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
...reatment
...l Assessment...
...should assess patients with diabetes...
...ating pharmacologic intervention for painful d...
...d assess patients with painful diabetic neuropa...
...patients with painful diabetic neur...
...assess patient preferences for effective oral, to...
...patients preferring topical, nontraditional, o...
...fficacy, clinicians should conside...
...ients of child-bearing potential with painfu...
...n all patients with painful diabet...
...should counsel patients that a series of me...
...hould determine that an individual intervention...
...dication...
...ld offer patients a trial of a medication from a...
...achieve partial improvement with an initial...
...ians should NOT use opioids for the treatment o...
...are currently on opioids for the treatment of pain...
...uld NOT use tramadol and tapentadol (opioi...
...s are currently on tramadol and ta...
...cation Dosage and Duration InformationHavin...
.... Class Effects for the Most Well-Studied Oral T...