Neuropathic Pain NICE Stepwise — FRCA Final MCQ

Instant feedback + full explanation. One question, done properly.

ModeratePain MedicineNeuropathic Pain NICE StepwiseFRCA Final

Diabetic neuropathy: amitriptyline (anticholinergic side effects) and pregabalin (dizziness/weight gain) failed. NICE CG173 next step?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: C — Duloxetine

NICE CG173 first-line: amitriptyline, duloxetine, gabapentin, pregabalin. After 2 failures, switch to another first-line. Duloxetine (SNRI) has strong diabetic neuropathy evidence. Tramadol third-line. Carbamazepine specifically for trigeminal neuralgia.

Reference: NICE – 2023 – CG173 Neuropathic pain