Painful Diabetic Polyneuropathy
Key Points
Key Points
- Clinicians should offer tricyclic antidepressants (TCAs), serotonin-norepinephrine reuptake inhibitors (SNRIs), gabapentinoids, and/or sodium channel blockers to reduce pain.
- Clinicians should not use opioids for the treatment of painful diabetic neuropathy.
- For patients with painful diabetic neuropathy, clinicians should review all of the available options to reduce pain, including oral, topical, and nonpharmacologic interventions.
- It is important for clinicians to think about treatment of painful diabetic neuropathy in terms of medication class. Patients need to be re-evaluated, in regard to efficacy and tolerability, after starting treatment. If a medication in one class is not working or is causing intolerable side effects, another medication class should be tried instead of another medication in the same class.
Treatment
...reatmen...
...itial Assessmen...
...nicians should assess patients with dia...
...en initiating pharmacologic intervention for...
...should assess patients with painful dia...
...ith painful diabetic neuropathy, clinicians sho...
...may assess patient preferences for eff...
...preferring topical, nontraditional...
...ven similar efficacy, clinicians should consid...
...tients of child-bearing potential with painful d...
...all patients with painful diabetic...
...ians should counsel patients that a series...
...d determine that an individual interven...
Medicati...
...linicians should offer patients a trial of a medi...
...who achieve partial improvement with an initi...
...ould NOT use opioids for the treatment...
...tients are currently on opioids for the treatment...
...icians should NOT use tramadol and tapenta...
...e currently on tramadol and tapentadol (opioids/...
...cation Dosage and Duration Informa...
...ass Effects for the Most Well-Studied Ora...