Which medications in the drug class Opioid Analgesics are used in the treatment of Osteoarthritis?

Updated: Jun 10, 2020
  • Author: Carlos J Lozada, MD; Chief Editor: Herbert S Diamond, MD  more...
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Answer

Opioid Analgesics

Opioid analgesics are used in patients whose pain has not been controlled with weaker analgesic medications. They are a particularly reasonable choice in patients who do not want joint-replacement surgery, are too medically ill for joint replacement, are not candidates for joint replacement for other reasons, or are trying to buy time for subsequent joint-replacement surgery.

Elderly patients (aged 65 years and older) with arthritis are more likely to incur a fracture when initiating opioid therapy as opposed to NSAID therapy. A higher opioid dose is associated with a greater risk of fracture; this risk is due to an increased risk of falls. During the first 2 weeks after initiation of opioid treatment, short-acting opioids are associated with a greater fracture risk than long-acting opioids are. [159]

Tramadol (Ultram, Ultram ER, ConZip)

Tramadol inhibits ascending pain pathways, altering perception of and response to pain. This agent also inhibits the reuptake of norepinephrine and serotonin.

Oxycodone (OxyContin, Roxicodone)

Pure narcotic analgesics, such as oxycodone, might be the initial drug of choice. Eventually, this short-acting narcotic can be replaced with a long-acting transdermal preparation, such as fentanyl (Duragesic patch).


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