Table 14—

Table of drugs to treat symptomatic DPN

ClassExamplesTypical doses*
Tricyclic drugsAmitriptyline10–75 mg at bedtime
Nortriptyline25–75 mg at bedtime
Imipramine25–75 mg at bedtime
AnticonvulsantsGabapentin300–1,200 mg t.i.d.
Carbamazepine200–400 mg t.i.d.
Pregabalin100 mg t.i.d.
5-hydroxytryptamine and norepinephrine uptake inhibitorDuloxetine60–120 mg daily
Substance P inhibitorCapsaicin cream0.025–0.075% applied t.i.d. or q.i.d.
  • *

    * Dose response may vary; initial doses should be low and titrated up.

  • Has FDA indication for treatment of painful diabetic neuropathy.