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Pain Relieving Medications Dataset – Analgesic Drugs Database
Pain Relieving Medications Dataset
The Pain Relieving Medications Dataset is a structured pharmaceutical database containing a comprehensive list of analgesic drugs used to relieve pain.
Pain relievers are among the most widely used medications globally and include several categories such as non-steroidal anti-inflammatory drugs (NSAIDs), opioids, acetaminophen-based medications, and other analgesic compounds.
This dataset provides organised information about pain-relieving medications, helping developers, researchers, and healthcare professionals analyse drug classifications and therapeutic uses.
The dataset has been cleaned and structured for easy integration into spreadsheets, databases, and analytical systems.
It is ideal for pharmaceutical research, healthcare software development, educational platforms, and medical data science projects.
Dataset Contents
The dataset includes fields such as:
- Medication Name
- Drug Class
- Primary Medical Use
- Mechanism of Action
- Route of Administration (Oral, Topical, Injection, etc.)
- Prescription Status (Prescription / Over-the-Counter)
Example Medications Included
- Paracetamol (Acetaminophen)
- Ibuprofen
- Aspirin
- Naproxen
- Diclofenac
- Morphine
- Codeine
- Tramadol
- Oxycodone
- Fentanyl
...and many other pain-relieving medications.
Data Preview
17 columns
25 rows shown
| No. | Generic Name | Brand Names | Mechanism of Action | Common Indications | Route of Administration | Common Dosage Forms | Typical Adult Dose | Onset of Action | Duration of Action | Common Side Effects | Serious Side Effects / Warnings | Contraindications | Drug Interactions | Special Populations Notes | OTC / Rx | Pregnancy Category | |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1 | 1 | acetaminophen (paracetamol) | Tylenol, Panadol, Calpol, Mapap, Ofirmev (IV), FeverAll (suppository), Tempra | Inhibits COX enzymes centrally (weak peripheral action); modulates endocannabinoid and serotonergic pathways; antipyretic via hypothalamic heat-regulation | Mild to moderate pain; headache; fever; osteoarthritis; musculoskeletal pain; dental pain | Oral; rectal; IV (Ofirmev) | Tablets; capsules; extended-release tablets; oral liquid; suppositories; IV solution; chewable tablets; gummies | 325-1000 mg q4-6h (max 4 g/day); ER: 1300 mg q8h | 30-60 min (oral); 5-20 min (IV) | 4-6 hours; 8 hours (ER) | Generally well tolerated; rare: nausea; rash | Hepatotoxicity (dose-dependent, potentially fatal); severe skin reactions (SJS/TEN, AGEP); anaphylaxis (rare) | Severe hepatic impairment; severe active liver disease; known hypersensitivity | Warfarin (increased INR at high doses); alcohol (increased hepatotoxicity risk); isoniazid; carbamazepine; phenytoin | Max 4g/day in healthy adults; max 2g/day in liver disease/chronic alcohol use; leading cause of acute liver failure in overdose; adjust dose in hepatic impairment | Rx/OTC | C |
| 2 | 2 | acetaminophen / benzhydrocodone | Apadaz | Benzhydrocodone: prodrug of hydrocodone (activated by GI enzymes) + Acetaminophen: central analgesic | Moderate to severe pain; chronic pain (when non-opioid options insufficient); acute post-surgical pain | Oral | Tablets | 1-2 tablets q4-6h PRN (max 8 tablets/day) | 30-60 min | 4-6 hours | Constipation; nausea/vomiting; drowsiness; dizziness; pruritus; dry mouth; sedation | Respiratory depression; physical dependence/addiction; overdose death; serotonin syndrome; adrenal insufficiency; QT prolongation (methadone); neonatal abstinence syndrome | Significant respiratory depression; acute/severe bronchial asthma (unmonitored); known or suspected GI obstruction; MAOIs within 14 days | Benzodiazepines/CNS depressants (profound sedation, respiratory depression, death); MAOIs; serotonergic agents; CYP3A4 inhibitors/inducers; alcohol | Prodrug design may deter intranasal/injection abuse; Schedule II; monitor acetaminophen total | Rx | N/A |
| 3 | 3 | acetaminophen / caffeine | Excedrin Tension Headache, Panadol Extra | Acetaminophen: central COX inhibition + Caffeine: analgesic adjuvant, enhances absorption, vasoconstrictor | Mild to moderate pain; headache; fever; osteoarthritis; musculoskeletal pain; dental pain | Oral | Tablets; caplets; geltabs | 1-2 tablets q6h (max 8/day) | 15-30 min | 4-6 hours | Generally well tolerated; rare: nausea; rash | Hepatotoxicity (dose-dependent, potentially fatal); severe skin reactions (SJS/TEN, AGEP); anaphylaxis (rare) | Severe hepatic impairment; severe active liver disease; known hypersensitivity | Warfarin (increased INR at high doses); alcohol (increased hepatotoxicity risk); isoniazid; carbamazepine; phenytoin | Caffeine enhances analgesic effect ~40%; may cause insomnia if taken late; monitor total acetaminophen from all sources | OTC | N |
| 4 | 4 | acetaminophen / caffeine / dihydrocodeine | Trezix, Panlor DC | Dihydrocodeine: mu-opioid agonist + Acetaminophen: central analgesic + Caffeine: analgesic adjuvant (enhances absorption and analgesic effect) | Moderate to severe pain; chronic pain (when non-opioid options insufficient); acute post-surgical pain | Oral | Capsules (320/30/16 mg or similar) | 1-2 capsules q4h PRN (max 10 capsules/day) | 30-60 min | 4-6 hours | Constipation; nausea/vomiting; drowsiness; dizziness; pruritus; dry mouth; sedation | Respiratory depression; physical dependence/addiction; overdose death; serotonin syndrome; adrenal insufficiency; QT prolongation (methadone); neonatal abstinence syndrome | Significant respiratory depression; acute/severe bronchial asthma (unmonitored); known or suspected GI obstruction; MAOIs within 14 days | Benzodiazepines/CNS depressants (profound sedation, respiratory depression, death); MAOIs; serotonergic agents; CYP3A4 inhibitors/inducers; alcohol | Caffeine enhances analgesic effect; monitor acetaminophen total; Schedule III | Rx | C |
| 5 | 5 | acetaminophen / codeine | Tylenol with Codeine (#3, #4), Capital and Codeine | Codeine: prodrug → morphine via CYP2D6 + Acetaminophen: central COX inhibition | Moderate to severe pain; chronic pain (when non-opioid options insufficient); acute post-surgical pain | Oral | Tablets; oral solution | 1-2 tablets q4h PRN (typically 300/30 mg) | 30-60 min | 4-6 hours | Constipation; nausea/vomiting; drowsiness; dizziness; pruritus; dry mouth; sedation | Respiratory depression; physical dependence/addiction; overdose death; serotonin syndrome; adrenal insufficiency; QT prolongation (methadone); neonatal abstinence syndrome | Significant respiratory depression; acute/severe bronchial asthma (unmonitored); known or suspected GI obstruction; MAOIs within 14 days | Benzodiazepines/CNS depressants (profound sedation, respiratory depression, death); MAOIs; serotonergic agents; CYP3A4 inhibitors/inducers; alcohol | CYP2D6 ultra-rapid metabolisers at risk; CONTRAINDICATED in children <12 and post-tonsillectomy <18; monitor acetaminophen total; Schedule III (with APAP) | Rx | C |
| 6 | 6 | acetaminophen / diphenhydramine | Tylenol PM, Mapap PM, Percogesic | Acetaminophen: central analgesic + Diphenhydramine: antihistamine with sedative properties | Mild to moderate pain; headache; fever; osteoarthritis; musculoskeletal pain; dental pain | Oral | Tablets; caplets; geltabs | 1-2 tablets at bedtime | 30 min | 6-8 hours | Drowsiness; dry mouth; dizziness; next-day grogginess | Hepatotoxicity (dose-dependent, potentially fatal); severe skin reactions (SJS/TEN, AGEP); anaphylaxis (rare) | Severe hepatic impairment; severe active liver disease; known hypersensitivity | Warfarin (increased INR at high doses); alcohol (increased hepatotoxicity risk); isoniazid; carbamazepine; phenytoin | For nighttime pain with difficulty sleeping; anticholinergic load – caution in elderly; not for long-term use | OTC | N |
| 7 | 7 | acetaminophen / hydrocodone | Vicodin, Norco, Lortab, Lorcet, Hycet, Xodol, Zamicet | Hydrocodone: mu-opioid agonist + Acetaminophen: central COX inhibition; synergistic analgesia | Moderate to severe pain; chronic pain (when non-opioid options insufficient); acute post-surgical pain | Oral | Tablets; capsules; oral solution | 1-2 tablets q4-6h (varies by strength; max acetaminophen 4 g/day) | 20-30 min | 4-6 hours | Constipation; nausea/vomiting; drowsiness; dizziness; pruritus; dry mouth; sedation | Respiratory depression; hepatotoxicity (acetaminophen component); physical dependence; constipation | Significant respiratory depression; acute/severe asthma; hepatic impairment (acetaminophen risk); MAOI use | Benzodiazepines/CNS depressants (profound sedation, respiratory depression, death); MAOIs; serotonergic agents; CYP3A4 inhibitors/inducers; alcohol | Most commonly prescribed opioid combination; monitor total acetaminophen intake from all sources; Schedule II | Rx | C |
| 8 | 8 | acetaminophen / ibuprofen | Advil Dual Action, Combogesic | Acetaminophen: central analgesic + Ibuprofen: peripheral COX inhibition; complementary mechanisms provide superior analgesia | Mild to moderate pain; headache; fever; osteoarthritis; musculoskeletal pain; dental pain | Oral; IV | Tablets; IV solution | Oral: 1 tablet (125/250 mg) q6h; IV: per protocol | 15-30 min | 6-8 hours | Generally well tolerated; rare: nausea; rash | Hepatotoxicity (dose-dependent, potentially fatal); severe skin reactions (SJS/TEN, AGEP); anaphylaxis (rare) | Severe hepatic impairment; severe active liver disease; known hypersensitivity | Warfarin (increased INR at high doses); alcohol (increased hepatotoxicity risk); isoniazid; carbamazepine; phenytoin | Dual mechanism may provide better pain relief than either agent alone; monitor hepatic and renal function | Rx/OTC | N/A |
| 9 | 9 | acetaminophen / oxycodone | Percocet, Endocet, Roxicet, Tylox, Primlev, Xartemis XR | Oxycodone: mu-opioid agonist + Acetaminophen: central COX inhibition; synergistic analgesia | Moderate to severe pain; chronic pain (when non-opioid options insufficient); acute post-surgical pain | Oral | Tablets; capsules; oral solution | 1-2 tablets q4-6h (varies by strength; max acetaminophen 4 g/day) | 15-30 min | 4-6 hours | Constipation; nausea/vomiting; drowsiness; dizziness; pruritus; dry mouth; sedation | Respiratory depression; hepatotoxicity (acetaminophen); physical dependence | Significant respiratory depression; acute/severe bronchial asthma (unmonitored); known or suspected GI obstruction; MAOIs within 14 days | Benzodiazepines/CNS depressants (profound sedation, respiratory depression, death); MAOIs; serotonergic agents; CYP3A4 inhibitors/inducers; alcohol | Monitor total daily acetaminophen from all sources (max 4 g/day); Schedule II | Rx | C |
| 10 | 10 | acetaminophen / tramadol | Ultracet | Tramadol: weak mu-agonist + SNRI + Acetaminophen: central COX inhibition | Moderate to severe pain; chronic pain (when non-opioid options insufficient); acute post-surgical pain | Oral | Tablets (37.5 mg tramadol / 325 mg acetaminophen) | 2 tablets q4-6h PRN (max 8 tablets/day for ≤5 days) | 30 min | 4-6 hours | Constipation; nausea/vomiting; drowsiness; dizziness; pruritus; dry mouth; sedation | Respiratory depression; physical dependence/addiction; overdose death; serotonin syndrome; adrenal insufficiency; QT prolongation (methadone); neonatal abstinence syndrome | Significant respiratory depression; acute/severe bronchial asthma (unmonitored); known or suspected GI obstruction; MAOIs within 14 days | Benzodiazepines/CNS depressants (profound sedation, respiratory depression, death); MAOIs; serotonergic agents; CYP3A4 inhibitors/inducers; alcohol | Seizure risk (tramadol); monitor acetaminophen total; serotonin syndrome risk; Schedule IV | Rx | C |
| 11 | 11 | alfentanil | Alfenta | Binds to mu-opioid receptors in the CNS, inhibiting ascending pain pathways and altering perception of pain | Moderate to severe pain; chronic pain (when non-opioid options insufficient); acute post-surgical pain | IV | Injection | 8-100 mcg/kg (anaesthesia adjunct); highly variable based on procedure | 1-2 min (IV) | 30-60 min | Constipation; nausea/vomiting; drowsiness; dizziness; pruritus; dry mouth; sedation | Respiratory depression; physical dependence/addiction; overdose death; serotonin syndrome; adrenal insufficiency; QT prolongation (methadone); neonatal abstinence syndrome | Significant respiratory depression; acute/severe bronchial asthma (unmonitored); known or suspected GI obstruction; MAOIs within 14 days | Benzodiazepines/CNS depressants (profound sedation, respiratory depression, death); MAOIs; serotonergic agents; CYP3A4 inhibitors/inducers; alcohol | Ultra-short acting; used primarily as anaesthesia adjunct; rapid onset; Schedule II | Rx | C |
| 12 | 12 | amitriptyline | Elavil, Endep | Inhibits reuptake of serotonin and norepinephrine; blocks sodium channels and NMDA receptors; descending pain pathway modulation | Neuropathic pain (off-label for pain); fibromyalgia; chronic pain syndromes; migraine prophylaxis; depression | Oral | Tablets | Pain: start 10-25 mg at bedtime; titrate to 50-150 mg/day | 2-4 weeks for full analgesic effect | Continuous (daily dosing) | Drowsiness; dry mouth; constipation; weight gain; blurred vision; urinary retention; orthostatic hypotension | Cardiac arrhythmias (QT prolongation); seizures; serotonin syndrome; suicidal ideation (young adults); anticholinergic toxicity in overdose | Recent MI; cardiac conduction disorders; concurrent MAOI use; acute recovery phase of MI; known hypersensitivity | MAOIs (serotonin syndrome); SSRIs/SNRIs (additive serotonergic effects); CYP2D6 inhibitors; anticholinergic agents; alcohol/CNS depressants | First-line for neuropathic pain (off-label); sedating – dose at bedtime; weight gain common; anticholinergic burden significant in elderly | Rx | C |
| 13 | 13 | aspirin | Bayer, Ecotrin, Bufferin, St. Joseph, Vazalore | Irreversibly inhibits COX-1 (and COX-2 at higher doses); inhibits thromboxane A2 → antiplatelet effect | Mild to moderate pain; arthritis (OA, RA); musculoskeletal pain; headache; dysmenorrhoea; fever | Oral; rectal | Tablets; chewable; enteric-coated; effervescent; suppositories | Pain: 325-650 mg q4-6h (max 4 g/day); Cardioprotective: 81-325 mg daily | 15-30 min | 4-6 hours (analgesic); 7-10 days (antiplatelet) | Nausea; dyspepsia; GI upset; headache; dizziness; fluid retention | GI bleeding/ulceration; haemorrhagic stroke; Reye's syndrome (children); bronchospasm; tinnitus | Children/teens with viral illness (Reye's); active GI bleeding; aspirin allergy; bleeding disorders; 3rd trimester pregnancy | Anticoagulants (increased bleeding); lithium (increased levels); ACE inhibitors/ARBs (reduced efficacy); methotrexate (increased toxicity); aspirin (reduced cardioprotection) | Irreversible antiplatelet effect – hold 7-10 days before surgery; avoid in children <16 years; enteric coating reduces GI irritation | Rx/OTC | N |
| 14 | 14 | aspirin / acetaminophen / caffeine | Excedrin Extra Strength, Excedrin Migraine, Vanquish, Goody's Extra Strength | Aspirin + Acetaminophen: dual analgesic/antipyretic + Caffeine: analgesic adjuvant | Mild to moderate pain; headache; fever; osteoarthritis; musculoskeletal pain; dental pain | Oral | Tablets | 1-2 tablets q4-6h | 15-30 min | 4-6 hours | Generally well tolerated; rare: nausea; rash | Hepatotoxicity (dose-dependent, potentially fatal); severe skin reactions (SJS/TEN, AGEP); anaphylaxis (rare) | Severe hepatic impairment; severe active liver disease; known hypersensitivity | Warfarin (increased INR at high doses); alcohol (increased hepatotoxicity risk); isoniazid; carbamazepine; phenytoin | Max 4g/day in healthy adults; max 2g/day in liver disease/chronic alcohol use; leading cause of acute liver failure in overdose; adjust dose in hepatic impairment | Rx/OTC | N |
| 15 | 15 | aspirin / butalbital / caffeine | Fiorinal | Butalbital: barbiturate (CNS depressant/muscle relaxant) + Aspirin: COX inhibitor + Caffeine: analgesic adjuvant/vasoconstrictor | Moderate to severe pain; chronic pain (when non-opioid options insufficient); acute post-surgical pain | Oral | Capsules; tablets | 1-2 tablets/capsules q4h PRN (max 6/day) | 15-30 min | 4-6 hours | Drowsiness; dizziness; nausea; GI upset; lightheadedness | Physical dependence (butalbital); medication overuse headache; respiratory depression; GI bleeding | Significant respiratory depression; acute/severe bronchial asthma (unmonitored); known or suspected GI obstruction; MAOIs within 14 days | Benzodiazepines/CNS depressants (profound sedation, respiratory depression, death); MAOIs; serotonergic agents; CYP3A4 inhibitors/inducers; alcohol | High abuse potential; medication overuse headache with frequent use; Schedule III; avoid abrupt discontinuation | Rx | C |
| 16 | 16 | aspirin / caffeine | Anacin, Bayer Back & Body | Aspirin: COX inhibition + Caffeine: analgesic adjuvant, enhances aspirin absorption and efficacy | Mild to moderate pain; arthritis (OA, RA); musculoskeletal pain; headache; dysmenorrhoea; fever | Oral | Tablets; powders | 1-2 tablets or 1 powder q4-6h | 15-30 min | 4-6 hours | Nausea; dyspepsia; GI upset; headache; dizziness; fluid retention | GI bleeding/ulceration; cardiovascular events (MI, stroke); renal impairment; serious skin reactions (SJS/TEN); anaphylaxis | NSAID/aspirin allergy; active GI bleeding; perioperative CABG; severe renal/hepatic impairment; 3rd trimester pregnancy | Anticoagulants (increased bleeding); lithium (increased levels); ACE inhibitors/ARBs (reduced efficacy); methotrexate (increased toxicity); aspirin (reduced cardioprotection) | Caffeine enhances analgesic effect; powdered forms (BC) have rapid onset; aspirin bleeding risks apply | OTC | N |
| 17 | 17 | aspirin / caffeine / dihydrocodeine | Synalgos-DC | Dihydrocodeine: mu-opioid agonist + Aspirin: COX inhibitor + Caffeine: analgesic adjuvant | Moderate to severe pain; chronic pain (when non-opioid options insufficient); acute post-surgical pain | Oral | Capsules | 1-2 capsules q4h PRN | 30 min | 4-6 hours | Constipation; nausea/vomiting; drowsiness; dizziness; pruritus; dry mouth; sedation | Respiratory depression; physical dependence/addiction; overdose death; serotonin syndrome; adrenal insufficiency; QT prolongation (methadone); neonatal abstinence syndrome | Significant respiratory depression; acute/severe bronchial asthma (unmonitored); known or suspected GI obstruction; MAOIs within 14 days | Benzodiazepines/CNS depressants (profound sedation, respiratory depression, death); MAOIs; serotonergic agents; CYP3A4 inhibitors/inducers; alcohol | Aspirin adds bleeding risk; Schedule III | Rx | N |
| 18 | 18 | aspirin / carisoprodol / codeine | Soma Compound with Codeine | Codeine: mu-opioid agonist + Carisoprodol: centrally acting muscle relaxant + Aspirin: COX inhibitor | Moderate to severe pain; chronic pain (when non-opioid options insufficient); acute post-surgical pain | Oral | Tablets | 1-2 tablets QID | 30 min | 4-6 hours | Constipation; nausea/vomiting; drowsiness; dizziness; pruritus; dry mouth; sedation | Respiratory depression; physical dependence/addiction; overdose death; serotonin syndrome; adrenal insufficiency; QT prolongation (methadone); neonatal abstinence syndrome | Significant respiratory depression; acute/severe bronchial asthma (unmonitored); known or suspected GI obstruction; MAOIs within 14 days | Benzodiazepines/CNS depressants (profound sedation, respiratory depression, death); MAOIs; serotonergic agents; CYP3A4 inhibitors/inducers; alcohol | Multiple abuse-liable components; carisoprodol metabolised to meprobamate; rarely prescribed; Schedule III | Rx | C |
| 19 | 19 | aspirin / oxycodone | Percodan, Endodan | Oxycodone: mu-opioid agonist + Aspirin: irreversible COX inhibition | Moderate to severe pain; chronic pain (when non-opioid options insufficient); acute post-surgical pain | Oral | Tablets | 1 tablet q6h PRN | 15-30 min | 4-6 hours | Constipation; nausea/vomiting; drowsiness; dizziness; pruritus; dry mouth; sedation | Respiratory depression; physical dependence/addiction; overdose death; serotonin syndrome; adrenal insufficiency; QT prolongation (methadone); neonatal abstinence syndrome | Significant respiratory depression; acute/severe bronchial asthma (unmonitored); known or suspected GI obstruction; MAOIs within 14 days | Benzodiazepines/CNS depressants (profound sedation, respiratory depression, death); MAOIs; serotonergic agents; CYP3A4 inhibitors/inducers; alcohol | Aspirin component adds bleeding risk; avoid in children (Reye's); largely replaced by acetaminophen combinations; Schedule II | Rx | B |
| 20 | 20 | belladonna / opium | B&O Supprettes | Opium alkaloids: mu-opioid agonism + Belladonna alkaloids: anticholinergic/antispasmodic | Moderate to severe pain; chronic pain (when non-opioid options insufficient); acute post-surgical pain | Rectal | Suppositories | 1 suppository 1-2 times daily | 30-60 min | 4-8 hours | Constipation; nausea/vomiting; drowsiness; dizziness; pruritus; dry mouth; sedation | Respiratory depression; physical dependence/addiction; overdose death; serotonin syndrome; adrenal insufficiency; QT prolongation (methadone); neonatal abstinence syndrome | Significant respiratory depression; acute/severe bronchial asthma (unmonitored); known or suspected GI obstruction; MAOIs within 14 days | Benzodiazepines/CNS depressants (profound sedation, respiratory depression, death); MAOIs; serotonergic agents; CYP3A4 inhibitors/inducers; alcohol | Used for bladder/rectal spasm and pain; anticholinergic side effects; limited availability; Schedule II | Rx | C |
| 21 | 21 | benzocaine | Orajel, Anbesol, Hurricaine, Americaine, Dermoplast | Ester-type local anaesthetic; blocks sodium channels in peripheral nerves | Local/topical anaesthesia; neuropathic pain; minor procedures; dental anaesthesia; skin conditions | Topical (oral, skin) | Gel; cream; spray; lozenges; ointment; liquid | Apply to affected area up to QID; lozenges: dissolve slowly in mouth | 1-5 min | 15-60 min | Application site reactions (burning, stinging, erythema); numbness; dizziness | Methemoglobinaemia (serious risk, especially in children and high doses); allergic contact dermatitis; systemic toxicity if over-absorbed | Known hypersensitivity to amide/ester-type local anaesthetics; application to large or damaged skin areas (risk of systemic absorption) | Other local anaesthetics (additive toxicity); class I antiarrhythmics (additive cardiac effects); beta-blockers (reduced hepatic clearance) | Risk of methemoglobinaemia – avoid in children <2; contraindicated in methemoglobin reductase deficiency; ester type has higher allergy risk than amide type | Rx/OTC | C |
| 22 | 22 | bupivacaine liposome | Exparel | Liposomal encapsulation of bupivacaine provides prolonged release from depot at injection site → extended sodium channel blockade → prolonged local anaesthesia | Local/topical anaesthesia; neuropathic pain; minor procedures; dental anaesthesia; skin conditions | Local infiltration; nerve block | Liposomal injectable suspension (13.3 mg/mL) | Infiltration: up to 266 mg; Nerve block: up to 133 mg (site-dependent) | Gradual release over hours | Up to 72 hours | Application site reactions (burning, stinging, erythema); numbness; dizziness | Systemic toxicity (if absorbed): CNS excitation then depression, seizures, cardiac arrhythmias, cardiovascular collapse; methemoglobinaemia (benzocaine/prilocaine) | Known hypersensitivity to amide/ester-type local anaesthetics; application to large or damaged skin areas (risk of systemic absorption) | Other local anaesthetics (additive toxicity); class I antiarrhythmics (additive cardiac effects); beta-blockers (reduced hepatic clearance) | Extended release provides up to 72h of local anaesthesia; administered by surgeon/anaesthetist; do NOT mix with other local anaesthetics (causes rapid drug release) | Rx | C |
| 23 | 23 | buprenorphine | Subutex, Belbuca, Butrans, Sublocade, Suboxone (with naloxone) | Partial mu-opioid agonist and kappa-opioid antagonist; ceiling effect on respiratory depression | Moderate to severe pain; chronic pain (when non-opioid options insufficient); acute post-surgical pain | Transdermal; buccal; IV; IM; sublingual | Transdermal patch (Butrans); buccal film (Belbuca); injection | Butrans: 5-20 mcg/h q7d; Belbuca: 75-900 mcg buccal q12h; Injection: 0.3 mg q6-8h | Transdermal: 12-24h; Buccal: 30 min; IV: 15 min | Patch: 7 days; Buccal: 12h; IV: 6-8h | Constipation; nausea/vomiting; drowsiness; dizziness; pruritus; dry mouth; sedation | Respiratory depression; physical dependence/addiction; overdose death; serotonin syndrome; adrenal insufficiency; QT prolongation (methadone); neonatal abstinence syndrome | Significant respiratory depression; acute/severe bronchial asthma (unmonitored); known or suspected GI obstruction; MAOIs within 14 days | Benzodiazepines/CNS depressants (profound sedation, respiratory depression, death); MAOIs; serotonergic agents; CYP3A4 inhibitors/inducers; alcohol | Ceiling effect reduces overdose risk; Schedule III; can precipitate withdrawal in opioid-dependent patients; used for both pain and opioid use disorder | Rx | C |
| 24 | 24 | butorphanol | Stadol | Kappa-opioid agonist and mu-opioid partial agonist/antagonist; mixed agonist-antagonist | Moderate to severe pain; chronic pain (when non-opioid options insufficient); acute post-surgical pain | IV; IM; intranasal | Injection; nasal spray | IV: 0.5-2 mg q3-4h; IM: 1-4 mg q3-4h; Nasal: 1 spray (1 mg) q3-4h | IV: 2-3 min; IM: 10-30 min; Nasal: 15 min | 3-4 hours | Drowsiness; dizziness; nausea; nasal congestion (nasal); sweating | Respiratory depression; physical dependence/addiction; overdose death; serotonin syndrome; adrenal insufficiency; QT prolongation (methadone); neonatal abstinence syndrome | Significant respiratory depression; acute/severe bronchial asthma (unmonitored); known or suspected GI obstruction; MAOIs within 14 days | Benzodiazepines/CNS depressants (profound sedation, respiratory depression, death); MAOIs; serotonergic agents; CYP3A4 inhibitors/inducers; alcohol | Can precipitate withdrawal in opioid-dependent patients; nasal spray form useful for migraine; Schedule IV | Rx | C |
| 25 | 25 | camphor / menthol | Tiger Balm, Salonpas, Icy Hot | Camphor: activates TRPV3 and TRPA1 receptors (warming) + Menthol: activates TRPM8 (cooling); combined counterirritant effect overrides pain signals | Minor aches and pains of muscles/joints; arthritis; backache; strains; sprains; bruises | Topical | Ointment; balm; cream; patch | Apply to affected area 3-4 times daily; do not bandage tightly | 5-10 minutes | 1-3 hours | Mild skin irritation; cooling/tingling sensation; redness at application site | Severe skin burns (rare, with excessive application or heating pads); allergic contact dermatitis | Open wounds or damaged skin; hypersensitivity to ingredients; children under 2 years | No significant systemic interactions (minimal absorption); avoid combining with heating pads | External use only; wash hands after application; avoid eyes and mucous membranes; not for children <2 years | OTC | N |
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