Home » 6 fibromyalgia painkillers

Of primary concern for sufferers of fibromyalgia, of course, is the issue of painkillers and which are going to be most effective for your pain. There are different symptoms of the syndrome, but pain is the most pertinent condition. Effective pain relief can come from over-the-counter, prescription drugs or a combination.


Advil is a brand of ibuprofen, first developed in 1962.  It is a type of non-steroidal anti-inflammatory drug or NSAID. There are different brands of ibuprofen, but Advil is one of the best known. Similar to Tylenol, Advil is used for pain or fever relief. However, unlike Tylenol, Advil also soothes inflammation.

NSAIDs are among the most common pain relief medicines in the world. Over 30 million Americans use them every day to soothe headaches, sprains, arthritis symptoms, and other aches and pains. And, because of the anti-inflammatory abilities that NSAIDs have, they can also lower fever and reduce swelling.

NSAID drugs work by inhibiting cyclo-oxygenase-1 (COX-1), the chemical responsible for production and release of prostaglandins, which are, in turn, responsible for pain and fever. They also inhibit cyclo-oxygenase-2 (COX-2), which is responsible for inflammatory response.

These drugs are very effective for relief of pain caused by inflammation. Unfortunately, while the causes of fibromyalgia are still a bit of a mystery, it is known that it is not caused by inflammation. While these drugs have been prescribed often for fibromyalgia pain, they haven’t actually been all that effective on their own. However, NSAIDs have seen success in combination with other pain relievers.


Plain old Aspirin is also an NSAID like Advil. The chemical name of Aspirin is acetylsalicylic acid, or ASA for short. The use of willow and other salicylate-rich plants has an ancient history, being used by the ancient Sumerians. More recently, ASA in its pure form was distilled in 1899 by a scientist working for Bayer. There are also other brands available such as Bufferin, Entrophen and house brands. Like Advil, because it has anti-inflammatory properties, it can provide fever and pain relief. However, unlike either Tylenol or Advil, Aspirin also works to thin the blood, and is therefore often used to prevent stroke and heart disease.

As part of the NSAID class of drugs, Aspirin inhibits COX-1 and COX-2 to provide relief from pain, fever, and inflammation. While most NSAIDs also inhibit platelets in the blood, Aspirin does so irreversibly for eight to ten days, the full lifespan of the platelet. It is this which gives it the ability to act as a blood-thinner, but can also make you more prone to bleeding.

Aspirin is generally safe, but children under 18 years of age should avoid it. While the side effect that might cause Reye’s syndrome is rare and only occurs in very specific circumstances, it is also very serious. Since there are other types of painkillers available, it is easier for children to simply avoid the drug altogether. It should also be noted that while there are products called “baby aspirin” or “low-dose ASA.” In spite of the names, these should also be avoided for children. These products are actually blood-thinners for adults to take to prevent heart disease and stroke.

6 fibromyalgia painkillers


The chemical name of Tylenol is acetaminophen. This drug was discovered and marketed in 1956. It is called acetaminophen in the US, Canada and Japan, and paracetamol elsewhere. Unlike Advil and Aspirin, Tylenol is not in the NSAID category. Because it works on the nervous system instead of inflammation, it is more effective than NSAIDs for fibromyalgia pain.

Tylenol is used for pain or fever relief, but it has no anti-inflammatory action. Therefore, it won’t affect any underlying inflammation that can cause pain. Conversely, it can have a greater effect on pain like fibromyalgia where pain is brought on by conditions in the nervous system rather than inflammation.

Tylenol is a safe drug to take for pain during pregnancy or lactation. That is because though it can be detected in breast milk, no adverse effects on either mothers or infants have been reported. Therefore, it is considered to be the first choice painkiller in pregnancy and lactation.

Acetaminophen is generally considered a very safe drug because it has few interactions with other drugs. It has also been around for a long time, so health care professionals are very familiar with it.  However, this can lead to a significant risk of overdose with the drug. First, because of the way it is perceived, it can mean that people are not as cautious with it as they really need to be. Because fibromyalgia pain is ongoing, it seems likely that, in an attempt to relieve pain, a person might be tempted to take more of the drug than is recommended.

Also, acetaminophen overdose can be quite serious. The symptoms of overdose include nausea, diarrhea, abdominal pain and jaundice. It also has several symptoms that may easily blend with symptoms that a patient is already suffering because of fibromyalgia and can therefore be easily missed.

Finally, it can be very easy to overdose on acetaminophen accidentally. This is because he drug is often included in other kinds of drugs. For example, you might be taking Tylenol for your fibromyalgia pain, and then get a cold. Cold medication often also includes acetaminophen.

Acetaminophen is also sold in combination with opioid and other drugs.

Like ibuprofen and ASA, there are generics and other brands which have acetaminophen as the main active ingredient. They are virtually the same thing as Tylenol, and so it’s up to you which brand you want to use. If cost is an issue, you may want to buy the house brand acetaminophen, which is generally cheaper than the brand name Tylenol.


Unfortunately, there has been a long history of fibromyalgia being treated as a psychosomatic condition, so naturally, you might be suspicious if your doctor prescribes an antidepressant. However, there has been a great deal of success in treating pain through tricyclic antidepressants like Amitriptyline.

It is believed that this is because the mechanism for fibromyalgia pain is chemically based on the neurotransmitters that carry pain signals to the brain. Many of these same neurotransmitters are involved in depression, which helps explain why antidepressants can help with fibromyalgia pain.

Unlike Tylenol, Aspirin and Advil, Amitriptyline is not available over-the-counter. It is only available through a prescription. The drug can also help with sleep issues that come with fibromyalgia. So it can not only help with pain, but help you get more and better sleep.

It’s also not much of a surprise if the chronic pain of fibromyalgia might have made you depressed. Because there is generally a linkage between physical and emotional health, it will be helpful if it’s possible to elevate your mood. So in another way, an antidepressant can help with fibromyalgia suffering.


Lyrica is an oral medication that is classified as an anti-seizure or anti-convulsant drug. Lyrica is the trade name of the drug Pregabalin. It was the first drug approved by the FDA for treatment of fibromyalgia. Like Amitriptyline, Lyrica is not an over-the-counter drug and must be prescribed.

Lyrica binds to a part of the nerves and it is thought that this reduces the ability for nerves to send pain messages to each other; it slows down impulses in the brain that cause seizures, and affects chemicals in the brain that send pain signals across the nervous system.

Again, like Amitriptyline, the anticonvulsants work on the nervous system to relieve pain. The drug will reduce the number of pain signals that are sent to the brain. Fibromyalgia is believed to be caused, at least in part, by nerves being effectively “hyperactive” and so sending too many signals. What anticonvulsants do is calm the nerves and cause them to send fewer signals. This helps them prevent seizures in other conditions, and also helps relieve pain in fibromyalgia.


There is little doubt that opioids do the job, and they will almost definitely be effective in relieving pain. However, they also carry a very significant risk of creating dependence. For this reason, while there is very little question that opioids are effective, it is generally seen as a measure to be taken only after other treatments have been tried.

However, because antidepressants and anticonvulsants can take several days to take effect, opioids are sometimes prescribed in conjunction with other drugs. Also, where other options aren’t effective at relieving pain, long-acting opioids are often prescribed to stay on top of the pain while other solutions are explored.

While there are drugs with a higher success rate than others, it is also important to note that what works for one person may not work for another. One single drug won’t work for everyone. Conversely, a drug that may work for you won’t necessarily work for other people. To a certain extent, it will require some investigating and some trial and error.

Further Reading

“Treating Fibromyalgia Pain: Medication Options—5 types of medications help ease fibromyalgia symptoms.” By Jeanie Lerche Davis. WebMD.  http://www.webmd.com/fibromyalgia/features/treating-fibromyalgia-pain-medication-options.

“Patient information: Fibromyalgia (Beyond the Basics).” by Don L Goldenberg, MD. UpToDate.comhttp://www.uptodate.com/contents/fibromyalgia-beyond-the-basics.

“Painkillers.” Patient.co.uk. http://www.patient.co.uk/health/painkillers

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