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Review
. 2025 Aug;43(3):485-500.
doi: 10.1016/j.ncl.2025.05.001.

Exploring Beyond Mu: Nonopioid Analgesics

Brittany A Henault  1 , Katrina M Dean  2 , Jeffrey J Bettinger  3 , Erica L Wegrzyn  4
Affiliations
Review

Exploring Beyond Mu: Nonopioid Analgesics

Brittany A Henault et al. Neurol Clin. 2025 Aug.

Abstract

Pain remains one of the most common reasons patients seek medical care with rates of chronic pain affecting 20.6% of the US population. The polarizing narrative around opioid prescribing has been accompanied by the publishing and revision of several related guidelines. Certainly, a common theme amongst these publications is the importance of nonopioid analgesics as first-line treatments of chronic pain. This underscores the importance for providers to have a sound understanding of analgesic pharmacology when considering patient-centered approaches to pain. This includes consideration of drug-drug interactions, drug-comorbidity interactions, contraindications and metabolism including pathways using the phase 1 cytochrome P450 enzymes.

Keywords: First-line therapies; Musculoskeletal pain; Neuropathic pain; Nonopioid analgesics; Pain pharmacology.

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Conflict of interest statement

Disclosure Dr. Bettinger discloses Consultant fees with Scilex Holding Company and Salix Pharmaceutical Inc. Scientific Advisory Board: PainScript, LLC. ​Drs. Wegrzyn, Henault and Dean have nothing to disclose. ​The contents of this work represent the views of the authors and do not represent the views of the Department of Veteran's Affairs or the United States Government.

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