1st line

Low abuse potential, low cost

Off label use

2nd line

Be aware of abuse and addiction potential associated with this class of agent

Due to the risk of adverse effects associated with Gabapentin,start with the lowest effective dose and titrate up to the minimum effective dose. Educate patient on titration
At follow up, check patient's tolerance of treatment and understanding of dose titration

See Gabapentin leave sheet for dose titration information

Reduce dose in renal impairment

Third line after gabapentin

On advice of specilaist - initiate at 30 mg OD for 1 month, then 60 mg OD

More cost effective options available

NICE suggests 1st line for Diabetic neuropathy

Low abuse potential , high cost £££££

Not licensed for use in children

4th line after duloxetine

On the advice of a specialist where duloxetine is unsuitable

Please be aware of abuse potential associated with this class of agent

From 17th July 2017, clinicians can now return to normal practice when prescribing pregabalin and no longer need to specify a brand name when prescribing for neuropathic pain