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Treatment area: nerve pain

Targeted treatment of nerve pain

Burning, stabbing, or shooting pains can occur when nerves are damaged, for example, due to diabetes or after shingles. Our doctors will review your questionnaire to determine whether prescription treatment with pregabalin, gabapentin, or amitriptyline is suitable for you.

Behandlungsoptionen vergleichenCompare treatment optionsComparer les options de traitementBehandelopties vergelijken
Ratgeber lesenRead the guideLire le guideGids lezen
  • online questionnaire
  • Medical examination
  • Discreet Shipping
  • Money back if not suitable

BehandlungsoptionenTreatment optionsOptions de traitementBehandelopties

Medication for nerve pain

All medications require a prescription and are initially dosed gradually. After making your selection, you will complete a medical questionnaire, after which a doctor will decide whether treatment is suitable for you.

Selbst einschätzenAssess it yourselfFaire le point vous-mêmeZelf inschatten

Which active ingredient might be suitable?

  1. 1 If you prefer to take it only once a day Amitriptyline is usually taken once daily in the evening; it often only starts to work against pain after 2 to 4 weeks. Pregabalin and gabapentin are taken throughout the day. Your doctor will decide which medication is right for you.
  2. 2 If you have a heart condition, for example after a heart attack or with cardiac arrhythmias Amitriptyline is not suitable in this case. There are also precautions with pregabalin and gabapentin, for example, in cases of heart failure. Please list all medical conditions in the questionnaire. The doctor will decide.
  3. 3 If you are taking opioids, sleeping pills or tranquilizers, or have had problems with addiction in the past Pregabalin and gabapentin can be addictive and, when used with sedatives, can slow breathing. In such cases, particularly careful monitoring is necessary. The doctor will decide.
  4. 4 If you are pregnant, breastfeeding, or could become pregnant For all three active ingredients, a careful assessment of benefits and risks is necessary; in the case of pregabalin, this includes effective contraception. Your doctor will decide whether treatment is suitable for you.

Diese Hinweise helfen bei der Orientierung und ersetzen keine ärztliche Beratung. Ob und welche Behandlung für Sie geeignet ist, entscheidet der Arzt anhand Ihres Fragebogens.This guidance helps you get your bearings and does not replace medical advice. Whether a treatment is suitable for you, and which one, is decided by the doctor on the basis of your questionnaire.Ces indications vous aident à vous orienter et ne remplacent pas un avis médical. C’est le médecin qui décide, sur la base de votre questionnaire, si un traitement vous convient et lequel.Deze aanwijzingen helpen u op weg en vervangen geen medisch advies. Of en welke behandeling voor u geschikt is, bepaalt de arts aan de hand van uw vragenlijst.

Gabapentinoids

Pregabalin and gabapentin dampen hypersensitive nerve cells and are taken several times throughout the day.

Pregabalin RezeptpflichtigPrescription onlySur ordonnanceUitsluitend op recept

Lyrica (Pregabalin)

Pregabalin capsules for nerve pain, also approved for use in epilepsy and generalized anxiety disorder.

WirkeintrittOnsetDélai d’actionWerkingsaanvang
Studies show a reduction in pain starting in the first week.
WirkdauerDurationDurée d’actionWerkingsduur
a few hours, therefore 2 to 3 incomes daily
FormFormFormeVorm
Hard capsules

So wirkt es:How it works:Mode d’action :Zo werkt het: Pregabalin binds to a subunit of certain calcium channels on nerve cells in the brain and spinal cord. This dampens overactive nerve cells that transmit pain signals. The dose is usually increased gradually at the beginning.

Das kann für Sie passenThis may suit youCela peut vous convenirDit kan bij u passen
  • If you have been medically diagnosed with nerve pain
  • If there is or was no dependence on alcohol, medication or drugs
  • If there is no pregnancy and reliable contraception is used in case of possible pregnancy
Anwendung & wichtige HinweiseUse & important informationUtilisation et informations importantesGebruik en belangrijke aandachtspunten

Anwendung:Use:Utilisation :Gebruik: The capsules are taken 2 or 3 times daily, with or without food. The treatment is discontinued gradually over at least one week.

Verfügbare Stärken:Available strengths:Dosages disponibles :Beschikbare sterktes: 25 mg · 75 mg

Pregabalin can be addictive, cause dizziness and fatigue, and, when taken with opioids, sedatives, or alcohol, can depress breathing. Do not stop taking it abruptly. Women who could become pregnant should use effective contraception.

abfromà partir devanaf 43,88 € Endpreis, inkl. ärztlicher PrüfungFinal price, incl. medical reviewPrix final, évaluation médicale incluseEindprijs, incl. medische beoordeling
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Gabapentin RezeptpflichtigPrescription onlySur ordonnanceUitsluitend op recept

Gabapentin

Gabapentinoid for peripheral nerve pain, for example in diabetic neuropathy or after shingles.

WirkdauerDurationDurée d’actionWerkingsduur
Half-life approximately 5 to 7 hours
FormFormFormeVorm
Tablets

So wirkt es:How it works:Mode d’action :Zo werkt het: Gabapentin binds to a subunit of certain calcium channels on nerve cells, thereby reducing the transmission of pain signals. Hypersensitive nerves are dampened. The drug is excreted unchanged via the kidneys.

Das kann für Sie passenThis may suit youCela peut vous convenirDit kan bij u passen
  • When peripheral nerve pain has been medically diagnosed
  • If there are no problems with alcohol, medication, or drugs
  • If no opioids or strong sedatives are taken
Anwendung & wichtige HinweiseUse & important informationUtilisation et informations importantesGebruik en belangrijke aandachtspunten

Anwendung:Use:Utilisation :Gebruik: Tablets for oral administration, usually three times a day, spaced throughout the day. The dose is gradually increased at the beginning and slowly reduced at the end.

Verfügbare Stärken:Available strengths:Dosages disponibles :Beschikbare sterktes: 100 mg

It can be addictive and is not stopped abruptly. When used with opioids, alcohol, or sedatives, it can dangerously suppress breathing.

abfromà partir devanaf 51,48 € Endpreis, inkl. ärztlicher PrüfungFinal price, incl. medical reviewPrix final, évaluation médicale incluseEindprijs, incl. medische beoordeling
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Tricyclic antidepressants

Amitriptyline is used to treat pain in low doses and is usually taken once daily in the evening.

Amitriptyline RezeptpflichtigPrescription onlySur ordonnanceUitsluitend op recept

Amitriptylin

Low-dose tricyclic antidepressant for nerve pain and for the prevention of migraine and tension headaches.

WirkeintrittOnsetDélai d’actionWerkingsaanvang
Relief from pain usually takes 2 to 4 weeks.
FormFormFormeVorm
Film-coated tablets

So wirkt es:How it works:Mode d’action :Zo werkt het: Amitriptyline inhibits the reuptake of the neurotransmitters norepinephrine and serotonin and blocks certain ion channels on nerve cells. This reduces the transmission of pain signals. Its pain-relieving effect is independent of its antidepressant effect.

Das kann für Sie passenThis may suit youCela peut vous convenirDit kan bij u passen
  • If nerve pain has been medically diagnosed
  • If no heart attack, coronary artery disease, or cardiac arrhythmia is known
  • If no MAO inhibitors are taken
Anwendung & wichtige HinweiseUse & important informationUtilisation et informations importantesGebruik en belangrijke aandachtspunten

Anwendung:Use:Utilisation :Gebruik: Film-coated tablets for oral administration, usually once daily in the evening. Treatment begins with a low dose, is gradually increased, and finally discontinued slowly.

Verfügbare Stärken:Available strengths:Dosages disponibles :Beschikbare sterktes: 10 mg · 25 mg · 50 mg

Not for use after a heart attack, in cases of cardiac arrhythmia, or in combination with MAOIs. Life-threatening in large quantities; seek immediate medical attention if you have thoughts of self-harm.

abfromà partir devanaf 36,28 € Endpreis, inkl. ärztlicher PrüfungFinal price, incl. medical reviewPrix final, évaluation médicale incluseEindprijs, incl. medische beoordeling
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RatgeberGuideGuideGids

What you should know about nerve pain

Nerve pain arises from damage to or disease of the nerves themselves. Medications can alleviate the symptoms, but they do not replace the diagnosis and treatment of the underlying cause.

What is nerve pain?

Nerve pain (neuropathic pain) occurs when nerves themselves are damaged or no longer function properly. Common causes include:

  • Nerve damage caused by diabetes (diabetic polyneuropathy)
  • Persistent pain after shingles (post-herpetic neuralgia)
  • pinched nerves, as well as injuries or diseases of the spinal cord and brain

Typical symptoms include burning, stabbing, or electric-shock-like pain, tingling, numbness, or hypersensitivity even to light touch. The symptoms often affect the feet and hands and are frequently worse at night. Common painkillers like ibuprofen usually provide little relief.

Which medications are suitable?

Different medications are used to treat nerve pain than ordinary pain. These medications suppress the overactive transmission of pain signals.

  • Pregabalin (Lyrica): in peripheral and central nerve pain
  • Gabapentin: in cases of peripheral nerve pain, such as in diabetes or after shingles
  • Amitriptyline: a tricyclic antidepressant, used in low doses for pain relief

All three medications are started with a gradual increase in dosage and are not abruptly discontinued. The goal is usually noticeable relief, not complete pain freedom. Which active ingredient is suitable depends on the cause, pre-existing conditions, and other medications being taken.

Side effects and cautions

Common side effects include dizziness, fatigue, and drowsiness, especially at the beginning of treatment and after a dose increase. Pregabalin and gabapentin can also cause fluid retention and weight gain, while amitriptyline can cause dry mouth and constipation.

Pregabalin and gabapentin can be addictive. When used with opioids, sedatives, or alcohol, they can dangerously suppress breathing. A lower dose is necessary in patients with impaired kidney function. Amitriptyline is not suitable after a heart attack, in cases of cardiac arrhythmias, or when used with MAOIs; even a few extra tablets can be life-threatening.

As long as it is unclear how you will tolerate the treatment, it is best not to drive a car.

When should you seek immediate medical attention?

Call emergency services immediately on 112 (Switzerland: 144) if:

  • when breathing becomes slow or shallow, or when someone is almost impossible to keep awake
  • Swelling of the face, lips or tongue, or shortness of breath occurs
  • Significantly more tablets or capsules were taken than prescribed.
  • Sudden paralysis occurs or bladder and bowel control can no longer be achieved.

Seek immediate medical help if you have suicidal thoughts or develop a rash accompanied by fever or blisters. Consult a local doctor promptly if numbness or weakness worsens, wounds on your feet heal poorly, or nerve pain develops for no known reason.

In everyday life

Coping well with nerve pain

Treating nerve pain often requires patience. The dose is adjusted slowly, and it frequently takes several weeks before the effect can be assessed. A pain diary helps to track the progress: Note the intensity and type of pain, sleep patterns, side effects, and the dose taken. This provides a good basis for discussion with your doctor.

  • If you have diabetes, aim for well-controlled blood sugar levels and check your feet daily for injuries.
  • It's best to avoid alcohol, as it can damage nerves and increase fatigue and dizziness.
  • Schedule regular exercise and physiotherapy, and especially at the beginning, get up slowly to avoid falls.

Do not stop taking your medication on your own, even if you feel better. Instead, discuss a gradual discontinuation with your doctor. More information on blood sugar: Diabetes type 2. Our online doctor answers general questions..

Zu den BehandlungsoptionenView treatment optionsVoir les options de traitementNaar de behandelopties

AblaufHow it worksDéroulementWerkwijze

In vier Schritten zur BehandlungFour steps to your treatmentEn quatre étapes vers votre traitementIn vier stappen naar uw behandeling

Ärztlich geprüft, diskret und ohne Wartezimmer.Reviewed by a doctor, discreet and without a waiting room.Examiné par un médecin, discret et sans salle d’attente.Door een arts beoordeeld, discreet en zonder wachtkamer.

  1. 1Behandlung wählenChoose a treatmentChoisir un traitementBehandeling kiezenWählen Sie Ihr Anliegen und das gewünschte Präparat oder stellen Sie eine allgemeine Anfrage.Choose your concern and the medicine you want, or send a general request.Choisissez votre problème et le médicament souhaité, ou envoyez une demande générale.Kies uw klacht en het gewenste middel, of stuur een algemene aanvraag.
  2. 2Fragebogen ausfüllenFill in the questionnaireRemplir le questionnaireVragenlijst invullenDie medizinischen Fragen beantworten Sie online, vertraulich und in Ruhe.You answer the medical questions online, confidentially and at your own pace.Vous répondez aux questions médicales en ligne, en toute confidentialité et à votre rythme.U beantwoordt de medische vragen online, vertrouwelijk en in alle rust.
  3. 3Ärztliche PrüfungMedical reviewÉvaluation médicaleMedische beoordelingEin zugelassener Arzt prüft Ihre Angaben. Ist die Behandlung nicht geeignet, erhalten Sie Ihr Geld zurück.A licensed doctor reviews your answers. If the treatment is not suitable, you get your money back.Un médecin agréé examine vos réponses. Si le traitement ne convient pas, vous êtes remboursé.Een bevoegde arts beoordeelt uw gegevens. Is de behandeling niet geschikt, dan krijgt u uw geld terug.
  4. 4Diskreter VersandDiscreet deliveryLivraison discrèteDiscrete verzendingNach Ausstellung des Rezepts versendet eine EU-Partnerapotheke Ihr Arzneimittel meist innerhalb eines Werktages.Once the prescription has been issued, an EU partner pharmacy usually sends your medicine within one working day.Une fois l’ordonnance établie, une pharmacie partenaire de l’UE expédie votre médicament généralement sous un jour ouvré.Na het uitschrijven van het recept verstuurt een EU-partnerapotheek uw geneesmiddel meestal binnen één werkdag.

Häufige FragenFrequently asked questionsQuestions fréquentesVeelgestelde vragen

Questions about the treatment of nerve pain

Haben Sie eine andere Frage? Unsere Ärzte und unser Service-Team helfen Ihnen gerne weiter.Have another question? Our doctors and our service team will be glad to help.Vous avez une autre question ? Nos médecins et notre équipe de service vous aident volontiers.Heeft u een andere vraag? Onze artsen en ons serviceteam helpen u graag verder.

Frage an einen ArztAsk a doctorPoser une question à un médecinVraag stellen aan een arts
Do I need a prescription for these medications?

Yes. Pregabalin, gabapentin, and amitriptyline are prescription-only medications. A licensed physician will review your questionnaire to determine if a prescription is medically appropriate. Therefore, please provide complete information about any pre-existing conditions, other medications, alcohol consumption, and previous substance abuse problems. If you are currently receiving treatment, details of your current dosage and a doctor's letter will be helpful.

This varies. The dose is increased gradually at the beginning, so the effect can often only be assessed after a few weeks. With amitriptyline, the pain usually subsides after 2 to 4 weeks. With pregabalin, studies have sometimes shown improvement as early as the first week. Do not stop taking the medication prematurely, but talk to your doctor.

Amitriptyline is an antidepressant, but it is used in significantly lower doses for nerve pain. Its pain-relieving effect is independent of its effect on mood. Therefore, a prescription does not imply that depression is suspected. Because amitriptyline causes drowsiness, it is usually taken in the evening. Treatment for depression should be part of an existing primary care or specialist's care.

Yes, both active ingredients can be addictive even at the prescribed dose. Therefore, never take more or for a longer time than prescribed. Treatment should only be discontinued after consulting a doctor and then gradually. When taken with opioids, sleeping pills, tranquilizers, or alcohol, breathing can be dangerously suppressed. Therefore, list all medications on the questionnaire, including over-the-counter drugs.

In that case, no prescription will be issued and you will receive a full refund of all payments made. If the nerve pain has not yet been medically diagnosed, we recommend having the cause examined by a local doctor as soon as possible. In case of warning signs such as shortness of breath, sudden paralysis, or suicidal thoughts, call emergency services immediately at 112.

Medizinische ExpertiseMedical expertiseExpertise médicaleMedische expertise

Jede Anfrage in ärztlichen HändenEvery request in a doctor’s handsChaque demande entre des mains médicalesElke aanvraag in medische handen

Dr. Viktor Simunovic
Medizinischer GutachterMedical assessorMédecin évaluateurMedisch beoordelaarDr. Viktor SimunovicAllgemeinmedizin & digitale GesundheitGeneral medicine & digital healthMédecine générale et santé numériqueHuisartsgeneeskunde en digitale zorg
Dr. Codruta Anca Pandalache
Medizinische GutachterinMedical assessorMédecin évaluatriceMedisch beoordelaarDr. Codruta Anca PandalacheReproduktionsmedizin & FrauengesundheitReproductive medicine & women’s healthMédecine de la reproduction et santé des femmesVoortplantingsgeneeskunde en vrouwengezondheid
Lernen Sie unsere Ärzte kennenMeet our doctorsFaites connaissance avec nos médecinsMaak kennis met onze artsenHintergrund, Erfahrung und FachgebieteBackground, experience and specialismsParcours, expérience et spécialitésAchtergrond, ervaring en vakgebieden

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