4.7.3. Neuropathic pain
Prescribing Notes:
Use in the treatment of neuropathic pain is an unlicensed indication of amitriptyline.
Restrictions:
Use in peripheral diabetic neuropathic pain in adults is restricted to specialist initiation as second or third line therapy.
Restrictions:
Restricted to use in the management of neuropathic pain where amitriptyline is not appropriate because of issues with sedation or hypotension.
Prescribing Notes:
Use in the treatment of neuropathic pain is an unlicensed indication for imipramine.
Restrictions:
Restricted to use for peripheral neuropathic pain in adults who have not responded to or tolerated conventional first and second line treatments. Treatment should be discontinued if the patient has not shown sufficient benefit within 8 weeks of reaching the maximally tolerated therapeutic dose. The oral solution is further restricted to those patients who find it difficult to or are unable to swallow tablets.
Restrictions:
Restricted to use in the management of neuropathic pain where amitriptyline is not appropriate because of issues with sedation or hypotension.
Prescribing Notes:
Use in the treatment of neuropathic pain is an unlicensed indication for nortriptyline.