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Q: My husband, 79, was recently diagnosed with shingles, and the doctor prescribed Acyclovir. Calamine lotion seems to be helping with the discomfort of the rash and blisters. The ibuprofen helps a little for pain during the day but not at night. The pain is so bad he doesn't get any sleep. Is there any other pain medication that will help nerve pain at night or maybe an OTC sleep aid?
A: The pain due to shingles is very severe and difficult to bear. However, there are a number of remedies for a very effective pain control that can help him in this situation.
These are prescription medications which can help as nerve soothers: gabapentin, pregabalin, and carbamazepine. Other strong pain medications like tramadol, oxycodone and hydrocodone can also be taken either alone or in combination with the other drugs I just mentioned.
Topical analgesics like aspirin and lidocaine can also be sued (in the form of creams) only if the sores are not open or secondarily infected.
A few studies have also shown a beneficial role of intrathecal, epidural nerve blocks, and percutaneous electrical nerve stimulation.
Sleep medications are not going to help at this point unless the pain is controlled. You can discuss these options with his physician and ask for a prescription for these drugs.
At home, he can add Tylenol to the treatment right now along with ibuprofen and both working together can provide a better pain relief than ibuprofen alone. (You can take them together -- one each every 6 hours.)
-- Answer from Dr. Sohaib, a medical internist on JustAnswer.
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