In November 2013, duloxetine was licensed for diabetic peripheral neuropathic pain only, and gabapentin was licensed for peripheral neuropathic pain only, so use for other conditions was off label. See NICE's information on prescribing medicines.
Pregabalin and gabapentin are Class C controlled substances (under the Misuse of Drugs Act 1971) and Schedule 3 under the Misuse of Drugs Regulations 2001. Evaluate patients carefully for a history of drug abuse before prescribing and observe patients for development of signs of abuse and dependence (MHRA, Drug Safety Update April 2019).
Follow the MHRA safety advice on pregabalin in pregnancy.
Return to recommendation 1.1.8
In November 2013), capsaicin cream (Axsain) was licensed for post-herpetic neuralgia and painful diabetic peripheral polyneuropathy only, so use for other conditions was off label. The SPC states that this should only be used for painful diabetic peripheral polyneuropathy 'under the direct supervision of a hospital consultant who has access to specialist resources'. See NICE's information on prescribing medicines.
Return to recommendation 1.1.11