Chronic Neuropathic Pain
Central nervous system
Appropriate for initiation and ongoing prescribing in both primary and secondary care provided: Additional criteria specific to the medicine or device are met, or The medicine or device is used following the failure of other therapies as defined by the relevant LSCMMG pathway. Generally, little or no routine drug monitoring is required.
NB. This New Medicines Recommendation is only applicable to the 10mg and 25mg tablet forms of Nortriptyline – the 50mg tablet is not to be prescribed (the 50mg tablet is not a Category M medicine).
Nortriptyline is only to be used as 3rd line treatment, for chronic neuropathic pain, in patients where ineffectiveness of or intolerance to amitriptyline and gabapentin has been demonstrated.
Reason for decision:
Suitable for initiation in primary care in line with restrictions