Pain Medication for Interstitial Cystitis

Interstitial cystitis (IC) is caused by inflammation of the lining of the bladder. People with IC have sudden frequent need to urinate that can also be painful. With IC, the epithelium (lining) that protects the bladder from the toxins that can irritate the bladder is defective, letting microbes into the interstitial area of the bladder wall. According to the National Institutes of Health, 700,000 Americans have IC, with 90 percent of diagnosed cases occurring in women. As of October 2009, there is no cure for IC, but some medications can help sufferers manage the subsequent pain.

Elmiron

• Elmiron is the only FDA-approved oral medication used specifically for IC. The exact mechanism isn't understood, but doctors believe the drug mimics the enzymes that line the bladder to repair the epithelium. Elmiron requires regular, long-term use, but some patients notice partial relief within four weeks. Side effects include constipation, diarrhea, gas, nausea and reversible hair loss.

Hydroxyzine

• Hydroxyzine is an oral antihistamine that has proven beneficial for some with IC. Hydroxyzine reduces the frequency and pain of urinating, along with lessening nighttime urination. Side effects include dry mouth and sedation.

Detrol

• Detrol, or Ditropan XL, reduces bladder spasms. This can reduce the frequency and urgency of urination. You shouldn't crush, chew, break, or open a controlled-release capsule, because it destroys the time-release properties. Detrol can cause blurred vision and mental "fog," so use with caution when you begin taking the drug. Other side effects include chest pain, rapid heartbeat, shortness of breath, dry mouth and eyes, dizziness, headache and joint pain.

Dimethyl Sulfoxide

• Dimethyl Sulfoxide (DMSO) is the only intravesical medication approved by the FDA to treat IC. The medication is applied directly to the bladder through a catheter. Once in the bladder, DMSO reduces inflammation and muscle spasms. DMSO has the potential to damage the liver and kidneys, so bi-annual blood tests are required. Side effects include a garlicky taste and odor to the skin following use, along with bladder discomfort. Contact your doctor immediately if you have trouble breathing or develop a rash; both are indications of an allergic reaction.

OTC Pain Medications

• There are several options for pain management, including over-the-counter non-steroidal anti-inflammatory drugs. OTC drugs like ibuprofen and aspirin can reduce inflammation in the bladder and provide some pain relief. Most people experience no side effects with these medications. Long-term use of these drugs may cause stomach bleeding, ulcers and liver or kidney damage.

Non-Opiods

• When OTC medications stop working, the next step is a non-opiod. Non-opiods include Urelle, Utira, Prosed/DS and Phenazopyridine Plus. These drugs generally cause similar side effects, such as dry mouth, confusion, nausea, agitation, diarrhea and difficulty urinating. Phenazopyridine Plus shouldn't be used for longer than two days and is best reserved for IC flareups. Non-opiods aren't usually as effective as opiods but have a much lower associated risk of addiction.

Opiods

• Opiods are strong painkillers that can be addictive and should only be used for short periods of time. Drugs in the opiod class include Opana, Vicodin, Lortab, Percocet, morphine, Diludad and Oxycodone. Side effects of these medications include constipation, shallow breathing, slow pulse, nausea, dry mouth, confusion, dizziness and blurred vision. Patients with severe IC will often receive a long-acting opiod like Opana, which has less potential for addiction. All opiods can cause stomach, liver and kidney damage with long-term use.

Nucynta

• Nucynta is a new pain medication that has similar strength to Oxycodone, but with fewer gastrointestinal side effects. According to its website, Nucynta works differently from other pain medications because it blocks the transmission of pain impulses and pain signals. Other pain relievers work on descending pain pathways, after the brain has already received the pain signal. Side effects associated with Nucynta include sleepiness, dizziness, nausea, vomiting and headache.