Neuropathic Pain Dosing

Provides starting doses, titration schedules, and maximum recommended doses for first-line neuropathic pain medications (gabapentin, pregabalin, duloxetine, amitriptyline).

Select the neuropathic pain medication.

Select a medication and click Calculate to see dosing information.

Note

Combination therapy (e.g., gabapentin + duloxetine, or TCA + anticonvulsant) may be more effective than monotherapy for severe neuropathic pain. Consider non-pharmacologic therapies as adjuncts.

Warnings & Limitations

  • Gabapentin/pregabalin require dose reduction in renal impairment.
  • Amitriptyline and other TCAs can cause QT prolongation - ECG in elderly.
  • Duloxetine contraindicated in severe hepatic impairment.
  • Lamotrigine requires VERY slow titration to avoid life-threatening rash.
  • Always start low, go slow with titration in elderly.