The lidocaine 5% medicated plaster (Versatis) is a topical analgesic, indicated for the symptomatic relief of neuropathic pain associated with previous herpes zoster infection (i.e. postherpetic neuralgia [PHN]) in adults. The lidocaine 5% medicated plaster has a direct local action with low systemic exposure and is effective in the treatment of patients with PHN. Limited data, from a study in patients with PHN or painful diabetic neuropathy, show that short-term treatment with lidocaine 5% medicated plaster was associated with numerically higher pain intensity response rates than pregabalin in the PHN subgroup. The efficacy of the lidocaine 5% medicated plaster was maintained in the longer term. Additionally, the lidocaine 5% medicated plaster was well tolerated, with application site reactions being the most commonly reported drug-related adverse events; drug-related adverse events were few, and most were of mild to moderate severity. Due to its low systemic exposure, the drug may be of particular advantage in the treatment of patients with a low tolerance for adverse events, or who are receiving concomitant drugs that may otherwise result in drug interactions. Thus, the lidocaine 5% medicated plaster is a useful first-line option for the treatment of patients with PHN.