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The first non-opoid painkiller

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Re: The first non-opoid painkiller

#91

Post by stavros »

4gotunameagain wrote: post #70
ggm wrote: post #2

Colloquially acetaminophen/paracetamol and ibuprofen are "painkillers" but this is in a different class, it's amazing to have something which performs like the opioid pain relief but without at least some of the side effects. It's the first non opioid painkiller applicable for situations like post operative use. I'd have loved this after my hernia op, the last thing you need with that is opioid induced constipation.

What kind of hernia ? In the US it seems like they prescribe opioids like candy. I've never heard of opioids post hernia surgery in Europe.

I got morphine for an appendectomy in the UK.

Re: The first non-opoid painkiller

#92

Post by johnisgood »

ggm wrote: post #2

Colloquially acetaminophen/paracetamol and ibuprofen are "painkillers" but this is in a different class, it's amazing to have something which performs like the opioid pain relief but without at least some of the side effects. It's the first non opioid painkiller applicable for situations like post operative use. I'd have loved this after my hernia op, the last thing you need with that is opioid induced constipation.

Opioid-induced constipation is easy to counteract, however, with the right form of magnesium, and/or laxatives. There are herbs that you could drink as a tea, too, for constipation.

If you ask me whether I choose pain or constipation, well, I am pretty sure you know the answer.

This constipation goes away once you stop, and everything depends on the dose and the frequency and duration of taking it.

Re: The first non-opoid painkiller

#93

Post by badmintonbaseba »

EasyMark wrote: post #85
OJFord wrote: post #9

I think a better title here than: > The first non-opoid [sic] painkiller might be: > The first non-opioid nociceptive pain-killer Nociceptive pain being that by actual damage to tissue, as opposed to neuropathic pain like a headache or inflammation that you might take a (non-opioid!) NSAID for. https://www.iasp-pain.org/resources/terminology/

I guess that would make sense in a scientific paper or journal, but most people would have no idea what that means and just make for a confusing title that would turn people off from reading it. Almost everyone has heard of opiates in the evening news or social media.

Also everyone heard of pain killers that are non-opioid, so you can't really get around explaining why this one is novel.

Re: The first non-opoid painkiller

#94

Post by Perenti »

The paragraph on the relation to Brugada Syndrome hits home, as I have that rare disease. What isn't clear is if it's safe for Brugada patients - a hell of a lot of drugs are not advisable for us. As I also have CRPS type II (complex regional pain syndrome) I'd like a non-narcotic strong pain killer that doesn't induce arrhythmia.

Re: The first non-opoid painkiller

#95

Post by cheshire_cat »

This news article claims that the results of the Phase II trials where not great?

https://www.painnewsnetwork.org/stories/2024/12/23/more-lack...

As someone else already mentioned in this thread, in Europe there is already metamizole which is used for post-surgery pain. Anyone knows if suzetrigine is more effective than metamizole?

Re: The first non-opoid painkiller

#96

Post by arthur2e5 »

xeeeeeeeeeeenu wrote: post #20
ggm wrote: post #2

Colloquially acetaminophen/paracetamol and ibuprofen are "painkillers" but this is in a different class, it's amazing to have something which performs like the opioid pain relief but without at least some of the side effects. It's the first non opioid painkiller applicable for situations like post operative use. I'd have loved this after my hernia op, the last thing you need with that is opioid induced constipation.

>It's the first non opioid painkiller applicable for situations like post operative use. Perhaps the first approved by FDA, I don't know. In many countries, metamizole is the first-line drug for postoperative pain. (It should be noted that metamizole may very rarely cause agranulocytosis. It is suspected that the risk varies depending on the genetic makeup of the population, which would explain why it is banned in so…

From my limited experience of metamizole it feels a bit stronger than paracetamol/acetaminophen. Neat little drug if your genetics can take it.

Tangential: China technically banned metamizole due to the agranulocytosis scare, but somehow small clinics always have fresh stocks of this stuff. And their stocks don't look like my metamizole for horses! It's pressed out of the usual magnesium stearate instead of whatever rock-hard thing they use for animal drugs in China.

Re: The first non-opoid painkiller

#97

Post by arthur2e5 »

PaulHoule wrote: post #80
ggm wrote: post #2

Colloquially acetaminophen/paracetamol and ibuprofen are "painkillers" but this is in a different class, it's amazing to have something which performs like the opioid pain relief but without at least some of the side effects. It's the first non opioid painkiller applicable for situations like post operative use. I'd have loved this after my hernia op, the last thing you need with that is opioid induced constipation.

Breaking news: turns out acetaminophen has an active metabolite that acts on... sodium channels. https://medicalxpress.com/news/2025-06-acetaminophen-discove...

AM404 really is the metabolite that keeps giving. The central nervous system system effects were fun too, acting on cannabinoid receptors and/or TRPV1 channels -- so either stony or spicy.

Re: The first non-opoid painkiller

#98

Post by PaulHoule »

arthur2e5 wrote: post #97
PaulHoule wrote: post #80

Earlier quoted context omitted.

Breaking news: turns out acetaminophen has an active metabolite that acts on... sodium channels. https://medicalxpress.com/news/2025-06-acetaminophen-discove...

AM404 really is the metabolite that keeps giving. The central nervous system system effects were fun too, acting on cannabinoid receptors and/or TRPV1 channels -- so either stony or spicy.

I can't say it ever made me feel high, but acetaminophen has been long shown to have significant behavioral effects

https://pubmed.ncbi.nlm.nih.gov/27217114/

https://pubmed.ncbi.nlm.nih.gov/32888031/

My primary care doc doesn't want me taking either NSAIDS or acetaminophen so when I get asked at the urgent care what I take for pain I say "Nothing".

Re: The first non-opoid painkiller

#99

Post by drewg123 »

closewith wrote: post #83
theoreticalmal wrote: post #82

Earlier quoted context omitted.

My wife and I got colds while vacationing in Edinburgh and had a heck of a time before realizing to ask for paracetamol rather than acetaminophen. Also, the rules the UK has for limiting paracetamol purchases to small amount per day are so fantastically stupid.

> Also, the rules the UK has for limiting paracetamol purchases to small amount per day are so fantastically stupid. Yes, but: > Responsible for 56,000 emergency department visits and 2600 hospitalizations, acetaminophen poisoning causes 500 deaths annually in the United States. Notably, around 50% of these poisonings are unintentional, often resulting from patients misinterpreting dosing instructions or unknowingly…

I was under the impression that a lot of overdoses of acetaminophen are due to it being included in many different multiple-medicine cold/flu remidies, like cough syrup, NyQuil, decongestants, etc. So people end up exceeding the max dose accidentally when they take acetaminophen along with some of those other things.

Does the UK have rules that prevent mixing acetaminophen with other drugs? Its getting so its sometimes hard to find over the counter cold/flu medicines without acetaminophen

Re: The first non-opoid painkiller

#100

Post by bigfudge »

stavros wrote: post #87
theoreticalmal wrote: post #82

Earlier quoted context omitted.

My wife and I got colds while vacationing in Edinburgh and had a heck of a time before realizing to ask for paracetamol rather than acetaminophen. Also, the rules the UK has for limiting paracetamol purchases to small amount per day are so fantastically stupid.

True, but paracetamol overdoses are not a fun death. Granted, you need to take a massive amount, but still.

You don't need to take that much. LD50 is surprisingly close to the normal dose, and possible to do if you don't realise that cold remedies contain it (or that aminocetophen and paracetamol are the same thing!)
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