Neuropathic pain

Other drugs which may also be used in the management of neuropathic pain are venlafaxine (unlicensed use), codeine,  buprenorphine and tramadol. Opioid analgesics are often of limited benefit.

Lidocaine Plasters

Kent and Medway Lidocaine Plaster Position Statement.

Lidocaine Plasters are NOT recommended for routine prescribing due to low clinical effectiveness and lack of robust evidence as per NHS England and NICE Guidelines.

Lidocaine Plasters should only be initiated on the advice or recommendation of a pain specialist for the licensed indication of post-herpetic neuralgia for those patients who have been treated in line with NICE [CG173] but are still experiencing neuropathic pain associated with previous herpes zoster infection. 

An individual management plan should be put in place for each patient specifying the duration of treatment, clear directions for reviews to take place and criteria outlining when prescribing should be continued or stopped.

Capsaicin 0.075% Cream

Capsaicin 0.075% cream is not recommended for prescribing in primary care due to limited evidence of benefit and significant cost impact. There is no licenced product available in the UK. For specialist use only within hospital pain services for defined patient cohorts.

Prescribers should not initiate or continue capsaicin in primary care. Patients requiring treatment should be referred to secondary care pain services.