Lidocaine plasters for postherpetic neuralgia?

doi:10.1136/dtb.2008.01.0002

Drug and Therapeutics Bulletin 2008;46:14-16; doi:10.1136/dtb.2008.01.0002

Lidocaine plasters for postherpetic neuralgia?

Relevant BNF section: BNF 4.7.3 &15.2

Each year in the UK, about 1 in 2,500 people experiences neuropathicpain that is still present 3–6 months after acute herpeszoster (shingles).¹ This condition, known as postherpetic neuralgia,is the most common complication of herpes zoster and can bechronic, intractable and distressing. Treatments used in anattempt to reduce postherpetic neuralgia include tricyclic antidepressants(e.g. amitriptyline – an unlicensed indication), antiepileptics(e.g. gabapentin) and opioid analgesics, as well as topicaltreatments such as capsaicin.² However, such treatments mayonly provide partial pain relief, and tolerability can be aproblem, particularly in older patients.² Versatis (GrunenthalLtd), a topical preparation of lidocaine formulated in a plaster,has recently been licensed for treating patients with postherpeticneuralgia.³ Does it offer useful benefit?