Fibromyalgia medical therapy: Difference between revisions

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==Overview==
==Overview==
==Medical Therapy==
==Medical Therapy==
As with many other syndromes, there is no universally accepted cure for fibromyalgia.<ref>{{cite book |author=Selfridge, Dr. Nancy, and Peterson, Franklynn|title=Freedom from Fibromyalgia: The 5-Week Program Proven to Conquer Pain |year=2001| isbn=0-8129-3375-3 }}</ref>  
There is no universally accepted cure for fibromyalgia. Medications are the mainstay of treatment.<ref>{{cite book |author=Selfridge, Dr. Nancy, and Peterson, Franklynn|title=Freedom from Fibromyalgia: The 5-Week Program Proven to Conquer Pain |year=2001| isbn=0-8129-3375-3 }}</ref>  
===Single agent therapy===
===Single agent therapy===
*Preferred regimen (1): Amitriptyline 10-70 mg orally once daily at bedtime
*Preferred regimen (1): Amitriptyline 10-70 mg orally once daily at bedtime

Revision as of 22:51, 14 June 2017

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

Medical Therapy

There is no universally accepted cure for fibromyalgia. Medications are the mainstay of treatment.[1]

Single agent therapy

  • Preferred regimen (1): Amitriptyline 10-70 mg orally once daily at bedtime
  • Preferred regimen (2): Cyclobenzaprine 5-30 mg orally once daily at bedtime
  • Preferred regimen (3): Duloxetine : 30-60 mg orally once daily
  • Preferred regimen (4): Milnacipran 12.5 mg orally once daily initially, followed by 12.5 mg twice daily for 2 days, followed by 25 mg twice daily for 4 days, then 50-100 mg twice daily thereafter
  • Preferred regimen (5): Pregabalin 75-225 mg orally twice daily, maximum 450 mg/day

Combination Thereapy

  • Preferred regimen (1): Amitriptyline 10-70 mg orally once daily at bedtime (OR)
  • Preferred regimen (2): Cyclobenzaprine 5-30 mg orally once daily at bedtime

AND

  • Preferred regimen (3): Duloxetine 30-60 mg orally once daily; higher doses have been used, consult specialist for guidance (OR)
  • Preferred regimen (4): Milnacipran 12.5 mg orally once daily initially, followed by 12.5 mg twice daily for 2 days, followed by 25 mg twice daily for 4 days, then 50-100 mg twice daily thereafter

AND

  • Preferred regimen (5): Pregabalin 75-225 mg orally twice daily, maximum 450 mg/day (OR)
  • Preferred regimen (6): Gabapentin 300 mg orally once daily on first day, followed by 300 mg twice daily on second day, followed by 300 mg three times daily on third day, then titrate dose according to response up to 1800-2400 mg/day given in 3 divided doses

References

  1. Selfridge, Dr. Nancy, and Peterson, Franklynn (2001). Freedom from Fibromyalgia: The 5-Week Program Proven to Conquer Pain. ISBN 0-8129-3375-3.

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