Peripheral neuropathy can cause significant discomfort for a diabetic. Proper management can significantly improve the patient's quality of life.
Management steps:
(1) optimized glucose control, so stable and without wide swings in the blood glucose
(2) medications targeting pain
|
Drug |
Common Daily Dose |
Reason to Select |
|
duloxetine |
60 to 120 mg po |
FDA approved |
|
pregabalin |
100 mg tid po |
FDA approved, anticonvulsant |
|
capsaicin cream |
0.025 to 0.075% tid topical |
topical |
|
amitriptyline |
10 to 75 mg po at bedtime |
antidepressant |
|
nortriptyline |
25 to 75 mg po at bedtime |
antidepressant |
|
imipramine |
25 to 75 mg po at bedtime |
antidepressant |
|
gabapentin |
300 to 1200 mg tid po |
anticonvulsant |
|
carbamazepine |
200 to 400 mg tid po |
anticonvulsant |
It is hard to predict the precise dose of a drug that will be effective. The dose of the selected agent is started low and that gradually titrated to meet the patient's needs.
Purpose: To manage pain associated with diabetic peripheral neuropathy.
Specialty: Pharmacology, clinical
Objective: options, dosage calculations, administration, response to therapy, quality of life, prevention
ICD-10: G63.2, E10-E14,
