Medicines used to relieve pain caused by damage from
diabetes to the nerves that supply sensation and touch
(peripheral neuropathy) may include:
Tricyclic antidepressants such as amitriptyline, desipramine, and imipramine.
Duloxetine (Cymbalta), which is an
antidepressant. It may cause dry mouth, nausea, constipation, diarrhea, and
sometimes dizziness and hot flashes.
Anticonvulsants such as
carbamazepine, gabapentin, and pregabalin. Anticonvulsants are also frequently
prescribed to reduce pain linked with diabetic neuropathy.
Lidocaine or mexiletine. Lidocaine comes as a patch that you can
put on your skin where the pain is the worst. Mexiletine is an oral medicine
similar to lidocaine. Both medicines are used to relieve pain caused by
Capsaicin cream. Capsaicin is a substance contained in
cayenne peppers. Although it may not provide complete pain relief, it may help
relieve minor pain in some people. Capsaicin cream is applied directly to the
skin over the painful area.
Nonprescription pain relievers. These
include acetaminophen and nonsteroidal anti-inflammatory drugs
(NSAIDs), such as aspirin, ibuprofen, or naproxen. Although they may provide some temporary pain relief, they are not
effective for long-term treatment of severe pain. Note:
People with diabetes need to be especially careful when taking NSAIDs because
these medicines may upset kidney function. Be safe with medicines. Read and follow all instructions on the label.
relievers such as oxycodone, which may reduce moderate to severe pain from
diabetic neuropathy. But opioids are usually only
given to people who do not have a personal or family history of addiction.
Opioids may also cause side effects that could make symptoms of autonomic
neuropathy worse. So opioids are not often the first type of medicine tried
for symptoms of diabetic neuropathy.
If you begin taking an antidepressant or an anticonvulsant medicine for pain, it may take several
weeks to see whether it is working. The dose may have to be adjusted more
than once to find the best balance between pain relief and medicine side
No matter what you or your doctor try, you may not be
pain-free. Your doctor may recommend using two or more drugs together to
control your pain best. Be clear with your doctor about what is working and
what is not. Together you and your doctor can find the best combination of
medicine and other treatments to help you the most.
The U.S. Food and Drug Administration (FDA) has issued an advisory on antidepressant medicines and the risk of suicide. Talk to your doctor about these possible side effects and the warning signs of suicide.
ByHealthwise Staff Primary Medical ReviewerE. Gregory Thompson, MD - Internal Medicine Adam Husney, MD - Family Medicine Kathleen Romito, MD - Family Medicine Specialist Medical ReviewerKarin M. Lindholm, DO - Neurology
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