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Topical non-steroidal anti-inflammatories (NSAIDs) and lidocaine are often used as single agents. Less common topical analgesics such as gabapentin, ketamine, and baclofen are often used in a compounded topical cream with three or more medications. This compounded formulation of Baclofen 2%/Gabapentin 6%/Amitriptyline HCl 2%/Lidocaine HCl 2% is a semisolid topical gel designed for targeted treatment of neuropathic pain, muscle spasms, and other chronic pain conditions. 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. 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). A new topical cream with gabapentin 6 percent, ketoprofen 10 percent, lidocaine 5 percent, and ketamine 10 percent was prescribed in addition to an oral mucosal topical agent containing gabapentin 10 percent in Orabase. What is Baclofen 2%/Ketoprofen 10%/Lidocaine 5%/Gabapentin 5% Topical Cream? This is a compounded formulation of four active ingredients: Baclofen, Ketoprofen, Lidocaine, and Gabapentin. It is a semisolid preparation designed for convenient and controlled application on the skin for localized treatment or absorption of these active ingredients. This formulation is a combination of four active ingredients: Baclofen, Diclofenac Sodium, Gabapentin, and Lidocaine HCl. Each of these ingredients works in a unique way to provide relief from pain and discomfort. Baclofen is a muscle relaxant and antispasmodic agent. In the past, EMLA was the most used form of topical anaesthetic, in which lidocaine 2.5% was associated with prilocaine 2.5% in a eutectic mixture of localized anaesthetics in a cream vehicle, causing the effects and skin penetration to be variable . 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 Gabapentin + Lidocaine + Baclofen is a combination of three medicines: Gabapentin , Lidocaine , and Baclofen. Gabapentin is an alpha 2 delta ligand which decreases pain by modulating calcium channel activity of the nerve cells. In addition, there is a relatively high percent of drug absorbed for ketamine, diclofenac, and pentoxifylline with lower absorption for baclofen, bupivacaine, orphenadrine, clonidine, and gabapentin (Bassani and Banov, 2016; Wang and Black, 2013) (see Tables 5-2 and 5-3). 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. This compounded formulation is a topical cream that combines four active ingredients: Baclofen 2%, Ketoprofen 10%, Lidocaine 5%, and Gabapentin 5%. Each ingredient plays a crucial role in providing relief from various conditions such as Fibromyalgia, Neuropathy, Arthritis, Sciatica, and Tendonitis. Mixed pain: The active treatment was 10% ketamine, 6% gabapentin, 3% diclofenac, 2% baclofen, 2% cyclobenzaprine, and 2% lidocaine. Creams were compounded in a typical pharmacy compounding base (carrier). Each Dipentocaine™ Topical Cream Pharmacy Compounding Kit provides 5.7 grams of Diclofenac Sodium USP, 5.7 grams of Gabapentin USP, 2.28 grams of Lidocaine HCL USP, and 100.32 grams of Base. Diclofenac Sodium: CAS Number 15307-79-6. 2-[(2,6-Dichlorophenyl)amino]benzeneacetic acid sodium salt. Gabapentin: CAS Number 60142-96-3 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) Gabagesic Gel is a combination of three medicines: Gabapentin, Lidocaine, and Baclofen. Gabapentin is an alpha 2 delta ligand which decreases pain by modulating calcium channel activity of the nerve cells. Lidocaine is a local anesthetic which works by blocking pain signals from the nerves to brain thereby decreasing the sensation of pain. A recent Cochrane review identified 12 studies (n=508) comparing topical lidocaine vs placebo or an active control. 28 The 5% medicated patch, gel and cream were used along with an 8% spray. 28 Lidocaine 5% may be effective in patients with localized peripheral neuralgia, including postherpetic neuralgia, for several weeks with a low risk of 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.
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