Postherpetic Neuralgia Medications

NSAIDs, Anti-depressants, and Other PHN Medications


When it comes to treating postherpetic neuralgia, you may need to take a combination of medications to effectively manage your pain and other PHN symptoms. No single treatment plan is right for everyone—what medications you take will depend on your PHN symptoms.

While symptoms differ from person to person, for most people, PHN does improve over time. Researchers found that more than half of all patients with PHN stop experiencing pain within one year.1

Fortunately, during that period of intense pain and other symptoms, there are certain medications that you can take to significantly help control postherpetic neuralgia symptoms.

In-depth Articles on Other Postherpetic Neuralgia Treatments

As always, before taking any new medications, talk to your doctor. Medications listed in this article may have side effects or interact with other medications you're taking. Be sure to let your doctor know about other medications you're taking.

Also, keep in mind that when taking medications, you should always follow your doctor's instructions carefully—know exactly when to take your medications as well as how often to take them.

Before trying a prescription medication, your doctor will most likely want you to try an over-the counter (OTC) analgesic (painkiller) medication, such as acetaminophen or non-steroidal anti-inflammatory drugs (NSAIDs). These medications can help relieve pain and other PHN symptoms.

Tylenol is an example of acetaminophen, and Advil is an example of an NSAID you can take to help treat PHN.

Another OTC medication you may want to try for PHN is capsaicin cream. This cream—made from hot chili pepper seeds—is applied to the affected skin, and it can be helpful for reducing PHN-related pain. But this cream can be painful, so talk to your doctor about how much you should apply.

If these medications aren't strong enough to treat your PHN symptoms, your doctor may suggest some of the prescription medications below to treat your postherpetic neuralgia.

Recently, Gabapentin enacarbil (eg, Horizant) has been approved by the FDA for the management of PHN in adults. These are extended release tablets that your doctor may recommend to help relieve pain and other PHN symptoms.

Lidocaine skin patches: Lidocaine patches are bandage-like patches that contain lidocaine—a pain-relieving medication.2 These patches are applied directly to the affected skin, and they can provide pain relief for hours.1

Tricyclic anti-depressants: Tricyclic anti-depressants (TCAs)—a particular type of anti-depressant—aren't just used to treat depression. TCAs can be used to treat PHN, too. As with other types of anti-depressants, TCAs affect key brain chemicals that influence how your body interprets pain.1

Many doctors prescribe anti-depressants for PHN in smaller doses than they would to treat depression.2

Examples of TCAs used to treat PHN are amitriptyline (eg, Elavil) and nortriptyline (eg, Aventyl).

Anti-epileptics: Anti-epileptics aren't just used to treat epilepsy: Some anti-epileptics can actually help reduce the pain associated with PHN by steadying abnormal electrical activity in the nervous system caused by damaged nerves.2

Gabapentin (eg, Neurontin) and pregabalin (eg, Lyrica) have been approved by the US Food and Drug Administration to treat PHN.3 Carbimazapine (eg, Tegretol) is an example of another anti-epileptic medication for PHN.

Epidural steroid injections: These injections (which are shots) into the bony area around the spinal cord can provide some pain relief for PHN.3

Opioids: Opioids are powerful painkillers. In fact, opioids are so potent that you'll need to take them under your doctor's supervision, and you'll only be on them temporarily. They work by acting on nerve cell receptors in the brain to relieve pain.1

If you have severe pain and other medications don't work for you, your doctor may want you to try an opioid. Tramadol (eg, Ultram) is an example of a relatively weak opioid that can be used to help you manage PHN. Your doctor may have you try a weaker opioid first.

Oxycodone (eg, OxyContin) is an example of a much stronger opioid. It may help reduce allodynia, which is an unusual sensitivity to touch (another common PHN symptom)3.

Which PHN Medications Should You Take?
Your doctor will let you know what coombination of medications will work to help ease your pain and other PHN symptoms. It's important to note that although medications for postherpetic neuralgia can help significantly reduce your symptoms, they're not curing the PHN. However, reducing the stinging, burning pain of PHN can help you increase your everyday activities.

Updated on: 07/10/13