From the Guidelines
Yes, gabapentin and lidocaine patches can be used together for treating shingles pain on the back, as this combination therapy can provide more effective pain relief than either treatment alone. This combination is often prescribed because they work in different ways to manage pain. Gabapentin is an oral medication that affects nerve signals throughout the body, while lidocaine patches provide localized pain relief directly to the affected skin area. For gabapentin, treatment typically starts at a low dose (such as 100-300mg at bedtime or 100-300mg 3 times daily) and gradually increases as needed and tolerated (often up to 300-600mg three times daily) 1. Lidocaine patches (usually 5% strength) are applied directly to the painful area for 12 hours, followed by 12 hours off, to prevent skin irritation 1.
When using both treatments, it's essential to follow the specific dosing instructions for each medication and to monitor for side effects. The combination can be more effective than either treatment alone because gabapentin addresses the nerve pain systemically while lidocaine provides targeted relief at the pain site. Recent studies have shown that combination therapies, such as gabapentin and lidocaine, can be beneficial in treating neuropathic pain, including shingles pain 1. However, you should always consult with your healthcare provider before combining these medications to ensure they're appropriate for your specific condition and to check for potential interactions with any other medications you may be taking.
Some key points to consider when using gabapentin and lidocaine patches together include:
- Starting with a low dose of gabapentin and gradually increasing as needed and tolerated
- Applying lidocaine patches directly to the painful area for 12 hours, followed by 12 hours off
- Monitoring for side effects, such as dizziness, drowsiness, and skin irritation
- Consulting with your healthcare provider before combining these medications to ensure they're appropriate for your specific condition.
From the Research
Treatment Options for Shingle Pain
- Gabapentin and lidocaine patches can be used to treat shingle pain, specifically post-herpetic neuralgia (PHN) 2, 3, 4, 5
- Gabapentin is an alpha-2 delta ligand that can be used orally to treat PHN 2, 3, 5
- Lidocaine patches are a topical analgesic that can be used to treat PHN 2, 6, 3, 4, 5
- The combination of both topical and systemic agents may be required for optimal outcomes in treating PHN 2
- Other treatment options for PHN include tricyclic antidepressants, anticonvulsants, and opioids 6, 3, 4, 5
Considerations for Treatment
- The treatment of PHN should be tailored to the individual patient's response 2
- The considerable side effect profiles of oral medications may limit their practical use 2
- Topical treatments like lidocaine patches may be used in combination with oral medications like gabapentin 2, 3, 4
- The varicella zoster virus vaccine can decrease the incidence of herpes zoster and subsequent PHN 3