�The medicated pain relief plaster,
(Versatis) is now approved by the Scottish Medicines Consortium (SMC) for
restricted use within NHS Scotland for patients suffering pain following
shingles(1) http://www.scottishmedicines.org.uk/smc/5850.hypertext markup language. This
reversal of the previous SMC decision (issued in February 2007) for
Versatis (5% lidocaine medicated plaster) is based on significant new
clinical and cost-effectiveness relative data and brings prescribing
availability of the treatment in bloodline with England and Wales. These new
data on Versatis testament be presented for the first time at the International
Association for the Study of Pain (IASP) Congress in Glasgow (17-22 August
2008).
The pain in the neck that persists for more than trinity months after the oncoming of
the shingles rash is called Post-herpetic Neuralgia (PHN) (2). PHN affects
approximately 200,000 people in the UK(3). PHN can be described as an
constant burning, stabbing or shooting pain. The pain can start several
weeks or even months after the shingles blizzard has bygone and potty continue for
weeks, months or old age(4).
Licensed in the UK in 2007, Versatis offers sustained pain relief
associated with PHN(5). Versatis is an innovative combination of local
analgesic lidocaine and a soft hydrogel plaster. Application of the plaster
to the tegument releases an appropriate grade of lidocaine into the skin to
impair the transfer of signals which would be associated with the
perception of hurting.
Based on clinical test data, Versatis is used as a continuous
once-daily 12 hours on/12 hours off applications programme schedule for 2-4 weeks and
provides rapid and continuous nuisance relief from 30 transactions after
application(6).
Dr Michael Serpell, Consultant and Senior Lecturer in Anaesthesia,
Glasgow says: "The newfangled recommendation from the SMC is to be welcomed. New
information supporting the role of Versatis in post-herpetic neuralgy will
farther establish that such a novel, non-systemic treatment approach shot offers
significant benefits in the old patient mathematical group who lose co-morbidities
and consequential polypharmacy".
Heather Wallace, Chairman of Pain Concern commented: "The SMC is to be
congratulated on its revised decision for Versatis. They've taken a huge
step forward in extending options for pain relief for people living with
neuropathic pain. This decision will alleviate a lot of suffering".
The risk of developing PHN increases with age - it is most vulgar in
people aged over 50. About half of shingles cases affecting hoi polloi of the
age of 65 will cause PHN(7,8).
Prescribing Information
Versatis 5% medicated plaster. Refer to the Summary of Product
Characteristics (SPC) for full inside information on side effects, warnings and
contra-indications before prescribing. Presentation: Versatis is a
medicated plaster (10cm x 14cm) containing 700 mg (5% w/w) of lidocaine in
an aqueous adhesive base. Indication: Treatment of neuropathic botheration
associated with previous herpes virus zoster infection (post-herpetic neuralgia,
PHN). Dosage and method of organisation: Adults and elderly patients: Use
up to three plasters for up to 12 hours, followed by at least a 12 hour
plaster-free interval. Cover painful area once casual. Apply the plaster to
intact, dry, non-irritated skin (after healing of the shingles). Remove
hairs in affected region with scissors (do not shave). Remove the beplaster
from sachet and its surface line drive before applying immediately to the skin.
Plasters may be cut to size. Patients under 18 years: Not recommended.
Contra-indications: Hypersensitivity to fighting substance, any excipients,
or local anaesthetics of amide type (e.g. bupivacaine, etidocaine,
mepivacaine and prilocaine). Warnings and precautions: Do not enforce to
inflamed or injured skin (e.g. active herpes zoster lesions, atopic
dermatitis or wounds), mucous membranes or the eyes. Plasters control
propylene ethylene glycol which english hawthorn cause skin irritation, methyl radical
parahydroxybenzoate and propyl parahydroxybenzoate which crataegus oxycantha cause allergic
reactions. Use with cautiousness in patients with severe cardiac impairment,
severe renal impairment or severe liverwort impairment. Interactions: No
clinically relevant interactions have been observed in clinical studies.
Absorption of lidocaine from the skin is low. Use with caution in patients
receiving Class I antiarrhythmic drugs (e.g. tocainide, mexitil) or
other local anaesthetics. Pregnancy and lactation: Do not use during
maternity or nursing. Undesirable effects: Very uncouth (greater than
or equal to 10%): administration website reactions (e.g. erythema, rash,
pruritus, burning). Uncommon (>0.1%-less than or equal to 1%): skin injury,
skin lesion. Very rare (less than or equal to 0.01%) but potentially
serious: anaphylaxis, hypersensitivity. Adverse reactions were
predominantly of mild and moderate loudness. Systemic adverse reactions
are unlikely. See SPC for full inside information. Overdose: Unlikely. If suspected,
remove plasters, provide supportive treatment (escort SPC). Legal
classification: POM. Marketing Authorisation number, pack sizes and basic
NHS cost: PL 21727/0016, 30 plasters (GBP 72.40). Marketing Authorisation
Holder: Grunenthal Ltd, Regus Lakeside House, 1 Furzeground Way, Stockley
Park East, Uxbridge, Middlesex, UB11 1BD, UK. Date of text: June 2008.
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References:
1) Scottish Medicines Consortium, NHS Scotland, web site:
http://www.herpes.org.uk/shingles/index.hypertext mark-up language
2) Cunningham, A. and Dworkin, R. (2000) The Management of
post-herpetic neuralgia. BMJ 321, 778-779
3) Shingles Support Society. Bowsher D. Treatment of post-herpetic
neuralgia in the elderly. Available at:
http://www.herpes.org.uk/shingles/index.hypertext markup language
4) Herpes Viruses Association. Available at: http://www.herpes.org.uk
5) Versatis Summary of Product Characteristics
6) Baron R et al. Abstract presented at the Congress of the
European Federation of IASP Chapter, Istanbul 2006
7) Shingles Support Society. Bowsher D. Treatment of post-herpetic
neuralgia in the elderly. Available at:
hTTP://www.herpes.org.uk/shingles/index.html
8) http://cks.library.nhs.
