North East and North Cumbria
ICS Formulary
6 Endocrine system
06-01-05 Diabetic neuropathy
Duloxetine 30mg and 60mg capsules
First Choice
Amitriptyline
Second Choice
Gabapentin
Third Choice
Also approved for hospital use as an adjunct to other treatment in
the management of peri/post-operative pain.
GPs should not be asked to prescribe gabapentin for this
unlicensed indication.
MHRA Drug Safety Alert (Oct 2017): Gabapentin (Neurontin): risk of severe respiratory depression
Pregabalin
Formulary
See 04.07.03 Neuropathic Pain
MHRA Drug Safety Update (Apr 2022): Pregabalin (Lyrica): findings of safety study on risks during pregnancy
MHRA Drug Safety Update (Feb 2021): Pregabalin (Lyrica): reports of severe respiratory depression
Tramadol
Formulary
50mg capsules, 50mg dispersible tablets & 100mg/2ml injection
MHRA Drug Safety Update (June 2024): Warfarin: be alert to the risk of drug interactions with tramadol
Links
MHRA Drug Safety Alert (Oct 2017): Gabapentin (Neurontin): risk of severe respiratory depression
MHRA Drug Safety Update (Apr 2022): Pregabalin (Lyrica): findings of safety study on risks during pregnancy
MHRA Drug Safety Update (Feb 2021): Pregabalin (Lyrica): reports of severe respiratory depression
MHRA Drug Safety Update (June 2024): Warfarin: be alert to the risk of drug interactions with tramadol
NICE CG173: Neuropathic pain in adults: pharmacological management in non-specialist settings
NICE NG 28: Type 2 diabetes in adults: management
NICE NG17: Type 1 diabetes in adults: diagnosis and management
NICE NG18: Diabetes (type 1 and type 2) in children and young people: diagnosis and management
NICE NG19: Diabetic foot problems: prevention and management
NICE NG3: Diabetes in pregnancy: management from preconception to the postnatal period
North East and North Cumbria ICS - Medication Management of Type 2 Diabetes in Adults Guidelines
NTAG Endocrine System Recommendations
Key
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