Pain Management
Topical Pain Medications
Transdermal drug delivery is evolving as an extremely useful therapeutic option in many treatment situations. Topical application of medication has been proven to provide higher therapeutic drug concentrations, while reducing or eliminating the adverse effects of systemic administration. Usual topical dosage is applied 2-3 times a day, massaged in well. Commercially available equivalents will not be compounded.
Drugs that can be used by the compounding
pharmacist (partial list).
- Amitriptyline
- Baclofen
- Betamethasone
- Capsaicin
- Carbamazepine
- Clonidine
- Cyclobenzaprine
- Deoxy-D-Glucose
- Dexamethasone
- Diclofenac
- Gabapentin
- Guaifenesin
- Guanethidine
- Ibuprofen
- Ketamine
- Ketoprofen
- Lidocaine
- Nifedipine
- Sarapin
- Diltiazem
Many disease states that may be treated with these formulations are arthritis, trigeminal neuralgia, fibromyalgia, peripheral neuropathy, shingles, migraines, anal fissures, carpal tunnel syndrome, tendonitis, and generalized tissue pain.
Examples of topical drug formulations:
- Ketoprofen 10%
- Ibuprofen 10-20%
- Ketoprofen 10% / Lidocaine 5% / Sarapin 10%
- Ketoprofen 10% / Gabapentin 6%
- Lidocaine 10%
- Ketamine 10% / Gabapentin 6% / Clonidine 0.2% / Nifedipine 2%
- Ketoprofen 15% / Cyclobenzaprine 3% / Lidocaine 5%
- Tricaine (Prilocaine 5% / Bupivacaine 2.5% / Lidocaine 15%)
- Quadcaine (Benzocaine 10% / Lidocaine 6% / Tetracaine 4% / Bupivacaine 2.5%)
- Baclofen 2% / Amitriptyline 2%
Other combinations can be made for individual usage by patient and physician preference.
Controlled Release Capsules (Methocel E4M)
Example drugs for oral narcotics:
- Hydrocodone
- Methadone
- Oxycodone
- Morphine Sulfate
Combination formulas can be made by adding any of the following:
- Dextromethorphan
- Ketoprofen
- Ibuprofen
- Acetaminophen
- APAP
- Cayenne (to prevent street abuse)
Customized oral dosing of pain medications provides for patient specific titration and can eliminate the potential for illegal abuse (street selling of prescription meds). Given the lack of distinguishable brand characteristics and potentially unpleasant additives such as cayenne; the compounded capsule will have no street value.
