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Quick reference guide

Issue date: March 2010

Neuropathic pain
The pharmacological management of neuropathic
pain in adults in non-specialist settings

NICE clinical guideline 96
Developed by the Centre for Clinical Practice at NICE

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Neuropathic pain Introduction

This is a quick reference guide that summarises the recommendations NICE has made to the NHS in
`Neuropathic pain: the pharmacological management of neuropathic pain in adults in non-specialist
settings' (NICE clinical guideline 96). This guidance updates and replaces recommendations on the
drug treatment of painful diabetic…

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Care pathway
After the diagnosis of neuropathic pain and appropriate
management of the underlying condition(s)
Neuropathic pain

People with painful diabetic neuropathy People with other neuropathic pain conditions

NICE clinical guideline 96
First-line treatment First-line treatment
G Offer oral duloxetine. G Offer oral amitriptyline* or pregabalin (see box A for…

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Perform: pain reduction Continue treatment ­ consider
G early clinical review (see box B) gradually reducing dose over
G regular clinical reviews (see box C). time if improvement is sustained

Unsatisfactory pain
reduction at maximum
tolerated dose

Third-line treatment
G Refer the person to a specialist pain service and/or…

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Key principles of care
G Address the person's concerns and expectations when agreeing which treatments to use by discussing:
­ benefits and possible adverse effects of each pharmacological treatment
­ why a particular pharmacological treatment is being offered
­ coping strategies for pain and for possible adverse effects of treatment…

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Neuropathic pain Further information

Further information
Ordering information Related NICE guidance
You can download the following documents For information about NICE guidance that
from has been issued or is in development, see
G A quick reference guide (this document) ­
a summary of the recommendations for G Depression…


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