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Analgesic drugs
For mild to moderate OA pain, acetaminophen is part of the first line of treatment. Some common brand names are Tylenol and certain types of Excedrin, and they are available without a prescription at pharmacies. Acetaminophen relieves pain but does not reduce inflammation.
Some patients with more advanced disease and who have intermittent severe pain can benefit from prescription opioids like Darvocet and Ultram. These medications are often necessary for patients with "end stage" hips or knees who are unable to undergo surgical replacement because they have heart or lung disease. Though drowsiness is an opioid side effect, that doesn't matter if the medications are taken at bedtime; these drugs may indeed help patients who feel pain more acutely at night and have trouble sleeping. Patients are often scared to take opioids, fearing addiction. But the use of time-release oral and skin-patch formulations prevents the rush that can encourage abuse. Moreover, research has indicated that the risk of addiction is small in patients with arthritis, especially when the drugs are used intermittently, and that it generally occurs only in people with a previous history of substance abuse.
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