What Medicines Treat Fibromyalgia?

There's no cure-all pill for your fibromyalgia, but you've got lots of medicines to choose from to treat your symptoms.

Some drugs ease the aches and pains, while others may boost your energy or improve your sleep. You may need to take more than one fibromyalgia medicine to find relief.

The FDA has approved three drugs to treat fibromyalgia: the antidepressants duloxetine (Cymbalta) and milnacipran (Savella), plus the anti-seizure medicine pregabalin (Lyrica). But your doctor may prescribe other drugs that aren't specifically approved for fibromyalgia. Medicines like these are sometimes called "off-label" medications.

Each fibromyalgia drug has its own side effects, ranging from mild to serious. You and your doctor will work together to figure out the right medicine to keep your symptoms under control.

Antidepressants

Even if you're not depressed, these drugs can ease pain and other fibromyalgia symptoms. Antidepressants raise levels of chemicals such as serotonin and norepinephrine that help control pain.

Serotonin and norepinephrine reuptake inhibitors (SNRIs). They can help with pain, sleep problems, and sad moods. The two main SNRI drugs for fibromyalgia are duloxetine (Cymbalta) and milnacipran (Savella).

Selective serotonin reuptake inhibitors (SSRIs). They're good for your pain and depression. Your doctor may suggest one of these:

Tricyclics. They're an older form of antidepressant. Amitriptyline (Elavil) is one of them. Low doses of these drugs relieve pain and fatigue, as well as improve sleep. But you may get side effects like drowsiness and weight gain.

Antidepressants can sometimes give you a bunch of different side effects, like:

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Anti-Seizure Medicines

Drugs that treat epilepsy seizures may also help ease your fibromyalgia pain. These medications prevent sensitive nerves from sending too many pain signals to the brain.

Pregabalin (Lyrica). The FDA has approved this drug for fibromyalgia treatment. It curbs your pain and can help your fatigue and sleep problems.

Gabapentin (Neurontin). Research shows this drug lessens pain and fatigue, and improves sleep. It's similar to pregabalin, and works in the same way.

If you take one of these drugs you may get side effects like:

  • Blurry vision
  • Dizziness
  • Drowsiness
  • Weight gain
  • Swelling of your hands or feet

Pain Relievers

These medications can ease fibromyalgia's aches and pains:

Over-the-counter medicines. These include acetaminophen and NSAIDs like aspirin, ibuprofen, and naproxen.

Check with your doctor before taking NSAIDs regularly. Over a long period of time, they may raise your chances of getting a heart attack or stroke. They may also cause ulcers and bleeding in the stomach or intestines.

Acetaminophen has fewer side effects, but it's important to stick to the dose your doctor recommends. Taking too much of the drug can lead to liver damage.

Prescription drugs. In most cases, opioid painkillers aren't recommended for fibromyalgia. They don't work, and they may even make the pain worse. But for serious cases, your doctor may prescribe tramadol (Ultram). Because tramadol can be addictive, you'll usually only take it for a short period of time. It can also lead to stomach pain, constipation, nausea, and trouble concentrating.

Muscle Relaxants

Although experts aren't sure why, muscle relaxants can treat a variety of fibromyalgia symptoms.

Cyclobenzaprine (Flexeril). Very low doses of this medication may help you sleep more soundly. It can also ease your fatigue and pain. Some side effects you may get are dry mouth, dizziness, and blurry vision.


Tizanidine (Zanaflex). A small study shows that this muscle relaxant eases pain, fatigue, and tenderness. It also improves sleep. Headaches, chest pain, nausea, and fever are some of the side effects of this drug.

WebMD Medical Reference Reviewed by David Zelman, MD on /2, 17

Sources

SOURCES:

Mayo Clinic: "Fibromyalgia," "Antidepressants: Another Weapon Against Chronic Pain."

FDA: "Living with Fibromyalgia, Drugs Approved to Manage Pain," "Medical Guide for Nonsteroidal Anti-Inflammatory Drugs (NSAIDS)."

Arthritis Foundation: "Fibromyalgia Treatment."

Johns Hopkins Lupus Center: "Fibromyalgia Medications."

American College of Rheumatology: "Fibromyalgia."

Journal of the American Medical Association: "Treatment of Fibromyalgia Syndrome With Antidepressants."

Medscape: "Fibromyalgia Medication."

Journal of Clinical Rheumatology: "Efficacy of Tramadol in Treatment of Pain of Fibromyalgia."

Pain Medicine: "The Effects of Tizanidine HCL (Zanaflex) in Patients With Fibromyalgia."

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