perhaps your life) at risk.

There are many reasons why people have trouble taking their medicine. But in most cases, there is something you can do. For suggestions on how to work around common problems, see the topic Taking Medicines as Prescribed.

Advice for women

If you are pregnant, breastfeeding, or planning to get pregnant, do not use any medicines unless your doctor tells you to. Some medicines can harm your baby. This includes prescription and over-the-counter medicines, vitamins, herbs, and supplements. And make sure that all your doctors know that you are pregnant, breastfeeding, or planning to get pregnant.

Checkups

Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor if you are having problems. It's also a good idea to know your test results and keep a list of the medicines you take.

Complete the new medication information form (PDF)(What is a PDF document?) to help you understand this medication.

References

Citations

  1. Lozada CJ (2013). Treatment of osteoarthritis. In GS Firestein et al., eds., Kelley's Textbook of Rheumatology 9th ed., vol. 2, pp. 1646-1659. Philadelphia: Saunders.

Credits

ByHealthwise Staff

Primary Medical ReviewerAnne C. Poinier, MD - Internal Medicine

Martin J. Gabica, MD - Family Medicine

Kathleen Romito, MD - Family Medicine

E. Gregory Thompson, MD - Internal Medicine

Adam Husney, MD - Family Medicine

Specialist Medical ReviewerStanford M. Shoor, MD - Rheumatology

Current as ofJune 1, 2017

Current as of: June 1, 2017

Author: Healthwise Staff

Medical Review: Anne C. Poinier, MD - Internal Medicine & Martin J. Gabica, MD - Family Medicine & Kathleen Romito, MD - Family Medicine & E. Gregory Thompson, MD - Internal Medicine & Adam Husney, MD - Family Medicine & Stanford M. Shoor, MD - Rheumatology