A Retrospective Study of Topical Lidocaine 5% Plasters in Chronic Off-Label Pain Conditions

Dear Editor,

Among many formulations, lidocaine (lignocaine) is available in a transdermal plaster (patch) containing 5% w/w lidocaine (Versatis®, trademark of Grünenthal GmbH used by Seqirus as an authorized user). This formulation is approved for symptomatic treatment of neuropathic pain associated with herpes zoster infection (post-herpetic neuralgia); thus, use of these plasters for other pain conditions is considered off-label.

The use of lidocaine 5% plasters (L5%P) in off-label indications has been explored in a limited number of small studies. Currently, L5%P are recommended as a second-line treatment for neuropathic pain in a systematic review by Finnerup et al., limited by weak evidence [1]. A number of small-scale studies show possible efficacy in various neuropathic [2, 3] and nociceptive [4] pain conditions. These studies also demonstrate a favorable safety profile of transdermal lidocaine; therefore, L5%P may be a suitable treatment for the elderly, those intolerant to other therapies, and patients taking medications with the potential for drug–drug interactions.