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Postherpetic neuralgia

Guidelines

Key sources

The following summarized guidelines for the management of postherpetic neuralgia are prepared by our editorial team based on guidelines from the American Academy of Family Physicians (AAFP 2017) and the European Federation of Neurological Societies (EFNS 2010).
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Medical management

Topical anesthetics: as per EFNS 2010 guidelines, consider offering topical lidocaine as first-line therapy in elderly patients with PHN, especially if there are concerns regarding the CNS side effects of oral medications. Attempt a trial of 2-4 weeks before starting other therapy.
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More topics in this section

  • TCAs

  • Anticonvulsants

  • Opioids

Nonpharmacologic interventions

Topical capsaicin: as per AAFP 2017 guidelines, offer capsaicin 8% patches applied for 30-90 minutes for pain relief in patients with PHN.
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