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Has Shingles. Suggested post herpetic neuralgia phase. Has ankles and feet swelling after taking Lyrica and Neurontin. Help?

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My father has shingles and has been told he is in the post herpetic neuralgia phase. He is 82 yrs old and is very healthy other than that. He has tried Lyrica which he felt no relief from and then had Neurontin (Gabapentin 100 mg 2 capsule three times a day, which caused his ankles and feet to swell badly. He has been on Vicodin, and now has Norco 7.5-325. He also has received the Lidocaine patches recently. They do give a small relief but only for a while. His pain is so bad that he just doesn't know what to do. Recently he took Lorazepam 1 time and thought that helped, but I know this is very addictive and I don't think it should be mixed with Norco. The Vicodin or Norco only works for about 3 hrs. He also has tried cold compresses which only help a small bit. Do you know of anything else that may be helpful or that we are missing?
Posted Mon, 1 Jul 2013 in General Health
Answered by Dr. Michelle Gibson James 40 minutes later
Hi, thanks for using healthcare magic

The pain related to post herpetic neuralgia can be severe, there can be slow resolution of the pain syndrome.

In addition to the use of medication, some medical studies have suggested that the anti oxidant vitamin c is low in persons with this type of pain. In this study which was small with less than 100 persons, restoring vitamin c levels by taking replacement supplements resulted in a decrease in pain.

In terms of medication, he has used medication that is normally recommended for this condition.
Other medication would be nortriptyline or amitriptyline . One study combined nortriptyline with gabapentin and found the combination effectiive, it may possibly mean a reduction in the dose of gabapentin.

In addition anti viral medication can be used to possibly shorten the course of illness. An example is fanciclovir.

After this episode has resolved he may want to consider the vaccine- this has been shown to prevent recurrences by 66%.

I hope this helps, feel free to ask any other questions
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