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`Postherpetic neuralgia
`Postherpetic neuralgia is pain that lasts for more than a month after a shingles infection occurred. The pain
`may last for months or years.
`
`Causes
`
`Postherpetic neuralgia occurs when the nerves have been damaged after an outbreak of shingles. Shingles is
`caused by the varicella zoster virus, the same virus that causes chickenpox.
`
`MedlinePlus Topics
`
`Shingles
`
`Postherpetic neuralgia is more likely to occur in people over age 60.
`
`Symptoms
`
`The main symptom is pain in the area where shingles once occurred.
`
`The pain can range from mild to very severe. It may continue, or come and go.
`The pain is described as a deep aching, burning, stabbing, or feeling like an electric shock.
`People with this pain are very sensitive to touch or temperature changes.
`
`The pain lasts for months or sometimes years after the shingles infection.
`
`Treatment
`
`Anticonvulsant drugs, usually used for seizures, may help with the pain of damaged nerves. Gabapentin and
`pregabalin are the ones most often used to treat postherpetic neuralgia.
`
`Skin patches with lidocaine (a numbing medicine) may also be prescribed to relieve some of the pain for a
`period of time.
`
`Pain medications are often needed. Sometimes acetaminophen or NSAIDs such as ibuprofen are enough.
`Many patients will need stronger, prescription drugs such as codeine, hydrocodone, or oxycodone.
`
`Drugs used to treat depression (antidepressants) may also help reduce pain, as well as help with sleep.
`
`Electrical nerve stimulators may be used for severe, long-term cases of postherpetic neuralgia.
`
`Some people may need help from a pain specialist.
`
`Prevention
`
`A herpes zoster vaccine is available. It is different from the chickenpox vaccine that children or young adults
`may receive. Adults over age 50 should get the herpes zoster vaccine as part of their routine medical care.
`
`A single shot of the vaccine can cut the risk of getting shingles by about half. It may also help prevent
`postherpetic neuralgia and ophthalmic herpes.
`
`Because the vaccine contains a live virus, it cannot be given to people who have a weak immune system.
`
`References
`
`Advisory Committee on Immunization Practices. Recommended adult immunization schedule: United States,
`2011. Ann Intern Med. 2011;154:168-173.
`
`Chen N, Li Q, Zhang Y, Zhou M, Zhou D, He L. Vaccination for preventing postherpetic neuralgia. Cochrane
`Database Syst Rev. 2011 Mar 16;3:CD007795.
`
`Wilson IF. Herpes zoster. Ann Intern Med. 2011;154:ITC31-15.
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`Depomed Exhibit 2053, Page 1 of 2
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`Update Date: 6/28/2011
`
`Updated by: Ari S. Eckman, MD, Chief, Division of Endocrinology, Diabetes and Metabolism, Trinitas Regional
`Medical Center, Elizabeth, NJ. Review provided by VeriMed Healthcare Network. Also reviewed by David
`Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
`
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`Page last updated: 02 October 2014
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`Depomed Exhibit 2053, Page 2 of 2
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