amitriptyline in the treatment of post-herpetic neuralgia

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The dose of amitriptyline used in the treatment of PHN is determined by the age and/or frailty of the patient:

  • robust or patients under 65 years:
    • initial dose is 25 mg nocte which may be increased , in weekly increments, by 25 mg per day, until pain pain relief is achieved or side effects become intolerable
    • patients rarely require more than 75 mg daily

  • frail or patients over 65 years:
    • initial dose is 10 mg nocte which may be increased, in weekly increments, by 10 mg per day, according to the criteria described above


  • Whitaker M (1995). Varicella-zoster virus infections (VZV) and their management. Clinical virology, April, 8-12.

Last reviewed 04/2021