Pain medicine for sickle cell disease

Sickle cell disease pain varies from mild to severe and can be difficult to treat. When developing a pain treatment plan with your doctor and/or pain treatment specialist, consider the following:

  • Treat mild pain with over-the-counter ibuprofen and/or acetaminophen, by mouth (orally). Do not give aspirin to children and teens younger than age 20, because it can cause Reye syndrome.
  • Treat mild progressing to moderate pain at home with oral codeine and ibuprofen or codeine and acetaminophen prescribed by your doctor. Codeine is usually derived from morphine and is less potent. It generally has less potential for addiction than morphine.
  • Treat moderate to severe pain with oral controlled-release morphine at home, prescribed by your doctor. Morphine is a potent medicine. Your doctor may not offer this option, preferring to prescribe morphine for inpatient hospital treatment only.
  • It's best to treat severe pain in the hospital with continuous opioid medicine, such as morphine or hydromorphone.
    • The medicine is given directly into a vein (intravenously, or IV) and may be patient-controlled, allowing you to push a button and release a dose when needed.
    • Continuous opioid medicine doesn't always relieve severe sickle cell pain.
    • As a painful event subsides, IV opioid medicine is gradually reduced and replaced with a less powerful oral medicine. These actions prevent a person's body from going through sudden drug withdrawal symptoms.

Pain management skills can help you or your child manage pain. These skills include distraction, guided imagery, deep breathing, relaxation, and positive, encouraging self-talk. They can also enhance the effect of pain medicine.

Doctors differ in their approaches to treating pain, as do people experiencing pain. Developing a pain treatment plan with your doctor and/or pain treatment specialist:

  • Clarifies your and your doctor's preferences ahead of time.
  • Explains your needs to other health professionals who care for you.
  • Offers you some predictability and control during times of crisis.

Last Updated: December 9, 2008

Author: Debby Golonka, MPH

Medical Review: Anne C. Poinier, MD - Internal Medicine & Martin Steinberg, MD - Hematology

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