Drugs Used in Trigeminal Neuralgia

Warning

Step 1 – Carbamazepine

Preferred list (P)

CARBAMAZEPINE

  • Restriction: For the treatment of trigeminal neuralgia only.

Prescribing Notes:

  • First line for the treatment of trigeminal neuralgia. Management should then follow the steps laid out under Chapter 4. Central Nervous System: Analgesics: Drugs Used in Neuropathic Pain.
  • If treatment with carbamazepine does not significantly reduce pain score (i.e. by at least 30%) or improve functional ability, carbamazepine should be stopped (taper and withdrawal is not required) and the pathway for management of neuropathic pain followed. 

NHSL Joint Adult Formulary Key

To indicate the category of a formulary medicine, updated sections adopt the following key:

Preferred list (P): First-line formulary choices.

Total list (T): Alternative choices when preferred list options not effective/not tolerated, or not indicated.

Specialist initiation (S1): Specialist initiation, or on the advice of a Consultant or Specialist Practitioner in this therapeutic area. Continuation in primary care is acceptable.

Specialist use only (S2): Supply via hospital, Homecare Service or a hospital based prescription (HBP) for dispensing by community pharmacy. Not prescribed in primary care setting.

Editorial Information

Last reviewed: 31/01/2022

Next review date: 31/01/2025

Author(s): NHSL.

Version: Please refer to the introduction section for an explanation of the review dates above.

Approved By: ADTC

Reviewer name(s): ADTC.