Adults ≥50 years with a clinical diagnosis of herpes zoster presenting <144 hours of rash onset.
Adults ≥50 years, with a clinical diagnosis of HZ, rash onset <144 hours
There are limited data available to quantify terms such as prolonged, recent, significant or severe; so it is within the prescriber’s clinical judgement
- Third or more episode of herpes zoster
- Known adverse reaction to amitriptyline or contraindications (monoamine oxidase inhibitors)
- Current/recent (within previous two weeks) use of a tricyclic antidepressant
- Prolonged Q-T interval or concomitant drugs that prolong the QT interval
- Suicidal ideation
- Heart block
- Recent (within 4 weeks) myocardial infarction
- Immunosuppressiona
- Significant bradycardia
- Uncompensated heart failure
- Hyperthyroidism
- Severe liver disease
- Phaeochromocytoma
- Urinary retention
- If female, current or planned (in the next 3 months) pregnancy or breast-feeding
- Currently (or recently, within the previous 4 months) enrolled in another CTIMP
- Inability to provide informed consent and complete study assessments/questionnaires
a Immunosuppression defined as:
Due to disease or treatment, including:
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- patients undergoing chemotherapy leading to immunosuppression
- patients undergoing radical radiotherapy
- recipient of solid organ, bone marrow or stem cell transplants
- HIV infection
- haematological malignancy, including leukaemia, lymphoma, and myeloma
- genetic disorders affecting the immune system (e.g. IRAK-4, NEMO, complement disorder, SCID).
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Individuals receiving immunosuppressive or immunomodulating biological therapy, including:
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- anti-TNF, alemtuzumab, ofatumumab, rituximab
- protein kinase inhibitors or PARP inhibitors
- sparing agents such as cyclophosphamide and mycophenolate mofetil
- systemic steroids for more than a month at a dose equivalent to prednisolone at 20mg or more per day for adults.
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