10 Drugs Commonly Prescribed for Fibromyalgia

Medically Reviewed By William C. Lloyd III, MD, FACS
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About 4 million people in the United States live with fibromyalgia. This chronic pain disorder can cause trouble sleeping and fatigue. It can also take a toll on quality of life. People with the disease often suffer with disability and mental health problems, including anxiety and depression. There is no cure for fibromyalgia. But treatment with medication for fibromyalgia can improve symptoms and functional ability.

Treating fibromyalgia involves a combination of medications and non-drug therapies. Physical activity and complementary therapies, such as acupuncture, can play an important role in managing the disease. It is also crucial to treat any related conditions that can worsen the symptoms. This includes arthritis and rheumatic diseases, such as lupus.

Classes of Fibromyalgia Drugs

The exact cause of fibromyalgia is unclear. This makes it challenging to treat. The main theory is that it results from abnormal pain processing in the central nervous system. Researchers believe people with fibromyalgia have abnormally high levels of brain chemicals that signal pain. In addition, pain receptors in the brain become hypersensitive and overreact to both painful and painless stimuli, such as touch. Basically, the brain’s pain perception is set too high.

Fibromyalgia treatment drugs aim to relieve pain, balance brain chemicals, and improve sleep. Classes of fibromyalgia drugs include:

  • Analgesics (pain relievers) you can buy over the counter (OTC) may be helpful in fibromyalgia. They generally will not relieve the pain of fibromyalgia itself. However, they can reduce painful triggers of fibromyalgia, such as arthritis. Doctors typically do not prescribe narcotics or opioid painkillers for fibromyalgia. These drugs usually do not help and can make pain sensitivity worse.

  • Antidepressants balance serotonin and norepinephrine levels in the brain. These brain chemicals play a role in pain perception, as well as depression. There are several classes of antidepressants, with varying side effects. It can take several weeks or even a couple of months to see the full benefit of these drugs. 

  • Antiseizure drugs work in complex ways and have many different mechanisms. The ones doctors use to treat fibromyalgia block overactive nerve cells that transmit pain signals. 

  • Muscle relaxants that are centrally acting—meaning they work in the brain—can help balance brain chemicals, leading to reduced pain. 

Common Fibromyalgia Drugs

There are three U.S. Food and Drug Administration (FDA)-approved drugs for fibromyalgia: Cymbalta, Savella and Lyrica. But doctors also prescribe several drugs similar to the officially approved ones. Drugs that treat fibromyalgia include:

  1. Acetaminophen (Tylenol) is an OTC pain reliever. It is a good alternative for people who cannot take other kinds of pain relievers. It comes in a variety of dosage forms and generally causes few side effects.

  2. Amitriptyline (Elavil) is a tricyclic antidepressant (TCA). It comes as a tablet you take up to four times a day. One of the main side effects is drowsiness. This makes it helpful for people with fibromyalgia who have sleep problems.

  3. Cyclobenzaprine (Flexeril) is a muscle relaxant. Its structure is similar to the TCAs. So, it can affect the same brain chemicals. This makes it useful in treating fibromyalgia. Like the TCAs, it causes drowsiness and can help improve sleep problems.

  4. Duloxetine (Cymbalta) is an SNRI (serotonin and norepinephrine reuptake inhibitor) antidepressant. This class usually has milder side effects than other kinds of antidepressants. It is available as an extended-release (ER) capsule you take once or twice a day. It is one of the FDA-approved drugs for fibromyalgia.

  5. Gabapentin (Neurontin) is an antiseizure drug. It has both ER (extended-release) and immediate-release forms, including a liquid. You need to separate taking gabapentin and antacids by two hours. Dizziness, fatigue, and weight gain are common side effects of gabapentin. It can cause drowsiness and is an option for people with sleep problems.

  6. Ibuprofen (Advil, Motrin) is an NSAID (nonsteroidal anti-inflammatory drug) pain reliever. It also treats swelling and inflammation. Ibuprofen is available OTC in a variety of dosage forms. There is also a prescription version. Common side effects include stomach upset, dizziness, and drowsiness.

  7. Milnacipran (Savella) is an SNRI specifically for fibromyalgia with FDA approval. It is a tablet you usually take twice a day. Side effects may include headache, stomach upset, and flushing.

  8. Naproxen (Aleve) is another NSAID pain reliever and anti-inflammatory. There are both prescription and OTC versions. You take the OTC product every 8 to 12 hours. For more convenient dosing, there is a once-daily ER (extended-release) form available by prescription.

  9. Pregabalin (Lyrica) is an antiseizure drug similar to gabapentin. It also has a similar side effect profile to gabapentin, including drowsiness. There is the potential for drug dependency and abuse. The typical dosing schedule is twice daily. It is an FDA-approved drug for fibromyalgia.

  10. Sertraline (Zoloft) is an SSRI (selective serotonin reuptake inhibitor) antidepressant. Like the SNRIs, it usually has fewer and milder side effects than other types of antidepressants. It comes as a tablet and a liquid. The usual dose is once daily. Stomach upset and restlessness are common side effects. Sexual difficulties are also possible.

Fibromyalgia can be hard to treat. It is important to work with a doctor who has plenty of experience with fibromyalgia. Usually, this is a rheumatologist.

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Medical Reviewer: William C. Lloyd III, MD, FACS
Last Review Date: 2021 Oct 6
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