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Post-herpetic neuralgia - Management
Gabapentin (neuropathic pain): starting doses

Age from 18 years onwards
Gabapentin: fast titration from 300mg to 900mg a day over 3 days
Gabapentin 300mg capsules
Take one capsule on the first day, then take one capsule twice a day on the second day, then take one capsule three times a day on the third day. If tolerated, increase the total daily dose by one capsule (300mg) every 2 to 3 days until the pain settles. Once you have reached 6 capsules (1800mg) daily, see your doctor to review this medicine before increasing the dose further.
Supply 100 capsules.
Age: from 18 years onwards
NHS cost: £4.99
Licensed use: yes
Patient information: This is a starting prescription for gabapentin. You do not have to increase the dose any further once the pain has settled, so, for example, if the pain is controlled by taking 5 capsules daily, there is no need to increase the dose any further.

You should trial the medicine for 3 to 8 weeks (if tolerated), with at least 2 weeks at the maximum tolerated dose, before deciding it is not effective.

Do not discontinue gabapentin suddenly. It should be discontinued gradually over a minimum of 1 week.
Gabapentin: fast titration from 900mg on day 1 onwards
Gabapentin 300mg capsules
Take one capsule three times a day for 3 days, then increasing the total daily dose by one capsule (300mg) every two or three days depending on response and if tolerated. Once you have reached 6 capsules (1800mg) daily, see your doctor to review this medicine before increasing the dose further.
Supply 100 capsules.
Age: from 18 years onwards
NHS cost: £4.99
Licensed use: yes
Patient information: This is a starting prescription for gabapentin. You do not have to increase the dose any further once the pain has settled, so, for example, if the pain is controlled by taking 5 capsules daily, there is no need to increase the dose any further.
You should trial the medicine for 3 to 8 weeks (if tolerated), with at east 2 weeks at the maximum tolerated dose, before deciding it is not effective.

Do not discontinue gabapentin suddenly. It should be discontinued gradually over a minimum of 1 week.
Gabapentin: slower titration regimen
Gabapentin 100mg capsules
Take one capsule at night, increasing by one capsule daily depending on response and if tolerated. Once you have reached 12 capsules (1200mg) daily, see your doctor before increasing the dose further.
Supply 100 capsules.
Age: from 18 years onwards
NHS cost: £3.77
Licensed use: no - off-label dose
Patient information: This is a starting prescription for gabapentin. You do not have to increase the dose any further once the pain has settled, so, for example, if the pain is controlled by taking 8 capsules daily, there is no need to increase the dose any further.

Once you have finished this course of 100mg capsules, ask your doctor to switch you to the gabapentin 300mg capsules.

You should trial the medicine for 3 to 8 weeks (if tolerated), with at least 2 weeks at the maximum tolerated dose, before deciding it is not effective.

Do not discontinue gabapentin suddenly. It should be discontinued gradually over a minimum of 1 week.

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