Carpal Tunnel Syndrome

Disease overview

Alterations

Molecular (A)

Clinical (B–E)

Trial outcome measures (T)

Direct drugs

Via biomarker

105

Natural agents

Natural products

Merged ranked

146

With trial/literature evidence

Sources: Open Targets, HPO, ClinicalTrials.gov, DGIdb, ChEMBL, PubMed Literature, Seeds, Examine.com · Pipeline phase 7 · Updated 2026-10-15

Remission & chronicity

Spontaneous remission

Mild CTS: spontaneous resolution in 30-40% within 12 months without treatment; moderate-severe: <5% spontaneous resolution; pregnancy-related CTS resolves in 80% post-delivery

Best-intervention remission

Surgical decompression (carpal tunnel release, CTR): 90% symptom resolution at 12 months; 85% satisfaction at 5 years; superior to splinting at 6 months (SEVIORAL trial); corticosteroid injection: 75% improvement at 4 weeks, 50% at 6 months, 20% at 12 months

Drug-free remission

—

Relapse after remission

—

Chronicity

—

Gap size

Small — surgery is highly effective; the question is appropriate timing and selecting patients for non-surgical management

Primary barrier

practice/framing

Barrier detail: Surgery is underused in some health systems where patients are kept on conservative management (splinting, cortisone) for years with progressive nerve damage; conversely, overused in mild cases where non-surgical management could suffice; ergonomic intervention is chronically under-addressed

Last SoC change: 2016 — AAOS CTS guideline updated; surgical release remains gold standard since 1970s; endoscopic vs open technique evidence established 2000s; no paradigm change

Remission data layers: disease_db_100 · source-locked manual data · confidence: high

Identifiers: MONDO: MONDO:0007275

Alterations

71 total · Types A (molecular) through E (functional). Molecular rows are Open Targets gene–disease associations (evidence column = OT association score), not measured levels; phenotypes are HPO terms annotated directly to this disease (Monarch); type T rows are outcome measures used in completed ClinicalTrials.gov studies, not alterations of the disease.

Hide alterations without a value (no direction or frequency)

Name	Type	Subtype	Direction	Frequency	Evidence	Sources	Links
COMP cartilage oligomeric matrix protein	Molecular	Gene	—	—	OT score 0.56	Open Targets	UniProt Ensembl Open Targets
ADAMTS17 ADAM metallopeptidase with thrombospondin type 1 motif 17	Molecular	Gene	—	—	OT score 0.56	Open Targets	UniProt Ensembl Open Targets
ADAMTS10 ADAM metallopeptidase with thrombospondin type 1 motif 10	Molecular	Gene	—	—	OT score 0.53	Open Targets	UniProt Ensembl Open Targets
EFEMP1 EGF-like fibulin extracellular matrix protein 1	Molecular	Gene	—	—	OT score 0.50	Open Targets	UniProt Ensembl Open Targets
ITGB5 integrin subunit beta 5	Molecular	Gene	—	—	OT score 0.49	Open Targets	UniProt Ensembl Open Targets
FTO FTO alpha-ketoglutarate dependent dioxygenase	Molecular	Gene	—	—	OT score 0.46	Open Targets	UniProt Ensembl Open Targets
ADAMTS14 ADAM metallopeptidase with thrombospondin type 1 motif 14	Molecular	Gene	—	—	OT score 0.42	Open Targets	UniProt Ensembl Open Targets
LOXL1 lysyl oxidase like 1	Molecular	Gene	—	—	OT score 0.41	Open Targets	UniProt Ensembl Open Targets
BMP2 bone morphogenetic protein 2	Molecular	Gene	—	—	OT score 0.40	Open Targets	UniProt Ensembl Open Targets
COL11A1 collagen type XI alpha 1 chain	Molecular	Gene	—	—	OT score 0.39	Open Targets	UniProt Ensembl Open Targets
AOC1 amine oxidase copper containing 1	Molecular	Gene	—	—	OT score 0.37	Open Targets	UniProt Ensembl Open Targets
LTBP1 latent transforming growth factor beta binding protein 1	Molecular	Gene	—	—	OT score 0.36	Open Targets	UniProt Ensembl Open Targets
GLI3 GLI family zinc finger 3	Molecular	Gene	—	—	OT score 0.33	Open Targets	UniProt Ensembl Open Targets
LOXL4 lysyl oxidase like 4	Molecular	Gene	—	—	OT score 0.32	Open Targets	UniProt Ensembl Open Targets
AEBP1 AE binding protein 1	Molecular	Gene	—	—	OT score 0.32	Open Targets	UniProt Ensembl Open Targets
DMRTA1 DMRT like family A1	Molecular	Gene	—	—	OT score 0.31	Open Targets	UniProt Ensembl Open Targets
HHIPL1 HHIP like 1	Molecular	Gene	—	—	OT score 0.30	Open Targets	UniProt Ensembl Open Targets
LHX9 LIM homeobox 9	Molecular	Gene	—	—	OT score 0.30	Open Targets	UniProt Ensembl Open Targets
COL10A1 collagen type X alpha 1 chain	Molecular	Gene	—	—	OT score 0.30	Open Targets	UniProt Ensembl Open Targets
CRPPA CDP-L-ribitol pyrophosphorylase A	Molecular	Gene	—	—	OT score 0.29	Open Targets	UniProt Ensembl Open Targets
ADAMTS19 ADAM metallopeptidase with thrombospondin type 1 motif 19	Molecular	Gene	—	—	OT score 0.29	Open Targets	Ensembl Open Targets
CPSF6 cleavage and polyadenylation specific factor 6	Molecular	Gene	—	—	OT score 0.28	Open Targets	UniProt Ensembl Open Targets
AFF3 ALF transcription elongation factor 3	Molecular	Gene	—	—	OT score 0.28	Open Targets	UniProt Ensembl Open Targets
HOXD12 homeobox D12	Molecular	Gene	—	—	OT score 0.28	Open Targets	UniProt Ensembl Open Targets
HS3ST5 heparan sulfate-glucosamine 3-sulfotransferase 5	Molecular	Gene	—	—	OT score 0.28	Open Targets	UniProt Ensembl Open Targets
DPEP1 dipeptidase 1	Molecular	Gene	—	—	OT score 0.27	Open Targets	UniProt Ensembl Open Targets
LNPK lunapark, ER junction formation factor	Molecular	Gene	—	—	OT score 0.27	Open Targets	UniProt Ensembl Open Targets
AKR1C1 aldo-keto reductase family 1 member C1	Molecular	Gene	—	—	OT score 0.26	Open Targets	UniProt Ensembl Open Targets
CACNA1A calcium voltage-gated channel subunit alpha1 A	Molecular	Gene	—	—	OT score 0.26	Open Targets	UniProt Ensembl Open Targets
CACNA1B calcium voltage-gated channel subunit alpha1 B	Molecular	Gene	—	—	OT score 0.26	Open Targets	UniProt Ensembl Open Targets
CACNA1C calcium voltage-gated channel subunit alpha1 C	Molecular	Gene	—	—	OT score 0.26	Open Targets	UniProt Ensembl Open Targets
CACNA1D calcium voltage-gated channel subunit alpha1 D	Molecular	Gene	—	—	OT score 0.26	Open Targets	UniProt Ensembl Open Targets
CACNA1E calcium voltage-gated channel subunit alpha1 E	Molecular	Gene	—	—	OT score 0.26	Open Targets	UniProt Ensembl Open Targets
CACNA1F calcium voltage-gated channel subunit alpha1 F	Molecular	Gene	—	—	OT score 0.26	Open Targets	UniProt Ensembl Open Targets
CACNA1G calcium voltage-gated channel subunit alpha1 G	Molecular	Gene	—	—	OT score 0.26	Open Targets	UniProt Ensembl Open Targets
CACNA1H calcium voltage-gated channel subunit alpha1 H	Molecular	Gene	—	—	OT score 0.26	Open Targets	UniProt Ensembl Open Targets
CACNA1I calcium voltage-gated channel subunit alpha1 I	Molecular	Gene	—	—	OT score 0.26	Open Targets	UniProt Ensembl Open Targets
CACNA1S calcium voltage-gated channel subunit alpha1 S	Molecular	Gene	—	—	OT score 0.26	Open Targets	UniProt Ensembl Open Targets
CACNA2D1 calcium voltage-gated channel auxiliary subunit alpha2delta 1	Molecular	Gene	—	—	OT score 0.26	Open Targets	UniProt Ensembl Open Targets
CACNA2D2 calcium voltage-gated channel auxiliary subunit alpha2delta 2	Molecular	Gene	—	—	OT score 0.26	Open Targets	UniProt Ensembl Open Targets
CACNA2D3 calcium voltage-gated channel auxiliary subunit alpha2delta 3	Molecular	Gene	—	—	OT score 0.26	Open Targets	UniProt Ensembl Open Targets
CACNA2D4 calcium voltage-gated channel auxiliary subunit alpha2delta 4	Molecular	Gene	—	—	OT score 0.26	Open Targets	UniProt Ensembl Open Targets
CACNB1 calcium voltage-gated channel auxiliary subunit beta 1	Molecular	Gene	—	—	OT score 0.26	Open Targets	UniProt Ensembl Open Targets
CACNB2 calcium voltage-gated channel auxiliary subunit beta 2	Molecular	Gene	—	—	OT score 0.26	Open Targets	UniProt Ensembl Open Targets
CACNB3 calcium voltage-gated channel auxiliary subunit beta 3	Molecular	Gene	—	—	OT score 0.26	Open Targets	UniProt Ensembl Open Targets
CACNB4 calcium voltage-gated channel auxiliary subunit beta 4	Molecular	Gene	—	—	OT score 0.26	Open Targets	UniProt Ensembl Open Targets
CACNG1 calcium voltage-gated channel auxiliary subunit gamma 1	Molecular	Gene	—	—	OT score 0.26	Open Targets	UniProt Ensembl Open Targets
CACNG2 calcium voltage-gated channel auxiliary subunit gamma 2	Molecular	Gene	—	—	OT score 0.26	Open Targets	UniProt Ensembl Open Targets
CACNG3 calcium voltage-gated channel auxiliary subunit gamma 3	Molecular	Gene	—	—	OT score 0.26	Open Targets	UniProt Ensembl Open Targets
CACNG4 calcium voltage-gated channel auxiliary subunit gamma 4	Molecular	Gene	—	—	OT score 0.26	Open Targets	UniProt Ensembl Open Targets
CACNG5 calcium voltage-gated channel auxiliary subunit gamma 5	Molecular	Gene	—	—	OT score 0.26	Open Targets	UniProt Ensembl Open Targets
CACNG6 calcium voltage-gated channel auxiliary subunit gamma 6	Molecular	Gene	—	—	OT score 0.26	Open Targets	UniProt Ensembl Open Targets
CACNG7 calcium voltage-gated channel auxiliary subunit gamma 7	Molecular	Gene	—	—	OT score 0.26	Open Targets	UniProt Ensembl Open Targets
CACNG8 calcium voltage-gated channel auxiliary subunit gamma 8	Molecular	Gene	—	—	OT score 0.26	Open Targets	UniProt Ensembl Open Targets
ADAR adenosine deaminase RNA specific	Molecular	Gene	—	—	OT score 0.18	Open Targets	UniProt Ensembl Open Targets
FRK fyn related Src family tyrosine kinase	Molecular	Gene	—	—	OT score 0.17	Open Targets	UniProt Ensembl Open Targets
ECRG4 ECRG4 augurin precursor	Molecular	Gene	—	—	OT score 0.17	Open Targets	UniProt Ensembl Open Targets
ITIH3 inter-alpha-trypsin inhibitor heavy chain 3	Molecular	Gene	—	—	OT score 0.17	Open Targets	UniProt Ensembl Open Targets
EYA4 EYA transcriptional coactivator and phosphatase 4	Molecular	Gene	—	—	OT score 0.16	Open Targets	UniProt Ensembl Open Targets
COBLL1 cordon-bleu WH2 repeat protein like 1	Molecular	Gene	—	—	OT score 0.16	Open Targets	UniProt Ensembl Open Targets
HOXC8 homeobox C8	Molecular	Gene	—	—	OT score 0.15	Open Targets	UniProt Ensembl Open Targets
Boston Carpal Tunnel Questionnaire (BCTQ)	Trial outcome measure	Clinical scale	—	—	Trial outcome measure	ClinicalTrials.gov	—
Clinical BCTQ	Trial outcome measure	Lab value	—	—	Trial outcome measure	ClinicalTrials.gov	—
Complications	Trial outcome measure	Lab value	—	—	Trial outcome measure	ClinicalTrials.gov	—
Cross sectional area of the median nerve with ultrasonography	Trial outcome measure	Lab value	—	—	Trial outcome measure	ClinicalTrials.gov	—
Distal upper limb pain	Trial outcome measure	Clinical scale	—	—	Trial outcome measure	ClinicalTrials.gov	—
Functional BCTQ	Trial outcome measure	Lab value	—	—	Trial outcome measure	ClinicalTrials.gov	—
Grip Strength	Trial outcome measure	Functional test	—	—	Trial outcome measure	ClinicalTrials.gov	—
Hand Grip Strength	Trial outcome measure	Functional test	—	—	Trial outcome measure	ClinicalTrials.gov	—
Incidence of Pillar Pain	Trial outcome measure	Clinical scale	—	—	Trial outcome measure	ClinicalTrials.gov	—
Intensity of numbness with the Visual Analogue Scale (VAS 1-10cm)	Trial outcome measure	Clinical scale	—	—	Trial outcome measure	ClinicalTrials.gov	—

Therapeutics

Direct disease associations, biomarker-linked drugs, OSMF narrative-review natural agents, and merged ranking. Only agents with registry trials or published clinical literature are shown by default.

Show agents without direct trial evidence

Drug	Type	Phase	Evidence	Score	Price (UK / US)	Trials & literature	Sources	Links
ACETAZOLAMIDE Repurposing	Small molecule	Approved	Strong	95	UK £3–£8 / 28–56 tabs · US $8–$15 / 30 tabs	—	ChEMBL	ChEMBL Open Targets
AMITRIPTYLINE HYDROCHLORIDE Repurposing	Small molecule	Approved	Strong	95	UK £1–£3 / 28 tabs · US $4–$10 / 30 tabs	—	DGIdb	—
AMLODIPINE BENZOATE Repurposing	Small molecule	Approved	Strong	95	Varies — check openprescribing.net (UK) or costplusdrugs.com / GoodRx (US)	No indexed hits View evidence CT.gov search · Cochrane · PubMed	DGIdb	ChEMBL Open Targets
AMLODIPINE BESYLATE Repurposing	Small molecule	Approved	Strong	95	Varies — check openprescribing.net (UK) or costplusdrugs.com / GoodRx (US)	No indexed hits View evidence CT.gov search · Cochrane · PubMed	DGIdb	—
AMLODIPINE BESYLATE Repurposing	Small molecule	Approved	Strong	95	Varies — check openprescribing.net (UK) or costplusdrugs.com / GoodRx (US)	—	DGIdb	ChEMBL Open Targets
AMLODIPINE MALEATE Repurposing	Small molecule	Approved	Strong	95	Varies — check openprescribing.net (UK) or costplusdrugs.com / GoodRx (US)	No indexed hits View evidence CT.gov search · Cochrane · PubMed	DGIdb	ChEMBL Open Targets
AMPHETAMINE Repurposing	Small molecule	Approved	Strong	95	Varies — check openprescribing.net (UK) or costplusdrugs.com / GoodRx (US)	—	ChEMBL	ChEMBL Open Targets
ATENOLOL Repurposing	Small molecule	Approved	Strong	95	UK £1–£3 / 28 tabs · US $3–$8 / 30 tabs	No indexed hits View evidence CT.gov search · Cochrane · PubMed	DGIdb	—
BEPRIDIL Repurposing	Small molecule	Approved	Strong	95	Varies — check openprescribing.net (UK) or costplusdrugs.com / GoodRx (US)	—	DGIdb	—
BEPRIDIL HYDROCHLORIDE Repurposing	Small molecule	Approved	Strong	95	Varies — check openprescribing.net (UK) or costplusdrugs.com / GoodRx (US)	—	DGIdb	ChEMBL Open Targets
BICALUTAMIDE Repurposing	Small molecule	Approved	Strong	95	Varies — check openprescribing.net (UK) or costplusdrugs.com / GoodRx (US)	—	ChEMBL	ChEMBL Open Targets
BUTAMBEN Repurposing	Small molecule	Approved	Strong	95	Varies — check openprescribing.net (UK) or costplusdrugs.com / GoodRx (US)	—	DGIdb	ChEMBL Open Targets
CANNABIDIOL Repurposing	Small molecule	Approved	Strong	95	UK Varies (specialist) · US $30–$80 / 30-day (varies by product)	—	DGIdb	—
CARBACHOL Repurposing	Small molecule	Approved	Strong	95	Varies — check openprescribing.net (UK) or costplusdrugs.com / GoodRx (US)	—	ChEMBL	ChEMBL Open Targets
CELECOXIB Repurposing	Small molecule	Approved	Strong	95	Varies — check openprescribing.net (UK) or costplusdrugs.com / GoodRx (US)	1 Trial pubs 1 RCT View evidence Published literature Clinical trial publication Efficacy of Preemptive Analgesia on Tourniquet and Postoperative Pain Relief in Open Carpal Tunnel Release: A Prospective Randomized Control Trial (The Journal of hand surgery, 2023) CT.gov search · Cochrane · PubMed	DGIdb	—
CHORIOGONADOTROPIN ALFA Repurposing	Small molecule	Approved	Strong	95	Varies — check openprescribing.net (UK) or costplusdrugs.com / GoodRx (US)	No indexed hits View evidence CT.gov search · Cochrane · PubMed	DGIdb	—
CINNARIZINE Repurposing	Small molecule	Approved	Strong	95	Varies — check openprescribing.net (UK) or costplusdrugs.com / GoodRx (US)	No indexed hits View evidence CT.gov search · Cochrane · PubMed	DGIdb	—
CIPROFLOXACIN Repurposing	Small molecule	Approved	Strong	95	Varies — check openprescribing.net (UK) or costplusdrugs.com / GoodRx (US)	—	ChEMBL	ChEMBL Open Targets
CITALOPRAM Repurposing	Small molecule	Approved	Strong	95	Varies — check openprescribing.net (UK) or costplusdrugs.com / GoodRx (US)	No indexed hits View evidence CT.gov search · Cochrane · PubMed	DGIdb	—
CLEVIDIPINE Repurposing	Small molecule	Approved	Strong	95	Varies — check openprescribing.net (UK) or costplusdrugs.com / GoodRx (US)	No indexed hits View evidence CT.gov search · Cochrane · PubMed	DGIdb	—
CLOMIPRAMINE Repurposing	Small molecule	Approved	Strong	95	Varies — check openprescribing.net (UK) or costplusdrugs.com / GoodRx (US)	—	ChEMBL	ChEMBL Open Targets
CLOZAPINE Repurposing	Small molecule	Approved	Strong	95	Varies — check openprescribing.net (UK) or costplusdrugs.com / GoodRx (US)	—	DGIdb	—
DEHYDRATED ALCOHOL Repurposing	Small molecule	Approved	Strong	95	Varies — check openprescribing.net (UK) or costplusdrugs.com / GoodRx (US)	2 trials View evidence Registry trials NCT06209918 — Effect of Bioptron Light on Carpal Tunnel Syndrome(BLCTS) (UNKNOWN) NA NCT05997823 — Dorsovolar Kinesiotape in Carpal Tunnel Syndrome (COMPLETED) NA CT.gov search · Cochrane · PubMed	DGIdb	—
DIAZEPAM Repurposing	Small molecule	Approved	Strong	95	UK £1–£3 / 28 tabs · US $3–$8 / 30 tabs	—	ChEMBL	ChEMBL Open Targets
DICHLORPHENAMIDE Repurposing	Small molecule	Approved	Strong	95	Varies — check openprescribing.net (UK) or costplusdrugs.com / GoodRx (US)	—	ChEMBL	ChEMBL Open Targets
DIETHYLSTILBESTROL Repurposing	Small molecule	Approved	Strong	95	Varies — check openprescribing.net (UK) or costplusdrugs.com / GoodRx (US)	—	ChEMBL	ChEMBL Open Targets
DILTIAZEM HYDROCHLORIDE Repurposing	Small molecule	Approved	Strong	95	Varies — check openprescribing.net (UK) or costplusdrugs.com / GoodRx (US)	No indexed hits View evidence CT.gov search · Cochrane · PubMed	DGIdb	ChEMBL Open Targets
DILTIAZEM MALATE Repurposing	Small molecule	Approved	Strong	95	Varies — check openprescribing.net (UK) or costplusdrugs.com / GoodRx (US)	No indexed hits View evidence CT.gov search · Cochrane · PubMed	DGIdb	ChEMBL Open Targets
DRONEDARONE HYDROCHLORIDE Repurposing	Small molecule	Approved	Strong	95	Varies — check openprescribing.net (UK) or costplusdrugs.com / GoodRx (US)	—	DGIdb	ChEMBL Open Targets
EPIRUBICIN Repurposing	Small molecule	Approved	Strong	95	Hospital / IV specialty — prices per vial or dose (often hundreds–thousands USD/GBP)	—	ChEMBL	ChEMBL Open Targets
ESTRONE Repurposing	Small molecule	Approved	Strong	95	Varies — check openprescribing.net (UK) or costplusdrugs.com / GoodRx (US)	No indexed hits View evidence CT.gov search · Cochrane · PubMed	DGIdb	—
ETHOXZOLAMIDE Repurposing	Small molecule	Approved	Strong	95	Varies — check openprescribing.net (UK) or costplusdrugs.com / GoodRx (US)	—	ChEMBL	ChEMBL Open Targets
FELODIPINE Repurposing	Small molecule	Approved	Strong	95	Varies — check openprescribing.net (UK) or costplusdrugs.com / GoodRx (US)	No indexed hits View evidence CT.gov search · Cochrane · PubMed	DGIdb	—
FLUMAZENIL Repurposing	Small molecule	Approved	Strong	95	Varies — check openprescribing.net (UK) or costplusdrugs.com / GoodRx (US)	—	ChEMBL	ChEMBL Open Targets
GABAPENTIN Repurposing	Small molecule	Approved	Strong	95	UK £2–£5 / 28–100 tabs · US $5–$12 / 30–90 tabs	8 trials 2 Cochrane 1 Meta-analysis 5 Trial pubs 3 RCT View evidence Registry trials NCT05584839 — Statistically Analysis of Carpal Tunnel Syndrome Diagnosis (UNKNOWN) NCT04285281 — Oral Gabapentin and Median Nerve Mobilization in the Treatment of Carpal Tunnel Syndrome (COMPLETED) PHASE4 NCT00137735 — Gabapentin for Carpal Tunnel Syndrome (COMPLETED) PHASE3 NCT04025203 — Pain Reduction and Changes in Upper Limb Function Produced by Different Treatments in Carpal Tunnel Syndrome (COMPLETED) PHASE4 NCT06781489 — Pain Reduction Caused by the Combined Treatment of Physiotherapy, Oral Gabapentin and Oral Ibuprofen Arginine. (COMPLETED) PHASE4 NCT01632215 — Preoperative Gabapentine for Carpal Tunnel (COMPLETED) PHASE3 NCT00904202 — A Study Of Lidocaine Patch 5% Alone, Gabapentin Alone, And Lidocaine Patch 5% And Gabapentin In Combination For The Relief Of Pain In Patients With Diverse Peripheral Neuropathic Pain Conditions (COMPLETED) PHASE4 NCT05577676 — Hydrodissection Between Normal Saline and a Combination of Triamcinolone Acetonide, Normal Saline, and Lidocaine in CTS (COMPLETED) NA Published literature Cochrane review Efficacy and Safety of Gabapentinoids in the Treatment of Carpal Tunnel Syndrome: A Systematic Review and Meta-Analysis (The journal of hand surgery Asian-Pacific volume, 2025) Cochrane review Analgesic Efficacy of Gabapentin in Patients Undergoing Carpal Tunnel Release Surgery: A Systematic Review and Meta-Analysis of Randomized Placebo-Controlled Trials (Cureus, 2025) Clinical trial publication Efficacy of Preemptive Analgesia on Tourniquet and Postoperative Pain Relief in Open Carpal Tunnel Release: A Prospective Randomized Control Trial (The Journal of hand surgery, 2023) Clinical trial publication Effect of preoperative gabapentin on pain intensity and development of chronic pain after carpal tunnel syndrome surgical treatment in women: randomized, double-blind, placebo-controlled study (Sao Paulo medical journal = Revista paulista de medicina, 2016) Clinical trial publication Gabapentin for the treatment of carpal tunnel syndrome: a randomized controlled trial (European journal of neurology, 2011) Clinical trial publication The efficacy and safety of gabapentin in carpal tunnel patients: open label trial (Neurology India, 2009) Clinical trial publication Assessment of the efficacy of gabapentin in carpal tunnel syndrome (Journal of clinical rheumatology : practical reports on rheumatic & musculoskeletal diseases, 2008) CT.gov search · Cochrane · PubMed	DGIdb	—
GABAPENTIN ENACARBIL Repurposing	Small molecule	Approved	Strong	95	UK £2–£5 / 28–100 tabs · US $5–$12 / 30–90 tabs	8 trials View evidence Registry trials NCT05584839 — Statistically Analysis of Carpal Tunnel Syndrome Diagnosis (UNKNOWN) NCT04285281 — Oral Gabapentin and Median Nerve Mobilization in the Treatment of Carpal Tunnel Syndrome (COMPLETED) PHASE4 NCT00137735 — Gabapentin for Carpal Tunnel Syndrome (COMPLETED) PHASE3 NCT04025203 — Pain Reduction and Changes in Upper Limb Function Produced by Different Treatments in Carpal Tunnel Syndrome (COMPLETED) PHASE4 NCT06781489 — Pain Reduction Caused by the Combined Treatment of Physiotherapy, Oral Gabapentin and Oral Ibuprofen Arginine. (COMPLETED) PHASE4 NCT01632215 — Preoperative Gabapentine for Carpal Tunnel (COMPLETED) PHASE3 NCT00904202 — A Study Of Lidocaine Patch 5% Alone, Gabapentin Alone, And Lidocaine Patch 5% And Gabapentin In Combination For The Relief Of Pain In Patients With Diverse Peripheral Neuropathic Pain Conditions (COMPLETED) PHASE4 NCT05577676 — Hydrodissection Between Normal Saline and a Combination of Triamcinolone Acetonide, Normal Saline, and Lidocaine in CTS (COMPLETED) NA CT.gov search · Cochrane · PubMed	DGIdb	—
HALOPERIDOL DECANOATE Repurposing	Small molecule	Approved	Strong	95	Varies — check openprescribing.net (UK) or costplusdrugs.com / GoodRx (US)	No indexed hits View evidence CT.gov search · Cochrane · PubMed	DGIdb	—
HESPERIDIN Repurposing	Small molecule	Approved	Strong	95	Varies — check openprescribing.net (UK) or costplusdrugs.com / GoodRx (US)	—	DGIdb	—
IBUTILIDE Repurposing	Small molecule	Approved	Strong	95	Varies — check openprescribing.net (UK) or costplusdrugs.com / GoodRx (US)	—	DGIdb	—
IMIPRAMINE Repurposing	Small molecule	Approved	Strong	95	Varies — check openprescribing.net (UK) or costplusdrugs.com / GoodRx (US)	—	ChEMBL	ChEMBL Open Targets
INDAPAMIDE Repurposing	Small molecule	Approved	Strong	95	Varies — check openprescribing.net (UK) or costplusdrugs.com / GoodRx (US)	—	ChEMBL	ChEMBL Open Targets
INDOMETHACIN Repurposing	Small molecule	Approved	Strong	95	Varies — check openprescribing.net (UK) or costplusdrugs.com / GoodRx (US)	—	ChEMBL	ChEMBL Open Targets
ISOSORBIDE DINITRATE Repurposing	Small molecule	Approved	Strong	95	Varies — check openprescribing.net (UK) or costplusdrugs.com / GoodRx (US)	—	ChEMBL	ChEMBL Open Targets
ISRADIPINE Repurposing	Small molecule	Approved	Strong	95	Varies — check openprescribing.net (UK) or costplusdrugs.com / GoodRx (US)	No indexed hits View evidence CT.gov search · Cochrane · PubMed	DGIdb	—
LEVAMLODIPINE MALEATE Repurposing	Small molecule	Approved	Strong	95	Varies — check openprescribing.net (UK) or costplusdrugs.com / GoodRx (US)	—	DGIdb	ChEMBL Open Targets
LEVETIRACETAM Repurposing	Small molecule	Approved	Strong	95	Varies — check openprescribing.net (UK) or costplusdrugs.com / GoodRx (US)	—	DGIdb	—
LEVONORGESTREL Repurposing	Small molecule	Approved	Strong	95	Varies — check openprescribing.net (UK) or costplusdrugs.com / GoodRx (US)	No indexed hits View evidence CT.gov search · Cochrane · PubMed	DGIdb	—
MAFENIDE Repurposing	Small molecule	Approved	Strong	95	Varies — check openprescribing.net (UK) or costplusdrugs.com / GoodRx (US)	—	ChEMBL	ChEMBL Open Targets
MECAMYLAMINE Repurposing	Small molecule	Approved	Strong	95	Varies — check openprescribing.net (UK) or costplusdrugs.com / GoodRx (US)	—	ChEMBL	ChEMBL Open Targets
METHAZOLAMIDE Repurposing	Small molecule	Approved	Strong	95	Varies — check openprescribing.net (UK) or costplusdrugs.com / GoodRx (US)	—	ChEMBL	ChEMBL Open Targets

Drug	Type	Phase	Evidence	Score	Price (UK / US)	Sources	Links
BETAMETHASONE	Small molecule	Phase III	Moderate	80	Varies — check openprescribing.net (UK) or costplusdrugs.com / GoodRx (US)	Open Targets	ChEMBL Open Targets
BETAMETHASONE DIPROPIONATE	Small molecule	Phase III	Moderate	80	Varies — check openprescribing.net (UK) or costplusdrugs.com / GoodRx (US)	Open Targets	ChEMBL Open Targets
BETAMETHASONE SODIUM PHOSPHATE	Small molecule	Phase III	Moderate	80	Varies — check openprescribing.net (UK) or costplusdrugs.com / GoodRx (US)	Open Targets	ChEMBL Open Targets
DEXAMETHASONE	Small molecule	Phase III	Moderate	80	Varies — check openprescribing.net (UK) or costplusdrugs.com / GoodRx (US)	Open Targets	ChEMBL Open Targets
DEXTROSE	Small molecule	Phase III	Moderate	80	Varies — check openprescribing.net (UK) or costplusdrugs.com / GoodRx (US)	Open Targets	ChEMBL Open Targets
GABAPENTIN	Small molecule	Phase III	Moderate	80	UK £2–£5 / 28–100 tabs · US $5–$12 / 30–90 tabs	Open Targets	ChEMBL Open Targets
HYALURONIC ACID	Small molecule	Phase III	Moderate	80	Varies — check openprescribing.net (UK) or costplusdrugs.com / GoodRx (US)	Open Targets	ChEMBL Open Targets
HYDROCORTISONE	Small molecule	Phase III	Moderate	80	Varies — check openprescribing.net (UK) or costplusdrugs.com / GoodRx (US)	Open Targets	ChEMBL Open Targets
LIDOCAINE	Small molecule	Phase III	Moderate	80	Varies — check openprescribing.net (UK) or costplusdrugs.com / GoodRx (US)	Open Targets	ChEMBL Open Targets
METHYLPREDNISOLONE	Small molecule	Phase III	Moderate	80	UK £2–£5 / 28 tabs · US $5–$10 / 30 tabs	Open Targets	ChEMBL Open Targets
METHYLPREDNISOLONE ACETATE	Small molecule	Phase III	Moderate	80	UK £2–£5 / 28 tabs · US $5–$10 / 30 tabs	Open Targets	ChEMBL Open Targets
PREDNISOLONE	Small molecule	Phase III	Moderate	80	UK £2–£5 / 28 tabs · US $5–$10 / 30 tabs	Open Targets	ChEMBL Open Targets
PREDNISONE	Small molecule	Phase III	Moderate	80	UK £2–£5 / 28–30 tabs · US $4–$8 / 30 tabs	Open Targets	ChEMBL Open Targets
TRIAMCINOLONE	Small molecule	Phase III	Moderate	80	Varies — check openprescribing.net (UK) or costplusdrugs.com / GoodRx (US)	Open Targets	ChEMBL Open Targets
ACETYLCARNITINE	Small molecule	Phase II	Emerging	60	Varies — check openprescribing.net (UK) or costplusdrugs.com / GoodRx (US)	Open Targets	ChEMBL Open Targets
AMITRIPTYLINE	Small molecule	Phase II	Emerging	60	UK £1–£3 / 28 tabs · US $4–$10 / 30 tabs	Open Targets	ChEMBL Open Targets
BOTULINUM TOXIN TYPE A	Biologic	Phase II	Emerging	60	Varies — check openprescribing.net (UK) or costplusdrugs.com / GoodRx (US)	Open Targets	ChEMBL Open Targets
CANNABIDIOL	Small molecule	Phase II	Emerging	60	UK Varies (specialist) · US $30–$80 / 30-day (varies by product)	Open Targets	ChEMBL Open Targets
DALFAMPRIDINE	Small molecule	Phase II	Emerging	60	Varies — check openprescribing.net (UK) or costplusdrugs.com / GoodRx (US)	Open Targets	ChEMBL Open Targets
FISETIN	Small molecule	Phase II	Emerging	60	Varies — check openprescribing.net (UK) or costplusdrugs.com / GoodRx (US)	Open Targets	ChEMBL Open Targets
LETIBOTULINUMTOXINA	Small molecule	Phase II	Emerging	60	Varies — check openprescribing.net (UK) or costplusdrugs.com / GoodRx (US)	Open Targets	ChEMBL Open Targets
LIPOIC ACID, ALPHA	Small molecule	Phase II	Emerging	60	Varies — check openprescribing.net (UK) or costplusdrugs.com / GoodRx (US)	Open Targets	ChEMBL Open Targets
ONABOTULINUMTOXINA	Small molecule	Phase II	Emerging	60	Varies — check openprescribing.net (UK) or costplusdrugs.com / GoodRx (US)	Open Targets	ChEMBL Open Targets
TETRACAINE	Small molecule	Phase II	Emerging	60	Varies — check openprescribing.net (UK) or costplusdrugs.com / GoodRx (US)	Open Targets	ChEMBL Open Targets
TRIAMCINOLONE ACETONIDE	Small molecule	Phase II	Emerging	60	Varies — check openprescribing.net (UK) or costplusdrugs.com / GoodRx (US)	Open Targets	ChEMBL Open Targets
TRIAMCINOLONE HEXACETONIDE	Small molecule	Phase II	Emerging	60	Varies — check openprescribing.net (UK) or costplusdrugs.com / GoodRx (US)	Open Targets	ChEMBL Open Targets
VITAMIN B COMPLEX	Small molecule	Phase II	Emerging	60	Varies — check openprescribing.net (UK) or costplusdrugs.com / GoodRx (US)	Open Targets	ChEMBL Open Targets
HYALURONATE SODIUM	Small molecule	Phase I	Emerging	35	Varies — check openprescribing.net (UK) or costplusdrugs.com / GoodRx (US)	Open Targets	ChEMBL Open Targets
HYALURONIDASE	Small molecule	Phase I	Emerging	35	Varies — check openprescribing.net (UK) or costplusdrugs.com / GoodRx (US)	Open Targets	ChEMBL Open Targets
INSULIN HUMAN	Biologic	Phase I	Emerging	35	Varies — check openprescribing.net (UK) or costplusdrugs.com / GoodRx (US)	Open Targets	ChEMBL Open Targets
MIDAZOLAM	Small molecule	Phase I	Emerging	35	Varies — check openprescribing.net (UK) or costplusdrugs.com / GoodRx (US)	Open Targets	ChEMBL Open Targets
ROPIVACAINE	Small molecule	Phase I	Emerging	35	Varies — check openprescribing.net (UK) or costplusdrugs.com / GoodRx (US)	Open Targets	ChEMBL Open Targets
BUPIVACAINE	Small molecule	Preclinical	Emerging	15	Varies — check openprescribing.net (UK) or costplusdrugs.com / GoodRx (US)	Open Targets	ChEMBL Open Targets
CARBAMAZEPINE	Small molecule	Preclinical	Emerging	15	Varies — check openprescribing.net (UK) or costplusdrugs.com / GoodRx (US)	Open Targets	ChEMBL Open Targets
DEXMEDETOMIDINE	Small molecule	Preclinical	Emerging	15	Varies — check openprescribing.net (UK) or costplusdrugs.com / GoodRx (US)	Open Targets	ChEMBL Open Targets
EPINEPHRINE	Small molecule	Preclinical	Emerging	15	Varies — check openprescribing.net (UK) or costplusdrugs.com / GoodRx (US)	Open Targets	ChEMBL Open Targets
LIDOCAINE HYDROCHLORIDE	Small molecule	Preclinical	Emerging	15	Varies — check openprescribing.net (UK) or costplusdrugs.com / GoodRx (US)	Open Targets	ChEMBL Open Targets
MEPIVACAINE	Small molecule	Preclinical	Emerging	15	Varies — check openprescribing.net (UK) or costplusdrugs.com / GoodRx (US)	Open Targets	ChEMBL Open Targets
OZONE	Small molecule	Preclinical	Emerging	15	Varies — check openprescribing.net (UK) or costplusdrugs.com / GoodRx (US)	Open Targets	ChEMBL Open Targets
SODIUM CHLORIDE	Small molecule	Preclinical	Emerging	15	Varies — check openprescribing.net (UK) or costplusdrugs.com / GoodRx (US)	Open Targets	ChEMBL Open Targets

Drug	Type	Phase	Evidence	Score	Price (UK / US)	Trials & literature	Sources	Links
ACETAZOLAMIDE Repurposing via ADAR	Small molecule	Approved	Strong	95	UK £3–£8 / 28–56 tabs · US $8–$15 / 30 tabs	—	ChEMBL	ChEMBL Open Targets
AMITRIPTYLINE HYDROCHLORIDE Repurposing via AOC1	Small molecule	Approved	Strong	95	UK £1–£3 / 28 tabs · US $4–$10 / 30 tabs	—	DGIdb	—
AMLODIPINE BENZOATE Repurposing via CACNA1C	Small molecule	Approved	Strong	95	Varies — check openprescribing.net (UK) or costplusdrugs.com / GoodRx (US)	No indexed hits View evidence CT.gov search · Cochrane · PubMed	DGIdb	ChEMBL Open Targets
AMLODIPINE BESYLATE Repurposing via CACNA1C	Small molecule	Approved	Strong	95	Varies — check openprescribing.net (UK) or costplusdrugs.com / GoodRx (US)	No indexed hits View evidence CT.gov search · Cochrane · PubMed	DGIdb	—
AMLODIPINE BESYLATE Repurposing via CACNA1D	Small molecule	Approved	Strong	95	Varies — check openprescribing.net (UK) or costplusdrugs.com / GoodRx (US)	—	DGIdb	ChEMBL Open Targets
AMLODIPINE MALEATE Repurposing via CACNA1C	Small molecule	Approved	Strong	95	Varies — check openprescribing.net (UK) or costplusdrugs.com / GoodRx (US)	No indexed hits View evidence CT.gov search · Cochrane · PubMed	DGIdb	ChEMBL Open Targets
AMPHETAMINE Repurposing via ADAR	Small molecule	Approved	Strong	95	Varies — check openprescribing.net (UK) or costplusdrugs.com / GoodRx (US)	—	ChEMBL	ChEMBL Open Targets
ATENOLOL Repurposing via CACNA1C	Small molecule	Approved	Strong	95	UK £1–£3 / 28 tabs · US $3–$8 / 30 tabs	No indexed hits View evidence CT.gov search · Cochrane · PubMed	DGIdb	—
BEPRIDIL Repurposing via CACNA1A	Small molecule	Approved	Strong	95	Varies — check openprescribing.net (UK) or costplusdrugs.com / GoodRx (US)	—	DGIdb	—
BEPRIDIL HYDROCHLORIDE Repurposing via CACNA1C	Small molecule	Approved	Strong	95	Varies — check openprescribing.net (UK) or costplusdrugs.com / GoodRx (US)	—	DGIdb	ChEMBL Open Targets
BICALUTAMIDE Repurposing via ADAR	Small molecule	Approved	Strong	95	Varies — check openprescribing.net (UK) or costplusdrugs.com / GoodRx (US)	—	ChEMBL	ChEMBL Open Targets
BUTAMBEN Repurposing via BMP2	Small molecule	Approved	Strong	95	Varies — check openprescribing.net (UK) or costplusdrugs.com / GoodRx (US)	—	DGIdb	ChEMBL Open Targets
CANNABIDIOL Repurposing via AOC1	Small molecule	Approved	Strong	95	UK Varies (specialist) · US $30–$80 / 30-day (varies by product)	—	DGIdb	—
CARBACHOL Repurposing via ADAR	Small molecule	Approved	Strong	95	Varies — check openprescribing.net (UK) or costplusdrugs.com / GoodRx (US)	—	ChEMBL	ChEMBL Open Targets
CELECOXIB Repurposing via CACNA1C	Small molecule	Approved	Strong	95	Varies — check openprescribing.net (UK) or costplusdrugs.com / GoodRx (US)	1 Trial pubs 1 RCT View evidence Published literature Clinical trial publication Efficacy of Preemptive Analgesia on Tourniquet and Postoperative Pain Relief in Open Carpal Tunnel Release: A Prospective Randomized Control Trial (The Journal of hand surgery, 2023) CT.gov search · Cochrane · PubMed	DGIdb	—
CHORIOGONADOTROPIN ALFA Repurposing via AKR1C1	Small molecule	Approved	Strong	95	Varies — check openprescribing.net (UK) or costplusdrugs.com / GoodRx (US)	No indexed hits View evidence CT.gov search · Cochrane · PubMed	DGIdb	—
CINNARIZINE Repurposing via CACNA1C	Small molecule	Approved	Strong	95	Varies — check openprescribing.net (UK) or costplusdrugs.com / GoodRx (US)	No indexed hits View evidence CT.gov search · Cochrane · PubMed	DGIdb	—
CIPROFLOXACIN Repurposing via ADAR	Small molecule	Approved	Strong	95	Varies — check openprescribing.net (UK) or costplusdrugs.com / GoodRx (US)	—	ChEMBL	ChEMBL Open Targets
CITALOPRAM Repurposing via CACNA1C	Small molecule	Approved	Strong	95	Varies — check openprescribing.net (UK) or costplusdrugs.com / GoodRx (US)	No indexed hits View evidence CT.gov search · Cochrane · PubMed	DGIdb	—
CLEVIDIPINE Repurposing via CACNA1C	Small molecule	Approved	Strong	95	Varies — check openprescribing.net (UK) or costplusdrugs.com / GoodRx (US)	No indexed hits View evidence CT.gov search · Cochrane · PubMed	DGIdb	—
CLOMIPRAMINE Repurposing via ADAR	Small molecule	Approved	Strong	95	Varies — check openprescribing.net (UK) or costplusdrugs.com / GoodRx (US)	—	ChEMBL	ChEMBL Open Targets
CLOZAPINE Repurposing via AOC1	Small molecule	Approved	Strong	95	Varies — check openprescribing.net (UK) or costplusdrugs.com / GoodRx (US)	—	DGIdb	—
DEHYDRATED ALCOHOL Repurposing via CACNA1C	Small molecule	Approved	Strong	95	Varies — check openprescribing.net (UK) or costplusdrugs.com / GoodRx (US)	2 trials View evidence Registry trials NCT06209918 — Effect of Bioptron Light on Carpal Tunnel Syndrome(BLCTS) (UNKNOWN) NA NCT05997823 — Dorsovolar Kinesiotape in Carpal Tunnel Syndrome (COMPLETED) NA CT.gov search · Cochrane · PubMed	DGIdb	—
DIAZEPAM Repurposing via ADAR	Small molecule	Approved	Strong	95	UK £1–£3 / 28 tabs · US $3–$8 / 30 tabs	—	ChEMBL	ChEMBL Open Targets
DICHLORPHENAMIDE Repurposing via ADAR	Small molecule	Approved	Strong	95	Varies — check openprescribing.net (UK) or costplusdrugs.com / GoodRx (US)	—	ChEMBL	ChEMBL Open Targets
DIETHYLSTILBESTROL Repurposing via ADAR	Small molecule	Approved	Strong	95	Varies — check openprescribing.net (UK) or costplusdrugs.com / GoodRx (US)	—	ChEMBL	ChEMBL Open Targets
DILTIAZEM HYDROCHLORIDE Repurposing via CACNA1C	Small molecule	Approved	Strong	95	Varies — check openprescribing.net (UK) or costplusdrugs.com / GoodRx (US)	No indexed hits View evidence CT.gov search · Cochrane · PubMed	DGIdb	ChEMBL Open Targets
DILTIAZEM MALATE Repurposing via CACNA1C	Small molecule	Approved	Strong	95	Varies — check openprescribing.net (UK) or costplusdrugs.com / GoodRx (US)	No indexed hits View evidence CT.gov search · Cochrane · PubMed	DGIdb	ChEMBL Open Targets
DRONEDARONE HYDROCHLORIDE Repurposing via CACNA1C	Small molecule	Approved	Strong	95	Varies — check openprescribing.net (UK) or costplusdrugs.com / GoodRx (US)	—	DGIdb	ChEMBL Open Targets
EPIRUBICIN Repurposing via ADAR	Small molecule	Approved	Strong	95	Hospital / IV specialty — prices per vial or dose (often hundreds–thousands USD/GBP)	—	ChEMBL	ChEMBL Open Targets
ESTRONE Repurposing via AKR1C1	Small molecule	Approved	Strong	95	Varies — check openprescribing.net (UK) or costplusdrugs.com / GoodRx (US)	No indexed hits View evidence CT.gov search · Cochrane · PubMed	DGIdb	—
ETHOXZOLAMIDE Repurposing via ADAR	Small molecule	Approved	Strong	95	Varies — check openprescribing.net (UK) or costplusdrugs.com / GoodRx (US)	—	ChEMBL	ChEMBL Open Targets
FELODIPINE Repurposing via CACNA1C	Small molecule	Approved	Strong	95	Varies — check openprescribing.net (UK) or costplusdrugs.com / GoodRx (US)	No indexed hits View evidence CT.gov search · Cochrane · PubMed	DGIdb	—
FLUMAZENIL Repurposing via ADAR	Small molecule	Approved	Strong	95	Varies — check openprescribing.net (UK) or costplusdrugs.com / GoodRx (US)	—	ChEMBL	ChEMBL Open Targets
GABAPENTIN Repurposing via CACNA1C	Small molecule	Approved	Strong	95	UK £2–£5 / 28–100 tabs · US $5–$12 / 30–90 tabs	8 trials 2 Cochrane 1 Meta-analysis 5 Trial pubs 3 RCT View evidence Registry trials NCT05584839 — Statistically Analysis of Carpal Tunnel Syndrome Diagnosis (UNKNOWN) NCT04285281 — Oral Gabapentin and Median Nerve Mobilization in the Treatment of Carpal Tunnel Syndrome (COMPLETED) PHASE4 NCT00137735 — Gabapentin for Carpal Tunnel Syndrome (COMPLETED) PHASE3 NCT04025203 — Pain Reduction and Changes in Upper Limb Function Produced by Different Treatments in Carpal Tunnel Syndrome (COMPLETED) PHASE4 NCT06781489 — Pain Reduction Caused by the Combined Treatment of Physiotherapy, Oral Gabapentin and Oral Ibuprofen Arginine. (COMPLETED) PHASE4 NCT01632215 — Preoperative Gabapentine for Carpal Tunnel (COMPLETED) PHASE3 NCT00904202 — A Study Of Lidocaine Patch 5% Alone, Gabapentin Alone, And Lidocaine Patch 5% And Gabapentin In Combination For The Relief Of Pain In Patients With Diverse Peripheral Neuropathic Pain Conditions (COMPLETED) PHASE4 NCT05577676 — Hydrodissection Between Normal Saline and a Combination of Triamcinolone Acetonide, Normal Saline, and Lidocaine in CTS (COMPLETED) NA Published literature Cochrane review Efficacy and Safety of Gabapentinoids in the Treatment of Carpal Tunnel Syndrome: A Systematic Review and Meta-Analysis (The journal of hand surgery Asian-Pacific volume, 2025) Cochrane review Analgesic Efficacy of Gabapentin in Patients Undergoing Carpal Tunnel Release Surgery: A Systematic Review and Meta-Analysis of Randomized Placebo-Controlled Trials (Cureus, 2025) Clinical trial publication Efficacy of Preemptive Analgesia on Tourniquet and Postoperative Pain Relief in Open Carpal Tunnel Release: A Prospective Randomized Control Trial (The Journal of hand surgery, 2023) Clinical trial publication Effect of preoperative gabapentin on pain intensity and development of chronic pain after carpal tunnel syndrome surgical treatment in women: randomized, double-blind, placebo-controlled study (Sao Paulo medical journal = Revista paulista de medicina, 2016) Clinical trial publication Gabapentin for the treatment of carpal tunnel syndrome: a randomized controlled trial (European journal of neurology, 2011) Clinical trial publication The efficacy and safety of gabapentin in carpal tunnel patients: open label trial (Neurology India, 2009) Clinical trial publication Assessment of the efficacy of gabapentin in carpal tunnel syndrome (Journal of clinical rheumatology : practical reports on rheumatic & musculoskeletal diseases, 2008) CT.gov search · Cochrane · PubMed	DGIdb	—
GABAPENTIN ENACARBIL Repurposing via CACNA1C	Small molecule	Approved	Strong	95	UK £2–£5 / 28–100 tabs · US $5–$12 / 30–90 tabs	8 trials View evidence Registry trials NCT05584839 — Statistically Analysis of Carpal Tunnel Syndrome Diagnosis (UNKNOWN) NCT04285281 — Oral Gabapentin and Median Nerve Mobilization in the Treatment of Carpal Tunnel Syndrome (COMPLETED) PHASE4 NCT00137735 — Gabapentin for Carpal Tunnel Syndrome (COMPLETED) PHASE3 NCT04025203 — Pain Reduction and Changes in Upper Limb Function Produced by Different Treatments in Carpal Tunnel Syndrome (COMPLETED) PHASE4 NCT06781489 — Pain Reduction Caused by the Combined Treatment of Physiotherapy, Oral Gabapentin and Oral Ibuprofen Arginine. (COMPLETED) PHASE4 NCT01632215 — Preoperative Gabapentine for Carpal Tunnel (COMPLETED) PHASE3 NCT00904202 — A Study Of Lidocaine Patch 5% Alone, Gabapentin Alone, And Lidocaine Patch 5% And Gabapentin In Combination For The Relief Of Pain In Patients With Diverse Peripheral Neuropathic Pain Conditions (COMPLETED) PHASE4 NCT05577676 — Hydrodissection Between Normal Saline and a Combination of Triamcinolone Acetonide, Normal Saline, and Lidocaine in CTS (COMPLETED) NA CT.gov search · Cochrane · PubMed	DGIdb	—
HALOPERIDOL DECANOATE Repurposing via CACNA1C	Small molecule	Approved	Strong	95	Varies — check openprescribing.net (UK) or costplusdrugs.com / GoodRx (US)	No indexed hits View evidence CT.gov search · Cochrane · PubMed	DGIdb	—
HESPERIDIN Repurposing via CACNA1B	Small molecule	Approved	Strong	95	Varies — check openprescribing.net (UK) or costplusdrugs.com / GoodRx (US)	—	DGIdb	—
IBUTILIDE Repurposing via CACNA1C	Small molecule	Approved	Strong	95	Varies — check openprescribing.net (UK) or costplusdrugs.com / GoodRx (US)	—	DGIdb	—
IMIPRAMINE Repurposing via ADAR	Small molecule	Approved	Strong	95	Varies — check openprescribing.net (UK) or costplusdrugs.com / GoodRx (US)	—	ChEMBL	ChEMBL Open Targets

Natural Products

17 natural products with the same evidence schema as repurposed drugs — registry trials, PubMed literature, and reference links (pipeline-ranked). Only agents with direct clinical evidence are shown by default.

Reference lookups: Examine.com

Show agents without direct trial evidence

Drug	Type	Phase	Evidence	Score	Price (UK / US)	Trials & literature	Sources	Links
Serrapeptase Natural product	Nutraceutical	Preclinical	Moderate	10	Varies — openprescribing.net (UK) / costplusdrugs.com or GoodRx (US)	No indexed hits View evidence CT.gov search · Cochrane · PubMed	Examine.com	Examine.com
Vitamin D3 Natural product Human Study Carpal tunnel syndrome may be triggered by vitamin D deficiency and its… Human Study This study suggests a potential link between vitamin D status and the o… Human Study Vitamin B6 is therapeutic in treating carpal tunnel syndrome.	Nutraceutical	Approved	Emerging	10	Varies — openprescribing.net (UK) / costplusdrugs.com or GoodRx (US)	1 trials View evidence Registry trials NCT06282640 — Comparıson Of Electromyography Results Before And After Vıtamın D Treatment In Patıents Wıth Carpal Tunnel Syndrome (COMPLETED) PHASE4 CT.gov search · Cochrane · PubMed		PubChem
Astaxanthin Natural product	Food compound	Preclinical	Moderate	10	Varies — openprescribing.net (UK) / costplusdrugs.com or GoodRx (US)	No indexed hits View evidence CT.gov search · Cochrane · PubMed	Examine.com	PubChem Examine.com
Alpha-Lipoic Acid Natural product Human Study ALA-R full dose administration for two months leads to positive short t… Human Study Alpha-lipoic acid administered 1 month before open decompression and af… Human Study Alpha-lipoic acid and gamma-linolenic acid significantly improve sympto…	Nutraceutical	Approved	Emerging	7	Varies — openprescribing.net (UK) / costplusdrugs.com or GoodRx (US)	5 trials 5 RCT View evidence Registry trials NCT02891512 — Very Low Frequency Magnetic Fields Versus the Supplement "Xinepa" in the Treatment of the Carpal Tunnel Syndrome (COMPLETED) NA NCT06940557 — Efficacy And Tolerability Of Alpha Lipoic Acid And Vitamin B Preparation In Carpal Tunnel Syndrome (COMPLETED) PHASE2, PHASE3 NCT02382328 — Alpha Lipoic Acid on Clinical and Electrophysiological Recovery in Carpal Tunnel Syndrome Undergoing Surgical Release (COMPLETED) PHASE2 NCT01895621 — Postoperative Alpha Lipoic Acid in the Carpal Tunnel Syndrome: a Randomized Controlled Trial. (COMPLETED) PHASE4 NCT07312123 — A Study to See Whether Taking a Mix of Vitamins Can Help Adults Recover Better After Surgery for Carpal Tunnel Syndrome (RECRUITING) NA CT.gov search · Cochrane · PubMed		PubChem
Chamomile Natural product Cochrane review Plant-derived medicines for neuropathies: a comprehensive review of cli… Clinical trial publication Efficacy of topical chamomile oil for mild and moderate carpal tunnel s… Clinical trial publication A pilot randomized double-blind placebo-controlled trial on topical cha…	Botanical	Preclinical	Emerging	7	Varies — openprescribing.net (UK) / costplusdrugs.com or GoodRx (US)	1 Cochrane 2 Trial pubs View evidence Published literature Cochrane review Plant-derived medicines for neuropathies: a comprehensive review of clinical evidence (Reviews in the neurosciences, 2019) Clinical trial publication Efficacy of topical chamomile oil for mild and moderate carpal tunnel syndrome: A randomized double-blind placebo-controlled clinical trial (Complementary therapies in clinical practice, 2017) Clinical trial publication A pilot randomized double-blind placebo-controlled trial on topical chamomile (Matricaria chamomilla L.) oil for severe carpal tunnel syndrome (Complementary therapies in clinical practice, 2015) CT.gov search · Cochrane · PubMed		—
Niacin Natural product Human Study Carpal tunnel syndrome may be triggered by vitamin D deficiency and its… Human Study This study suggests a potential link between vitamin D status and the o… Human Study Vitamin B6 is therapeutic in treating carpal tunnel syndrome.	Nutraceutical	Preclinical	Emerging	7	Varies — openprescribing.net (UK) / costplusdrugs.com or GoodRx (US)	No indexed hits View evidence CT.gov search · Cochrane · PubMed		PubChem
Echinacea Natural product Human Study Alpha-lipoic acid, linoleic acid and echinacea proved to be an effectiv…	Botanical	Preclinical	Emerging	7	Varies — openprescribing.net (UK) / costplusdrugs.com or GoodRx (US)	No indexed hits View evidence CT.gov search · Cochrane · PubMed		—
L-Carnitine Natural product Cochrane review L-Carnitine in the Treatment of Psychiatric and Neurological Manifestat…	Amino acid	Phase III	Emerging	7	Varies — openprescribing.net (UK) / costplusdrugs.com or GoodRx (US)	2 trials 1 Cochrane View evidence Registry trials NCT02891512 — Very Low Frequency Magnetic Fields Versus the Supplement "Xinepa" in the Treatment of the Carpal Tunnel Syndrome (COMPLETED) NA NCT02141035 — Acetyl-l-carnitine to Enhance Nerve Regeneration in Carpal Tunnel Syndrome (COMPLETED) PHASE2, PHASE3 Published literature Cochrane review L-Carnitine in the Treatment of Psychiatric and Neurological Manifestations: A Systematic Review (Nutrients, 2024) CT.gov search · Cochrane · PubMed		PubChem
Astaxanthin Natural product A blinded placebo-controlled randomized trial on the use of astaxanthin…	Food compound	Preclinical	Emerging	0	Varies — openprescribing.net (UK) / costplusdrugs.com or GoodRx (US)	No indexed hits View evidence CT.gov search · Cochrane · PubMed	Examine.com	PubChem Examine.com
Palmitoylethanolamide Natural product Randomized controlled trial Measuring the placebo effect in carpal tunnel syndrome Randomized controlled trial Ultra-micronized Palmitoylethanolamide Effects on Sleep-wake Rhythm and… Randomized controlled trial Use of palmitoylethanolamide in carpal tunnel syndrome: a prospective r…	Nutraceutical	Preclinical	Emerging	0	Varies — openprescribing.net (UK) / costplusdrugs.com or GoodRx (US)	4 RCT View evidence Published literature Randomized controlled trial Measuring the placebo effect in carpal tunnel syndrome (Journal of orthopaedics and traumatology : official journal of the Italian Society of Orthopaedics and Traumatology, 2020) Randomized controlled trial Ultra-micronized Palmitoylethanolamide Effects on Sleep-wake Rhythm and Neuropathic Pain Phenotypes in Patients with Carpal Tunnel Syndrome: An Open-label, Randomized Controlled Study (CNS & neurological disorders drug targets, 2018) Randomized controlled trial Use of palmitoylethanolamide in carpal tunnel syndrome: a prospective randomized study (Journal of orthopaedics and traumatology : official journal of the Italian Society of Orthopaedics and Traumatology, 2017) Randomized controlled trial Use of palmitoylethanolamide in the entrapment neuropathy of the median in the wrist (Minerva medica, 2011) CT.gov search · Cochrane · PubMed		—
Flaxseed Oil Natural product Human Study A Topical Gel From Flax Seed oil compared with hand splint in carpal tu… Human Study Flaxseed oil could be effective in the management of mild and moderate…	Nutraceutical	Preclinical	Emerging	0	Varies — openprescribing.net (UK) / costplusdrugs.com or GoodRx (US)	No indexed hits View evidence CT.gov search · Cochrane · PubMed		—
Linoleic Acid Natural product Human Study Alpha-lipoic acid, linoleic acid and echinacea proved to be an effectiv…	Nutraceutical	Preclinical	Emerging	0	Varies — openprescribing.net (UK) / costplusdrugs.com or GoodRx (US)	1 Trial pubs View evidence CT.gov search · Cochrane · PubMed		—
Arnica Natural product Randomized controlled trial Homeopathic arnica for prevention of pain and bruising: randomized plac… Human Study Arnica relieves pain after carpal-tunnel release surgery.	Nutraceutical	Preclinical	Emerging	0	Varies — openprescribing.net (UK) / costplusdrugs.com or GoodRx (US)	2 Cochrane 1 RCT View evidence Published literature Randomized controlled trial Homeopathic arnica for prevention of pain and bruising: randomized placebo-controlled trial in hand surgery (Journal of the Royal Society of Medicine, 2003) CT.gov search · Cochrane · PubMed		—
Homeopathic Medicine: All Natural product Human Study Arnica relieves pain after carpal-tunnel release surgery.	Nutraceutical	Preclinical	Emerging	0	Varies — openprescribing.net (UK) / costplusdrugs.com or GoodRx (US)	No indexed hits View evidence CT.gov search · Cochrane · PubMed		—
Bach Flower Remedies Natural product Human Study Bach flower remedy cream could be an effective intervention in the mana…	Nutraceutical	Preclinical	Emerging	0	Varies — openprescribing.net (UK) / costplusdrugs.com or GoodRx (US)	1 Trial pubs View evidence CT.gov search · Cochrane · PubMed		—
Flaxseed Natural product Human Study Flaxseed oil could be effective in the management of mild and moderate… Human Study A Topical Gel From Flax Seed oil compared with hand splint in carpal tu…	Nutraceutical	Preclinical	Emerging	0	Varies — openprescribing.net (UK) / costplusdrugs.com or GoodRx (US)	No indexed hits View evidence CT.gov search · Cochrane · PubMed		—
Gotu Kola Natural product Human Study The effect of Centella Asiatica cream on scar development in patients w…	Nutraceutical	Phase I	Emerging	0	Varies — openprescribing.net (UK) / costplusdrugs.com or GoodRx (US)	1 trials View evidence Registry trials NCT05017467 — The Effect of Centella Asiatica Cream on Scar Tenderness Who Underwent Open Carpal Tunnel Release Surgery (COMPLETED) EARLY_PHASE1 CT.gov search · Cochrane · PubMed		—

Alterations and therapeutics are aggregated from public databases (Open Targets, HPO, ChEMBL, DGIdb, and others). Natural agents are candidates from OSMF narrative reviews on opensourcemed.info/chronic-disease.html — not approved treatments. This page is for research orientation only — not medical advice.

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