MTW NHS Trust West Kent CCG

Drug Status Key

  • Preferred
  • Second Line
  • Third Line
  • Specialist Initiation
  • Hospital Only
  • Not Approved for Formulary

Neuropathic pain

Drug Safety Update

February 2021: Pregabalin (Lyrica): reports of severe respiratory depression

January 2021: SSRI/SNRI antidepressant medicines: small increased risk of postpartum haemorrhage when used in the month before delivery

 April 2019: Pregabalin (Lyrica), gabapentin (Neurontin) and risk of abuse and dependence: new scheduling requirements from 1 April

October 2017: Gabapentin (Neurontin): risk of severe respiratory depression

 December 2012: Carbamazepine, oxcarbazepine and eslicarbazepine potential risk of serious skin reactions

April 2008: Carbamazepine: genetic testing recommended in some Asian populations

  • Higher risk of carbamazepine-induced Stevens -Johnson syndrome in some Asian populations. Also see December 2012 update above

NICE guidance

 CG 173 Neuropathic pain in adults: pharmacological management in non-specialist settings, updated April 2018

Local guidelines

 Trust Guidelines for the management of neuropathic pain in adults, June 2017

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

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.

Pack Price
28 tablet £0.97
Pack Price
28 tablet £0.98
500 tablet
Pack Price
28 tablet £1.55
Pack Price
150 ml £18.00

Carbamazepine is used first line for the treatment of trigeminal neuralgia

Pack Price
28 tablet
500 tablet
56 tablet
84 tablet £2.07
Pack Price
100 tablet
28 tablet
500 tablet
56 tablet
84 tablet £3.83
Pack Price
250 ml
300 ml £9.06
50 ml
Pack Price
28 capsule £2.55
Pack Price
28 capsule £3.38
84 capsule
Pack Price
100 capsule £2.18
50 capsule
90 capsule
Pack Price
100 capsule £3.27
40 capsule
50 capsule
90 capsule
Pack Price
100 capsule £3.84
30 capsule
50 capsule
90 capsule
Pack Price
10 tablet
100 tablet £6.01
Pack Price
150 ml £65.46
Pack Price
100 capsule
14 capsule
56 capsule £2.31
84 capsule
Pack Price
21 capsule
56 capsule
84 capsule £3.73
Pack Price
100 capsule
14 capsule
56 capsule £2.62
Pack Price
21 capsule
56 capsule
84 capsule £4.14
Pack Price
100 capsule
14 capsule
56 capsule £3.61
Pack Price
84 capsule (12 x 7 capsules) £6.96
Pack Price
56 capsule (8 x 7 capsules) £4.13
Pack Price
56 capsule £5.17
Pack Price
473 ml £92.15
500 ml

On pain team advice only

Pack Price
250 tablet
28 tablet £1.86
Pack Price
28 tablet (2 x 14 tablets) £6.64

On pain team advice only

Pack Price
100 tablet £1.99
30 tablet
Pack Price
100 tablet £2.11
30 tablet (3 x 10 tablets)

On pain team advice only. 

Licensed for post-herpetic neuralgia and diabetic neuropathy only.

Pack Price
45 gram £14.58

On pain team/pain specialist advice only

Licensed for post-herpetic neuralgia only - see prescribing notes above

Pack Price
10 plaster
30 plaster £72.40