Qutenza® self-adhesive patches 179mg (8%).Initial burning sensations may be distressing (can pre-treat with EMLA®) but reduce after the first few applications.Use a gloved finger or wash hands carefully with soap after application.Must use regularly for at least 4 weeks, as delayed onset of action.
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Prescribers should therefore consider a trial withdrawal of therapy to reassess ongoing need at appropriate intervals e.g. Lidocaine plasters can result in gradual desensitisation of the nerves, leading to improvement in symptoms the plaster may be discontinued if this should occur.If successful, GPs may continue prescribing with ongoing input from pain specialists. Pain specialists may occasionally recommend a trial of lidocaine plasters in difficult to treat cases of other forms of neuropathic pain.Lidocaine plasters are only licensed for use in post herpetic neuralgia there is a paucity of data from double blind RCTs demonstrating efficacy in other neuropathic conditions.Only recommended for the treatment of post-herpetic neuralgia following initiation by specialist pain team (this may include recommendation to prescribe following outpatient appointment or "advice and guidance" service).Following national guidance from NHS England, not recommended for initiation in primary care.Review after 2-4 weeks, discontinue if ineffective.Up to 3 plasters may be used to cover large areas. Apply to the painful area once daily for up to 12 hours, followed by a 12-hour plaster-free period plasters may be cut to size if necessary.fibromyalgia, musculoskeletal pain, headache etc. Not to be used for non-neuropathic pain e.g.Post-herpetic neuralgia only (see Management of neuropathic pain) (but see notes below).Medicated plaster ( click here for preferred brand).Lidocaine 700mg (5% w/w) medicated plaster Prescribe by brand (to aid identification where products contain multiple ingredients, or to prevent confusion where multiple brands contain similar ingredients).Neuropathic pain (unlicensed indication).Ketoprofen: please see 10.1.1 Non-steroidal anti-inflammatory drugs (NSAIDs) Lidocaine Emla® Ibuprofen: please see 10.1.1 Non-steroidal anti-inflammatory drugs (NSAIDs)ĭiclofenac: please see 10.1.1 Non-steroidal anti-inflammatory drugs (NSAIDs) Tendon sheath concentrations are several hundred times higher than plasma concentrations after topical administration. Synovial fluid concentrations are only half those achieved with oral dosing. Local concentrations in cartilage and meniscus are several fold that achieved with oral dosing and the long term safety of this has not been established. Many products have a licence only for short term use (e.g. The appropriate place in therapy is in acute soft tissue injury or inflammation (strains, sprains, epicondylitis, tenosynovitis), and in localised peripheral OA where pathology is thought to be superficial (such as single joint OA in the hand or knee). There is evidence that topical NSAIDs are effective in acute soft tissue injury and localised osteoarthritis (OA).
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