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.
- Tricyclic antidepressants, such as amitriptyline (Elavil), nortriptyline (Pamelor), and desipramine (Norpramin) are effective at treating postherpetic neuralgia pain. Other classes of antidepressant are also helpful. All classes of antidepressant take a few weeks to start working.
- Anticonvulsants, developed to control seizures, can help reduce the pain of PHN. These include gabapentin (Neurontin), carbamazepine (Tegretol) and pregabalin (Lyrica). Gabapentin enacarbil (Horizant) and gabapentin (Gralise) are approved by the FDA for the treatment of PHN in adults.
- Anti-viral drugs valacyclovir and acyclovir are also becoming medications of choice for treating postherpetic neuralgia.
- Lidocaine Patches for Postherpetic Neuralgia. Lidocaine patches are FDA-approved to treat PHN. The medication in the patch—lidocaine—can penetrate your skin and go to the nerves that are sending the pain signals. A benefit of lidocaine patches is that they don’t numb the skin.
- Prescription capsaicin patches. These patches contain a very high concentration of the chili pepper extract capsaicin. The capsaicin patch Qutenza is applied in a doctor’s office for one hour every three months.
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. Opioids, such as morphine (MS Contin), oxycodone (OxyContin), and hydrocodone (Vidocin), are also used to treat moderate to severe pain of postherpetic neuralgia.3
Which PHN Medications Should You Take?
Your doctor will let you know what combination 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.