Nonopioid Pain Relievers Being Developed

SAN DIEGO – Pain management alternatives to opioids continue to evolve, said Joseph F. Dasta, M.Sc. (Pharm.).

New options include intravenous ibuprofen, approved in June 2009; nasal ketorolac (May 2010); and intravenous acetaminophen, (November 2010).

Nonopioid alternatives are needed because data “suggest that opioids as well as untreated pain are associated with development of postoperative delirium,” said Mr. Dasta, a health care consultant who is also with the College of Pharmacy at the University of Texas, Austin.

Most of the available agents for pain management are short acting, “which can be good and bad,” Mr. Dasta said. In addition, many of the currently approved agents for pain management require intravenous administration and may cause adverse drug reactions.

Intravenous diclofenac is currently being investigated as another possible therapy, he said, as are the cyclo-oxygenase-2 selective inhibitors etoricoxib and parecoxib, and the NSAID lornoxicam.

New studies of bupivacaine, an anesthetic drug that lasts for 6–10 hours, are also underway. “Several formulations are being developed whereby bupivacaine would be instilled into the surgical site, to the operative area, and last for several days,” said Mr. Dasta, who is a paid consultant for Cadence, Hospira, and Pacira Pharmaceuticals.