Non-Narcotic Analgesics for Breast Cancer Pain Management

Anti-inflammatory medicines such as acetaminophen or paracetamol, non-steroidal anti-inflammatory drugs (NSAIDs), and sodium channel blockers are types of non-narcotic analgesics that can be effective for breast cancer pain management.

You don’t need a prescription to buy some non-narcotics, which is why they are called over-the-counter medicines. But you should still talk to your doctor before taking these medicines to control mild to moderate pain. Your doctor may suggest you take a non-narcotic like acetaminophen or an NSAID regularly, to manage mild to moderate pain from breast cancer treatment.

If a non-narcotic is not enough to keep pain from getting too intense, your doctor might recommend narcotic pain medicines or opioids, which are much stronger. These medicines require a prescription and can be highly addictive.

The main types of non-narcotic medicines for breast cancer pain include the following:

Acetaminophen, also known as Tylenol or paracetamol, is the most common type of non-narcotic analgesic that helps relieve pain without causing major side effects when taken in moderate doses. Acetaminophen should not be combined with alcohol or taken in greater than the recommended dose because it can damage your liver and kidneys.

Non-steroidal anti-inflammatory drugs (NSAIDs) also help with breast cancer pain management as well as any inflammation. Before taking NSAIDs, it’s best to consult a medical professional to check about interactions with any other medicine you might be taking.

NSAIDs can cause heartburn, stomach bleeding, and kidney damage, and increase the risk of heart disease and stroke. In general, NSAIDs should be avoided by people who are taking blood pressure medicines, have stomach ulcers, or have a history of bleeding disorders. They may also not be recommended for those who are on chemotherapy, immunotherapy, or other novel treatments. NSAIDs should also not be taken for a long period of time without first checking with a doctor. The most common NSAIDs are Ibuprofen (Advil and Motrin) and Naproxen sodium (Aleve).

Sodium channel blockers work by blocking certain sodium channels in nerve cells that sense pain and then transmit a signal to the brain. These sodium channels are power sources that give the nerve cells the energy to send signals. When the channels are blocked, it stops the nerve cell from sending a pain signal.

Journavx, which requires a prescription, was approved in 2025 to treat moderate to severe short-term pain. Side effects include itching and rash. If you’re prescribed Journavx, you should not take medicines that are strong or moderate CYP2D6 inhibitors because they may increase the risk of side effects. You also should not eat or drink anything containing grapefruit while taking Journavx.

Corticosteroids such as prednisone, methylprednisolone, and dexamethasone, can help reduce pain and inflammation and can be taken orally as pills, topically in the form of creams, or intravenously. This type of medicine works quickly but due to the side effects, doctors usually recommend a low dose for a short amount of time.

Corticosteroids can increase blood sugar and may not be advisable for people with diabetes. Like NSAIDs, they can mask a fever or suppress the immune system so they may not be recommended for people with breast cancer who are being treated with immunotherapy or chemotherapy. They may also cause an increased risk of infection and an increased appetite and weight gain.

Anticonvulsants or anti-seizure drugs are medicines mainly used to prevent seizures but can also help relieve nerve pain, which may occur after surgery or even as a side effect of chemotherapy. Common anticonvulsants for pain management include gabapentin (Neurontin) and pregabalin (Lyrica). Possible side effects of anticonvulsants are dizziness, drowsiness, fatigue, nausea, and vomiting.

When taken at a lower dose, some types of antidepressants can help ease nerve pain as well as depression that may be caused by pain. Tricyclics are one of the most effective types of antidepressants for pain but can cause side effects such as dry mouth, drowsiness, nausea, and changes in appetite.

Muscle relaxants can help reduce tightness in muscles that can develop from radiation therapy or after surgery. They are recommended for short-term use in low doses and common side effects include fatigue and weakness. Baclofen and Valium (diazepam) are common examples of muscle relaxants.

Mild pain can also be treated without the use of medicine. Integrative therapies such as acupuncture, massage therapy, aromatherapy, yoga, and meditation, can help ease pain and support overall well-being.

Using heat packs can help relieve muscle pain while cold packs can be useful for numbing pain and decreasing inflammation. Physical therapy may also be useful for people receiving radiation therapy to prevent the development of scar tissue.

Cognitive behavioral therapy (CBT) can also aid pain management by shifting focus away from pain and changing the way your body responds to pain. CBT helps people develop better coping skills by changing negative thoughts and behaviors.

Longer-term or severe pain can affect your quality of life. If you are experiencing longer-term or severe pain, let your breast cancer care team know right away. Your cancer care team can help figure out the actual cause and recommend appropriate treatments for the type of pain it is.

If you need an opioid (a narcotic medicine), your doctor might recommend combining an opioid with a non-narcotic pain-relieving medicine, such as acetaminophen, to help lower the required opioid dose.