This guideline covers managing neuropathic pain (nerve pain) with pharmacological treatments (drugs) in adults in non-specialist settings. It aims to improve quality of life for people with conditions such as neuralgia, shingles and diabetic neuropathy by reducing pain and promoting increased participation in all aspects of daily living. The guideline sets out how drug treatments for neuropathic pain differ from traditional pain management.
In February 2017, changes were made to the footnote of recommendation 1.1.8 to clarify use of generic pregabalin and off-label status.
This guideline includes recommendations on:
- key principles of care
- treatments for all types of neuropathic pain except trigeminal neuralgia
- treatments for trigeminal neuralgia
- treatments that should not be started in non-specialist settings
Who is it for?
- Healthcare professionals
- Adults with neuropathic pain, their families and carers
Is this guideline up to date?
We have checked this guideline and are proposing not to update it. We are consulting on this proposal.
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Guideline development process
This guideline was previously called neuropathic pain – pharmacological management: the pharmacological management of neuropathic pain in adults in non-specialist settings.
The recommendations in this guideline represent the view of NICE, arrived at after careful consideration of the evidence available. When exercising their judgement, professionals are expected to take this guideline fully into account, alongside the individual needs, preferences and values of their patients or service users. The application of the recommendations in this guideline is not mandatory and the guideline does not override the responsibility of healthcare professionals to make decisions appropriate to the circumstances of the individual patient, in consultation with the patient and/or their carer or guardian.
Local commissioners and/or providers have a responsibility to enable the guideline to be applied when individual health professionals and their patients or service users wish to use it. They should do so in the context of local and national priorities for funding and developing services, and in light of their duties to have due regard to the need to eliminate unlawful discrimination, to advance equality of opportunity and to reduce health inequalities. Nothing in this guideline should be interpreted in a way that would be inconsistent with compliance with those duties.
Commissioners and providers have a responsibility to promote an environmentally sustainable health and care system and should assess and reduce the environmental impact of implementing NICE recommendations wherever possible.