Pain Neuropathic Pain Starting dose Maintenance dose FIRST LINE TCAs 10-25mg/day; increase by 50-150mg/day 10mg q1week Gabapentinoids Pregabalin 75-150mg/day; increase by 150-300mg BID 50-150mg q1week Gabapentin 300mg/day; increase by 300-1200mg TID 300mg q1week SECOND LINE SNRIs Venlafaxine 37.5mg/day; increase by 150-225mg/d 37.5mg q1wk Duloxetine 60mg/day 60-120mg/d Topical Lidocaine 5% patches or gel applied to painful area x 12h LINE Tramadol 50mg/day; increase by 50mg 50-150mg QID q1wk Opioids Morphine 15mg q12h q12h Oxycodone 10mg q12h 20-60mg q12h Fentanyl 25mcg/h patch 25-100mcg/h patch FOURTH LINE Cannabinoids Methadone
Pain Neuropathic Pain Starting dose Maintenance dose FIRST LINE TCAs 10-25mg/day; increase by 10mg q1week 50-150mg/day Gabapentinoids Pregabalin 75-150mg/day; increase by 50-150mg q1week 150-300mg BID Gabapentin 300mg/day; increase by 300mg q1week 300-1200mg TID SECOND LINE SNRIs Venlafaxine 37.5mg/day; increase by 37.5mg q1wk 150-225mg/d Duloxetine 60mg/day 60-120mg/d Topical Lidocaine 5% patches or gel applied to painful area x 12h LINE Tramadol 50mg/day; increase by 50mg q1wk 50-150mg QID Opioids Morphine 15mg q12h q12h Oxycodone 10mg q12h 20-60mg q12h Fentanyl 25mcg/h patch 25-100mcg/h patch FOURTH LINE Cannabinoids Methadone
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