Skip to main page content
Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2017 Feb 27;10:469-473.
doi: 10.2147/JPR.S129749. eCollection 2017.

Topical Phenytoin for the Treatment of Neuropathic Pain

Free PMC article

Topical Phenytoin for the Treatment of Neuropathic Pain

David J Kopsky et al. J Pain Res. .
Free PMC article


We developed and tested a new putative analgesic cream, based on the anticonvulsant phenytoin in patients suffering from treatment refractory neuropathic pain. The use of commercial topical analgesics is not widespread due to the facts that capsaicin creams or patches can give rise to side effects, such as burning, and analgesic patches (e.g., lidocaine 5% patches) have complex handling, especially for geriatric patients. Only in a few countries, compounded creams based on tricyclic antidepressants or other (co-)analgesics are available. Such topical analgesic creams, however, are easy to administer and have a low propensity for inducing side effects. We, therefore, developed a new topical cream based on 5% and 10% phenytoin and described three successfully treated patients suffering from neuropathic pain. All patients were refractory to a number of other analgesics. In all patients, phenytoin cream was effective in reducing pain completely, without any side effects, and the tolerability was excellent. The onset of action of the phenytoin creams was within 30 minutes. Phenytoin cream might become a new treatment modality of the treatment of neuropathic pain.

Keywords: analgesia; chemotherapy-induced polyneuropathy; diabetic neuropathy; drug repositioning; neuropathic pain; phenytoin; topical administration.

Conflict of interest statement

Disclosure The authors are holders of two patents: 1) topical phenytoin for use in the treatment of peripheral neuropathic pain and 2) topical pharmaceutical composition containing phenytoin and a (co-)analgesic for the treatment of chronic pain. The authors report no other conflicts of interest in this work.

Similar articles

See all similar articles

Cited by 6 articles

See all "Cited by" articles


    1. Jensen MP, Chodroff MJ, Dworkin RH. The impact of neuropathic pain on health-related quality of life: review and implications. Neurology. 2007;68(15):1178–1182. - PubMed
    1. Lukas K, Edte A, Bertrand I. The impact of herpes zoster and post-herpetic neuralgia on quality of life: patient-reported outcomes in six European countries. Z Gesundh Wiss. 2012;20(4):441–451. - PMC - PubMed
    1. Cheng JK, Ji RR. Intracellular signaling in primary sensory neurons and persistent pain. Neurochem Res. 2008;33(10):1970–1978. - PMC - PubMed
    1. Baron R, Hans G, Dickenson AH. Peripheral input and its importance for central sensitization. Ann Neurol. 2013;74(5):630–636. - PubMed
    1. Sawynok J. Topical analgesics for neuropathic pain: preclinical exploration, clinical validation, future development. Eur J Pain. 2014;18(4):465–481. - PubMed

LinkOut - more resources