The Rx Consultant 

Chronic Neuropathic Pain

This CE activity was originally published in The Rx Consultant.  If you received credit for it previously, you cannot receive credit for it again.
Despite the availability of new therapies, neuropathic pain (NP) continues to pose challenges to patients and practitioners alike. It is often chronic in nature and, in a substantial number of patients, is not relieved by medication. Consequences include diminished mobility and function, lack of sleep, depressed mood, and impaired relationships with family and friends. The full medical and societal burden of NP isn’t clear; however, medical costs are estimated to be 3 times higher than those of patients without NP. The loss of patients’ and/or caregivers' ability to work and the need for additional assistance with tasks of daily living are major societal costs.

The prevalence of NP is unknown; estimates place it as low as 1% and as high as 10% in the general population. NP is most commonly seen in patients with diabetic peripheral neuropathy (DPN), postherpetic neuralgia (PHN), radiculopathies (e.g., spinal nerve compression that causes pain in the legs or arms), and nerve trauma.

The mainstay of treatment for most types of NP consists of antidepressants, anticonvulsants, topical anesthetics, and opioid analgesics. Only a handful, however, have been FDA approved: gabapentin (Neurontin®, Gralise®), lidocaine 5% patch (Lidoderm®), and capsaicin 8% patch (Qutenza®) for PHN; duloxetine (Cymbalta®) and extended-release tapentadol (Nucynta® ER) for DPN; and pregabalin (Lyrica®) for PHN and DPN. In order to achieve clinically meaningful pain relief, patients commonly require more than one type of medication. Treatment is often complicated by coexisting health conditions, and current guidelines recommend a highly individualized approach to management. Community practitioners can play a key role in helping patients optimize drug therapy and minimize the consequences of NP. This issue briefly reviews NP and the medications recommended for treatment, with a focus on the treatment of DPN and PHN, the most thoroughly studied types of NP.
This CE activity is a monograph (PDF file).



CE Hours


CE Units


Activity Type


Target Audience(s)

Pharmacists, Nurse Practitioners, Clinical Nurse Specialists, and Registered Nurses


This CE activity was developed by The Rx Consultant, a publication of Continuing Education Network, Inc.

CE activities for Pharmacists and Pharmacy Technicians:
This continuing education (CE) activity meets the requirements of all state boards of pharmacy for approved continuing education hours.  CE credit is automatically reported to CPE Monitor.
CE activities for Nurse Practitioners and Clinical Nurse Specialists: 
    This continuing education activity meets the requirements of:
        The American Nurses Credentialing Center (ANCC) for formally approved continuing education (CE) hours, and CE hours of pharmacotherapeutics.
        The American Academy of Nurse Practitioners Certification Program (AANPCP) for acceptable, accredited CE.
    This is a pharmacotherapeutics/pharmacology CE activity.
  • The ANCC requires all advanced practice nursing certificants (CNSs and NPs) to complete 25 CE hours of pharmacotherapeutics as a portion of the required 75 continuing education hours.
  • Pharmacology CE is recommended by the AANPCP and will be required for Certificants renewing certification starting January 2017.  
  • Most State Boards of Nursing require a minimum number of pharmacy contact hours to renew an advanced practice license.
Accreditation Council for Pharmacy Education
Continuing Education Network, Inc. is accredited by the Accreditation Council for Pharmacy Education as a provider of continuing pharmacy education.

Requirements for CE Credit

CE No Longer Valid
To receive CE credit, the participant must read the monograph in its entirety, complete the online post-test and receive a score of 70% or greater, and complete the online evaluation.
Pharmacists and Pharmacy Technicians -
Be sure your profile has been updated with your NAPB e-profile # and birth date information BEFORE completing the online evaluation, or your credits cannot be reported to CPE Monitor.
Continuing pharmacy education credit is automatically reported to CPE Monitor once the post-test & evaluation are successfully completed.




  • Describe at least 4 common characteristics of neuropathic pain. Describe the risk factors and symptoms of DPN and PHN; discuss the relationship of neuropathic pain to these conditions.
  • Name 4 antidepressants, 2 anticonvulsants, and 2 topical agents with evidence of efficacy in neuropathic pain. Discuss their roles in the management of neuropathic pain caused by DPN & PHN, and list the main adverse effects and drug interactions.
  • Discuss the role of opioids (including tramadol and tapentadol) in the management of neuropathic pain.


Emily Meuleman, MS, FNP-BC

Brief Bio : Emily K. Meuleman, MS, FNP-BC, Editorial Advisor and Clinical Practice Consultant.
Disclosure : Ms. Meuleman reports no financial or personal relationship with any commercial interest producing, marketing, reselling, or distributing a product or service that appears in this issue.

Pamela Mausner, MD

Brief Bio : Pamela Mausner, MD; Medical Writer/Editor and Healthcare Advocate; and Associate Editor, The Rx Consultant.
Disclosure : Dr.Mausner reports no financial relationship with the manufacturer(s) or provider(s) of any commercial product(s) or service(s) that appear in this issue.

Tracy Farnen, PharmD

Brief Bio : Tracy Farnen, PharmD; Managing Editor, The Rx Consultant.
Disclosure : Dr. Farnen reports no financial relationship with the manufacturer(s) or provider(s) of any commercial product(s) or service(s) that appear in this issue.

Activity Number


Release Date: Nov 18, 2012
Credit Expiration Date: Nov 18, 2015

CE Hours