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Neuropathic pain

NICE Clinical guideline [CG173] Neuropathic pain in adults: pharmacological management in non-specialist settings. Last updated Sep 2020.

Guidelines

Pharmacological Management

1st line: monotherapy – ANY of the following:

  • Amitriptyline (TCA)
  • Duloxetine (SNRI)
  • Gabapentin
  • Pregabalin

If not effective → switch the drug to 1 of the remaining 3 drugs


Consider tramadol as an acute rescue therapy (but do not prescribe for long-term).

If oral treatments not appropriate → consider capsaicin cream.

References

Original Guideline

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