Overview of the treatment of postherpetic neuralgia

* "Contraindication or inadequate response" includes patients who are unable to tolerate the medication, those who report partial relief after a trial of at least one month, and those who otherwise prefer an alternative option.
¶ "Add or switch" selection depends on whether initial agent provided partial versus no relief, the risk of adverse effects due to medication interactions from adding another agent, and patient/clinician preferences. Refer to the UpToDate topic for additional details.
Δ Not useful for patients with trigeminal region or other cranial pain.
◊ Opioids are generally reserved for short-term use in patients with intractable pain during the initial titration of other medications. The risks and benefits of using of opioid analgesic medications in this setting should be discussed with the patient before starting.