How Can Postherpetic Neuralgia Be Treated?

Posted on Fri, 22 Sep 2017

Question: I have PHN from a recent Shingles episode. I am taking gabapentin 300mg, 4 times a day, but the pain is still there. I tried an OTC Lidocane creme (Gold Bond Lidocane 4%) which helps some, but needs to be used more often than recommended. Is there a Rx medication with a higher dose of Lidocane available?

Answered by Dr. Noble Zachariah (1 hour later)

Brief Answer:
Discussion follows

Detailed Answer:
Hello,

Welcome and thanks for your query.
I understand your concern.
PHN is sometimes a very painful condition and the usual medicines of local anesthetic and gabapentin may not suffice. 5% Xylocaine ointment is available or even a 10.5% Ultra Strong one by the brand name of Anesten is available. But these high doses increase the chance of systemic side effects and hence are not recommended.
You may take an anti inflammatory analgesic like Ibuprofen 400mg in addition to Gabapentin to get better pain relief.
Another medication that may used would be small dose of amitriptyline like 10 mg or 25 mg which can be added to Gabapentin.
Do get back to me if you have further queries.

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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar