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Table 16 Drugs used by specialists in trigeminal neuralgia prophylaxis

From: Aids to management of headache disorders in primary care (2nd edition)

First line:
 • Carbamazepine 200–2400 mg daily
 • Oxcarbazepine 600–2400 mg daily
These drugs:
 • reduce efficacy of oral contraceptives;
 • may induce hyponatraemia (especially oxcarbazepine): regular monitoring is advised;
 • Mmay induce osteoporosis in long-term treatment: prophylaxis against this is advised
Second-line (either as monotherapy or as add-on medication):
 • Gabapentin 600–3600 mg daily
 • Pregabalin 150–600 mg daily
 • Lamotrigine 200–1000 mg daily (very slow up-titration necessary)