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Original Research

Open Access

Topical 5% lidocaine patches for treating postherpetic neuralgia: a survey among nurses and patients

  • Joseph V. Pergolizzi Jr.1
  • Sri Nalamachu2
  • Kailyn Mitchell1
  • Antonella Paladini3
  • Robert Taylor Jr.1
  • Giustino Varrassi1,4

1NEMA Research Inc., 868 106th Ave North, Naples, FL 34108, USA

2Mid-America Poly Clinic, 7100 College Boulevard, Overland Park, Overland Park, KS 66210, USA

3Department of MESVA, University of L’Aquila, 67100 L’Aquila, Italy

4Paolo Procacci Foundation, Via Tacito 7, 00193 Roma, Italy

DOI: 10.22514/sv.2021.114 Vol.18,Issue 1,January 2022 pp.84-95

Submitted: 18 January 2021 Accepted: 18 May 2021

Published: 08 January 2022

*Corresponding Author(s): Robert Taylor Jr. E-mail:


Introduction: Postherpetic neuralgia (PHN) is associated with moderate to severe pain with peripheral and central mechanisms. While there is no clear-cut first-line therapeutic approach to PHN pain control, lidocaine patches are frequently used as monotherapy or part of a multimodal pain regimen.

Methods: An online survey, the first of its kind, was conducted among PHN patients (n = 153) and nurses (n = 151) in order to determine clinical and patient knowledge, attitudes and practices toward the lidocaine patch and current unmet needs.

Results: Results of the survey indicated that PHN patients are prescribed a mean of 2.6 medications to control their PHN pain, including the lidocaine patch. There were negative responses related to the patches’ ability to adhere to the skin. Patients reported the use of tape to hold the patches in place and/or patches that detached completely, truncating the therapeutic dose period. Most nurses (53%) found the biggest obstacle to PHN pain control was noncompliance and 98% stated that reliable patch adhesion for the intended 12-hour application was “somewhat important” or “very important” for PHN pain control. Forty-five percent of nurses said that poor patient adherence to PHN analgesic regimens was related to poor adhesion of the lidocaine patch.

Conclusion: A new bioequivalent lidocaine patch has been developed with better adhesive characteristics, nine-fold greater bioavailability, and improved form factor.


Post-herpetic neuralgia; Lidocaine patch; Survey; Nurses; Pain; Quality of life; Daily living

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Joseph V. Pergolizzi Jr.,Sri Nalamachu,Kailyn Mitchell,Antonella Paladini,Robert Taylor Jr.,Giustino Varrassi. Topical 5% lidocaine patches for treating postherpetic neuralgia: a survey among nurses and patients. SignaVitae. 2022. 18(1);84-95.


[1] Jianbo W, Koshy E, Mengting L, Kumar H. Epidemiology, treatment and prevention of herpes zoster: a comprehensive review. Indian Journal of Dermatology, Venereology and Leprology. 2018; 84: 251–262.

[2] Gialloreti LE, Merito M, Pezzotti P, Naldi L, Gatti A, Beillat M, et al. Epidemiology and economic burden of herpes zoster and post-herpetic neuralgia in Italy: a retrospective, population-based study. BMC Infectious Diseases. 2010; 10: 230.

[3] Gauthier A, Breuer J, Carrington D, Martin M, Rémy V. Epidemiology and cost of herpes zoster and post-herpetic neuralgia in the United Kingdom. Epidemiology and Infection. 2009; 137: 38–47.

[4] Kawai K, Gebremeskel BG, Acosta CJ. Systematic review of incidence and complications of herpes zoster: towards a global perspective. BMJ Open. 2014; 4: e004833.

[5] Ragozzino MW, Melton LJ, Kurland LT, Chu CP, Perry HO. Population-based study of herpes zoster and its sequelae. Medicine. 1982; 61: 310–316.

[6] Sacks GM. Unmet need in the treatment of postherpetic neuralgia. American Journal of Managed Care. 2013; 19: S207–S213.

[7] Attal N, Cruccu G, Baron R, Haanpää M, Hansson P, Jensen TS, et al. EFNS guidelines on the pharmacological treatment of neuropathic pain: 2010 revision. European Journal of Neurology. 2011; 17: 1113–e1188.

[8] Finnerup NB, Attal N, Haroutounian S. Pharmacotherapy for neuropathic pain in adults: a systematic review and meta-analysis. Journal of Vascular Surgery. 2015; 14: 162–173.

[9] Liampas A, Rekatsina M, Vadalouca A, Paladini A, Varrassi G, Zis P. Pharmacological management of painful peripheral neuropathies: a systematic review. Pain and Therapy. 2021; 10: 55–68.

[10] Dubinsky RM, Kabbani H, El-Chami Z, Boutwell C, Ali H. Practice parameter: treatment of postherpetic neuralgia: an evidence-based report of the Quality Standards Subcommittee of the American Academy of Neurology. Neurology. 2004; 63: 959–965.

[11] Moulin D, Boulanger A, Clark AJ, Clarke H, Dao T, Finley GA, et al. Pharmacological management of chronic neuropathic pain: revised consensus statement from the Canadian Pain Society. Pain Research & Management. 2015; 19: 328–335.

[12] Johnson RW. Herpes zoster and postherpetic neuralgia. Expert Review of Vaccines. 2010; 9: 21–26.

[13] Johnson RW, Rice ASC. Clinical practice. Postherpetic neuralgia. The New England Journal of Medicine. 2014; 371: 1526–1533.

[14] Argoff CE, Katz N, Backonja M. Treatment of postherpetic neuralgia: a review of therapeutic options. Journal of Pain and Symptom Manage-ment. 2004; 28: 396–411.

[15] Hadley GR, Gayle JA, Ripoll J, Jones MR, Argoff CE, Kaye RJ, et al. Post-herpetic neuralgia: a review. Current Pain and Headache Reports. 2016; 20: 17.

[16] John AR, Canaday DH. Herpes zoster in the older adult. Infectious Disease Clinics of North America. 2018; 31: 811–826.

[17] Schmader K. Herpes zoster. Clinics in Geriatric Medicine. 2016; 32: 539–553.

[18] Baron R, Allegri M, Correa-Illanes G, Hans G, Serpell M, Mick G, et al. The 5% lidocaine-medicated plaster: its inclusion in international treatment guidelines for treating localized neuropathic pain, and clinical evidence supporting its use. Pain and Therapy. 2019; 5: 149–169.

[19] Navez ML, Monella C, Bösl I, Sommer D, Delorme C. 5% lidocaine medicated plaster for the treatment of postherpetic neuralgia: a review of the clinical safety and tolerability. Pain and Therapy. 2015; 4: 1–15.

[20] Dagli RJ, Sharma A. Polypharmacy: a global risk factor for elderly people. Journal of International Oral Health. 2015; 6: i–ii.

[21] Food and Drug Administration. FDA adverse event reporting system. Food and Drug Administration. 2020; Available ta: https://open. (Accessed: 11 April 2020).

[22] Davies PS, Galer BS. Review of lidocaine 0atch 5

[23] Hadley GR, Gayle JA, Ripoll J, Jones MR, Argoff CE, Kaye RJ, et al. Post-herpetic neuralgia: a review. Current Pain and Headache Reports. 2016; 20: 17.

[24] Gruver C, Guthmiller KB. Postherpetic neuralgia. In: StatPearls. Treasure Island (FL): StatPearls Publishing. 2021.

[25] Baron R. Post-herpetic neuralgia case study: optimizing pain control. European Journal of Neurology. 2004; 11: 3–11.

[26] Shrestha M, Chen A. Modalities in managing postherpetic neuralgia. The Korean Journal of Pain. 2018; 31: 235–243.

[27] Dworkin RH, Schmader KE. Treatment and prevention of postherpetic neuralgia. Clinical Infectious Diseases. 2003; 36: 877–882.

[28] Argoff CE, Galer BS, Jensen MP, Oleka N, Gammaitoni AR. Effective-ness of the lidocaine patch 5

[29] Camilloni A, Nati G, Maggiolini P, Romanelli A, Carbone G, Giannarelli D, et al. Chronic non-cancer pain in primary care: an Italian cross-sectional study. Signa Vitae. 2020; 17: 54–62.

[30] Paterniani A, Sperati F, Esposito G, Cognetti G, Pulimeno AML, Rocco G, et al. Quality of life and disability of chronic non-cancer pain in adults patients attending pain clinics: a prospective, multicenter, observational study. Applied Nursing Research. 2020; 56: 151332.

[31] Girach A, Julian TH, Varrassi G, Paladini A, Vadalouka A, Zis P. Quality of life in painful peripheral neuropathies: a systematic review. Pain Research and Management. 2019; 2019: 1–9.

[32] Liampas A, Rekatsina M, Vadalouca A, Paladini A, Varrassi G, Zis P. Non-pharmacological management of painful peripheral neuropathies: a systematic review. Advances in Therapy. 2020; 37: 4096–4106.

[33] Brandolini L, Grannonico M, Bianchini G, Colanardi A, Sebastiani P, Paladini A, et al. The Novel C5aR antagonist DF3016a protects neurons against ischemic neuroinflammatory injury. Neurotoxicity Research. 2019; 36: 163–174.

[34] Varrassi G, Alon E, Bagnasco M, Lanata L, Mayoral-Rojals V, Paladini A, et al. Towards an effective and safe treatment of inflammatory pain: a delphi-guided expert consensus. Advances in Therapy. 2019; 36: 2618–2637.

[35] Varrassi G, Pergolizzi JV, Dowling P, Paladini A. Ibuprofen safety at the golden anniversary: are all NSAIDs the same? A narrative review. Advances in Therapy. 2020; 37: 61–82.

[36] Varrassi G, Hanna M, Macheras G, Montero A, Montes Perez A, Meissner W, et al. Multimodal analgesia in moderate-to-severe pain: a role for a new fixed combination of dexketoprofen and tramadol. Current Medical Research and Opinion. 2017; 33: 1165–1173.

[37] Gay-Escoda C, Hanna M, Montero A, Dietrich T, Milleri S, Giergiel E, et al. Tramadol/dexketoprofen (TRAM/DKP) compared with tra-madolparacetamol in moderate to severe acute pain: results of a randomised, double-blind, placebo and active-controlled, parallel group trial in the impacted third molar extraction pain model (DAVID study). BMJ Open. 2019; 9: e023715.

[38] Pergolizzi JV, LeQuang J. Lidocaine topical systems in the treatment of postherpetic neuralgia. EC Anaesthesia. 2019; 5.8: 239–251.

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