For Surrey PAD, please go to https://surreyccg.res-systems.net/PAD.
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PAD Profile : Nortriptyline - Pain (Neuropathic)
Traffic Light Status
Status 1 of 1.
Guidelines
No guidelines returned.
Other Drugs
- Duloxetine hydrochloride
- Amitriptyline hydrochloride
- Gabapentin
- Pregabalin
- Imipramine hydrochloride
- Dosulepin hydrochloride
- Tramadol hydrochloride
- Capsaicin
Other Indications
No indications returned.
Additional Documents
Committee Recommendations
The Area Prescribing Committee recommends that nortriptyline for use in neuropathic pain should remain as unsuitable for prescribing and agreed to assign it a NON-FORMULARY status for this indication
There appears to be no evidence available to recommend this off label treatment. It is not recommended in NICE guidance (CG173) "Neuropathic pain in adults: pharmacological management in non-specialist settings ".
Amitriptyline is the only tricyclic recommended by NICE. It recommends a switch to another class of drug if amitriptyline is not tolerated or contra-indicated
See guidelines below
At the Surrey and North-West Sussex Area Prescribing Committee (APC) held in June 2020, it was decided that all BLACK status drugs would have their review dates extended for 5 years without the need for a review.
If a clinician or provider wishes to change the traffic light status of any BLACK drug then they will need to submit a paper for change as per usual APC process.