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.