UBC Faculty Research and Publications

Finding the lowest effective dose for non-opioid analgesics University of British Columbia. Therapeutics Initiative


Therapeutics Letter 134 explores effective dosing for non-opioid analgesics. Conclusions: Most patients do not obtain clinically meaningful pain relief at any dose of cyclobenzaprine, duloxetine, gabapentin, or pregabalin. High doses are unlikely to improve analgesia more than lower doses. They do increase harms. Clinical impacts of dose changes (good or bad) should usually be apparent within 1 week. Spontaneous improvement can appear to be a beneficial drug effect, even when it would have occurred without drug therapy. Try short therapeutic trials and periodic reassessment of patients whose pain improves during drug therapy.

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