Diagnosis and Assessment of Disease
Table 2B. Medications Not Approved for DPNP by FDA1 Drug
Dosage Form Recommended Dosage
Alpha-2-delta calcium channel modulators/anticonvulsants (α2 300 mg single dose at
Gabapentin Neurontin®
generics ,
100, 300, 400 mg capsules 600, 800 mg tablets
bedtime, Days 1 & 2; bid Days 3 & 4; tid Days 5 & 6; continue titration based on effectiveness/ tolerability to max 600 mg
Other anticonvulsants
Carbamazepine Carbatrol®
Tegretol XR®
100, 200, 300 mg capsules
100, 200, 400 mg tablets 100 mg/5 mL oral suspension
200 mg/d initially; titrate in increments of 200 mg/d q12h to max 1200 mg/d
100 mg bid initially; titrate in increments of 100 mg
q12h to max 1200 mg/d 1/2 tsp (50 mg) qid initially; titrate in increments of 1/2 tsp (50 mg) qid to max 1200 mg/d
Lamotrigine Lamictal®
25, 100, 150, 200 mg tablets
25 mg qod for first week, then titrate in increments of 25 mg/d every week to max 400 mg/d
■ Contraindicated if history of bone marrow depression, acute intermittent porphyria δ CCMs,
■ Avoid α2
■ Caution if hepatic dysfunction ■ Obtain pretreatment baseline complete blood counts and monitor for leukopenia
MAOIs, TCAs
■ Antidepressant effect appropriate if comorbid depression and intolerant of/unresponsive to duloxetine, TCAs, or venlafaxine ■ Discontinue if rash develops, unless rash clearly not drug related
■ Abrupt discontinuation may precipitate seizures
δ CCMs) ■ Avoid other α2
■ Abrupt discontinuation may precipitate seizures
δ CCMs
tid (1800 mg/d); reduce dosage if renal insufficiency
—continued Comments
1 If treatment plan includes these agents, obtain written patient consent.
