Table 14. Adjuvant analgesic drugs for cancer pain

Drug Approximate
adult daily
dose range		 Route of
administration[1]		 Type of pain
Corticosteroids
Dexamethasone[2] 16-96 mg PO, IV Pain associated with brain metastases and epidural spinalcord compression
Prednisone 40-100 mg PO
Anticonvulsants
Carbamazepine[3] 200-1,600 mg PO Neuropathic pain
Phenytoin[4] 300-500 mg PO
Antidepressants
Amitriptyline[5] 25-150 mg PO Neuropathic pain
Doxepin[6] 25-150 mg PO
Imipramine[7] 20-150 mg PO
Trazodone[8] 75-225 mg PO
Neuroleptics
Methotrimeprazine[9] 40-80 mg IM Analgesia; sedation; antiemetic
Antihistamines
Hydroxyzine[10] 300-450 mg IM Adjuvant to opioids in post-operative and other types of pain; relief of complicating symptoms including anxiety, insomnia, nausea
Local anesthetics/antiarrythmics
Lidocaine[11] 5 mg/kg IV/SC Neuropathic pain
Mexiletine[12] 450-600 mg PO
Tocainide[13] 20 mg/kg PO
Psychostimulants
Dextroamphetamine[14] 5-10 mg PO Improve opioid analgesia, decrease sedation
Methylphenidate[15] 10-15 mg PO

[1] PO=orally. IV=intravenously. IM=intramuscularly. SC=subcutaneously.
[2] French and Galicich, 1964; Greenberg, Kim, and Posner, 1980; Weissman, 1988.
[3] Lindstrom and Lindblom, 1987.
[4] Yajnik, Singh, Singh, et al., 1992.
[5] Max, Culnane, Schafer, et al., 1987; Max, Schafer, Culnane et al., 1988; Schafer, Culnane, et al., 1988; Onghena and Van Houhenh, 1992; Turkington, 1980; Ventafridda, Bonezzi, Caraceni, et al., 1987; Watson and Evans, 1985; Watson, Evans, Reed, et al., 1982; Young and Clarke, 1985.
[6] Cohn, Machado, Bier, et al., 1988.
[7] Kvinesdal, Molin, Froland, et al., 1984; Turkington, 1980; Young and Clarke, 1985.
[8] Khurana, 1983; Ventafridda, Bonezzi, Caraceni, et al., 1987.
[9] Beaver, Wallenstein, Houde, et al., 1966; Rogers, 1989.
[10] Beaver and Feise, 1976; Bellville, Dorey, Capparell, et al., 1979.
[11] Bach, Jensen, Kastrup, et al., 1990; Brose and Cousins, 1991.
[12] Dejgard, Petersen, and Kastrup, 1989.
[13] Lindstrom and Lindblom, 1987.
[14] Joshi, deJongh, Schnapper, et al., 1982.
[15] Bruera, Chadwick, Brenneis, et al., 1987.

Related Chunks

Rectal

Nasal

Patient-Controlled Analgesia (PCA)

Adjuvant Drugs

Antidepressants

Neuroleptic Agents

Hydroxyzine

Intraspinal drug delivery systems

Index