These custom-blended agents use a concoction of commonly used drugs. Compounded pain creams differ when used for neuropathic pain (ketamine, gabapentin, clonidine, and lidocaine), nociceptive pain (ketoprofen, baclofen, cyclobenzaprine, and lidocaine), or mixed pain (ketamine, gabapentin, diclofenac, baclofen, cyclobenzaprine, and lidocaine). Pain creams compounded for neuropathic pain (ketamine, gabapentin, clonidine, and lidocaine) Nociceptive pain (ketoprofen, baclofen, cyclobenzaprine, and lidocaine) Mixed pain (ketamine, gabapentin, diclofenac, baclofen, cyclobenzaprine, and lidocaine) Placebo; Cream applied to affected areas 3 times per day It has amantadine 6%, gabapentin 3%, cyclobenzaprine 2%, lidocaine 5%, clonidine 0.2%, diclofenac 3%, and nifedipine 0.2% in one bottle and I mix it with calcipotriene-betamethisone DP ointment. It actually works really well. Primary Source. Annals of Internal Medicine. Source Reference: Brutcher RE, et al "Compounded Topical Pain Creams to Treat Localized Chronic Pain: A Randomized Controlled Trial" Ann Intern Med This formulation is a compounded topical gel containing Baclofen 2%, Diclofenac Sodium 3%, Gabapentin 6%, Ketamine 10%, and Lidocaine HCl 5%. It is a semisolid formulation dispensed through a pump mechanism, which allows for easy and precise application on the skin. Intervention: Pain creams compounded for neuropathic pain (ketamine, gabapentin, clonidine, and lidocaine), nociceptive pain (ketoprofen, baclofen, cyclobenzaprine, and lidocaine), or mixed pain (ketamine, gabapentin, diclofenac, baclofen, cyclobenzaprine, and lidocaine), or placebo. • antiepileptics (gabapentin, topiramate) • NSAID (meloxicam) • antidepressant (amitriptyline) To more fully assess compounding across pain mechanisms, the committee also examined an additional 10 ingredients that are commonly used in compounded topical pain creams: • anesthetics (ketamine, bupivacaine, lidocaine) Nonetheless, Baclofen 2%/Cyclobenzaprine HCl 2%/Diclofenac Sodium 3%/Gabapentin 6%/Lidocaine HCl 5% Topical Gel might offer off-label uses. It is critical, however, that these proposed applications be approved by a healthcare professional prior to use. Here are potential other uses: Drug Information for Topical Pain Cream Ingredients Amitriptyline - Amitriptyline is a tricyclic antidepressant agent. It is reported to stabilize nerve ending and has been used extensively as an analgesic agent for management of neuropathic pain. Baclofen - Baclofen is a GABAβ receptor agonist. As discussed in Chapter 2, there are potential advantages for the use of topical medications to treat pain indications, including provision of local, regional, and systemic therapeutic effects, as well as the potential for better safety profiles than oral medications.1 Owing in part to their clinical potential, topical medications are one of the most commonly compounded preparations in the 4% amitriptyline, 1% baclofen, 2% ketamine Barton et al, 28 2011 208 Chemotherapy-induced peripheral neuropathy 4 wk Statistically reduced pain 4% amitriptyline, Lockhart, 29 2004 250 Postherpetic neuralgia 3 wk 30% reduction in pain 2% baclofen, 2% amitriptyline Nyirjesy et al, 30 2009 38 Vestibulodynia 33 wk 71% reduction in pain The topical pain cream contained 10 percent ketamine, 5 percent diclofenac, 2 percent baclofen, 1 percent bupivacaine, 2 percent cyclobenzaprine, 6 percent gabapentin, 3 percent ibuprofen, and 3 percent pentoxifylline in Lipoderm ActiveMax cream base. The researchers think there was a tiny difference favoring the pain creams because they contained two substances—lidocaine and prescription non-steroidal anti-inflammatory drugs, particularly ketoprofen and diclofenac—that were shown in earlier randomized trials to be effective topically. This formulation is a compounded topical gel containing Baclofen 2%, Diclofenac Sodium 3%, Gabapentin 6%, and Lidocaine HCl 5%. It is a semisolid formulation dispensed through a pump mechanism, which allows for easy and precise application on the skin. Topical medication for chronic neck pain: amitriptyline 3%, baclofen 0.5%, diclofenac 3%, and lidocaine 5% 3 to 4 times daily as needed; and a topical lidocaine gel for oral ulcers: Misuse: She was using the cream twice as often as instructed on her neck and in her mouth since she had run out of the lidocaine gel prescribed for her oral ulcers. Dipentocaine ™ Topical Cream Diclofenac Sodium, Gabapentin, and Lidocaine Hydrochloride Compounding Kit FOR PHARMACY PRESCRIPTION COMPOUNDING ONLY / Rx Only
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