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
...tial Assessment
...icians should assess patients with diabetes...
...ting pharmacologic intervention for painful di...
...hould assess patients with painful dia...
...th painful diabetic neuropathy, clinicians sh...
...s may assess patient preferences for effective ora...
...ents preferring topical, nontraditional, or nonph...
...n similar efficacy, clinicians should consider...
...tients of child-bearing potential with painfu...
...s with painful diabetic neuropathy, cl...
...ns should counsel patients that a se...
...uld determine that an individual interven...
...edicatio...
...ians should offer patients a trial of a medicati...
...r patients who achieve partial improve...
...d NOT use opioids for the treatment of painful d...
...atients are currently on opioids for the tr...
...hould NOT use tramadol and tapentadol (opioids/SN...
...e currently on tramadol and tapentadol (opi...
...dication Dosage and Duration InformationHavin...
...Effects for the Most Well-Studied Oral Treat...