I have very painful peripheral neuropathy. I have been on many antiretrovirals for about 10 years (including the usual suspects (DDI, D4T, dapsone to name only a few PN meds). I am adequately VL suppressed on D4t, 3TC, Fortavase and Ritonavir. I have tried many differ treatments for neuropathy and have just come off of Elavil. Wow was that addictive. I wish to use external pharmacologic approaches and am looking into acupuncture etc. I have heard of Voltaren Cream available in the US. How well does it work? How can I get it? (I am a Canadian and no one here knows about it.) Is it over the counter or by prescription?

Thanks for you help.

Greg

Greg,

I have not used Voltaren cream for anything (there is a solution available here for use in the eyes) so I can't be too helpful. Capsaicin cream can be of some use for peripheral neuropathy. Substituting off the D4T to something like Ziagen could be helpful. Use of L-acetyl carnitine and B vitamins, Ca, and Mg (some add co-Enzyme Q to that) has helped resulted in anecdotal benefit. Neurotin is also is widespread use in the US for peripheral neuropathy with fair results. Keith Henry, M.D.