Our specially formulated topical gel combines four potent active ingredients—Amitriptyline HCl (20 mg/g), Gabapentin (60 mg/g), Ketoprofen (100 mg/g), and Lidocaine (100 mg/g)—to provide targeted relief for patients experiencing pain. This semisolid gel is dispensed through a pump mechanism, facilitating easy and precise application on the skin, ensuring that the active ingredients are delivered directly to the site of discomfort.

Amitriptyline HCl is a tricyclic antidepressant that, when used topically, exhibits analgesic properties particularly beneficial in neuropathic pain management. It works by inhibiting the reuptake of neurotransmitters such as serotonin and norepinephrine, which modulate pain signaling pathways, thereby reducing pain perception.

Gabapentin is an anticonvulsant medication effective in treating neuropathic pain. Applied topically, gabapentin helps decrease the abnormal excitability of neurons associated with chronic pain conditions by modulating voltage-gated calcium channels, leading to reduced pain sensations.

Ketoprofen is a nonsteroidal anti-inflammatory drug (NSAID) that provides both analgesic and anti-inflammatory effects. When administered topically, ketoprofen penetrates the skin to reduce local inflammation and pain by inhibiting cyclooxygenase enzymes (COX-1 and COX-2), which are involved in the synthesis of pro-inflammatory prostaglandins.

Lidocaine is

This compounded topical gel formulation contains Amitriptyline HCl, Gabapentin, Ketoprofen, and Lidocaine, each of which can interact with other medications, potentially altering their effects or increasing the risk of adverse reactions. It is crucial for both patients and prescribers to be aware of these interactions to ensure safe and effective use of the formulation.

Amitriptyline HCl, a tricyclic antidepressant, can interact with a variety of medications. It may enhance the sedative effects of central nervous system depressants such as alcohol, benzodiazepines, and opioids, leading to increased drowsiness or respiratory depression. Concurrent use with monoamine oxidase inhibitors (MAOIs) can result in severe hypertensive crises or serotonin syndrome, a potentially life-threatening condition. Amitriptyline may also interact with anticholinergic agents, increasing the risk of side effects such as dry mouth, constipation, and urinary retention. Additionally, it can affect the metabolism of other drugs processed by the liver enzyme CYP2D6, potentially altering their plasma concentrations.

Gabapentin, an anticonvulsant and neuropathic pain agent, has fewer known drug interactions compared to other medications in this formulation. However, it can potentiate the effects of other central nervous system depressants, leading to enhanced sedation or dizziness. Antacids containing aluminum or magnesium can reduce the absorption of gabapentin, potentially decreasing its effectiveness. It is advisable to separate the administration of gabapentin and antacids by at least two hours.

Ketoprofen, a nonsteroidal anti-inflammatory drug (NSAID), can interact with other medications that affect bleeding risk, such as anticoagulants (e.g., warfarin) and antiplatelet agents (e.g., aspirin), increasing the likelihood of bleeding complications. Concurrent use with other NSAIDs or corticosteroids can heighten the risk of gastrointestinal irritation or ulceration. Ketoprofen may also reduce the antihypertensive effects of certain blood pressure medications, such as ACE inhibitors, angiotensin II receptor blockers, and diuretics. Additionally, it can increase the nephrotoxic potential of certain drugs, such as cyclosporine and tacrolimus.

Lidocaine, a local anesthetic, can interact with other antiarrhythmic agents, potentially leading to additive cardiac effects such as bradycardia or heart block. Caution is advised when used with beta-blockers or other medications that can affect cardiac conduction. Lidocaine may also enhance the effects of other local anesthetics or medications that cause methemoglobinemia, a condition where hemoglobin is unable to release oxygen effectively to body tissues.

Given the potential for drug interactions, it is essential for patients to inform their healthcare providers of all medications they are currently taking, including prescription drugs, over-the-counter medications, and herbal supplements. Prescribers should carefully evaluate the patient's medication regimen to identify any potential interactions and adjust treatment plans accordingly. If you have any questions or concerns about the use of this formulation, please reach out to us for further assistance.

This compounded topical gel formulation combines four active pharmaceutical ingredients: Amitriptyline HCl, Gabapentin, Ketoprofen, and Lidocaine, each contributing to the management of pain through distinct mechanisms of action. The semisolid gel is dispensed through a pump mechanism, ensuring easy and precise application on the skin, which allows for targeted treatment and absorption of the active ingredients directly at the site of discomfort.

Amitriptyline HCl, a tricyclic antidepressant, is utilized in this formulation for its ability to modulate pain pathways. It works by inhibiting the reuptake of neurotransmitters such as serotonin and norepinephrine, which are involved in the transmission of pain signals. By increasing the levels of these neurotransmitters in the central nervous system, Amitriptyline HCl can help reduce the perception of pain, making it particularly useful in treating neuropathic pain conditions.

Gabapentin, an anticonvulsant, is included for its efficacy in managing neuropathic pain. It binds to the alpha-2-delta subunit of voltage-gated calcium channels in the central nervous system, which reduces the release of excitatory neurotransmitters. This action helps to dampen the hyperexcitability of neurons that is often associated with chronic pain conditions, providing relief from symptoms such as burning, tingling, and shooting pain.

Ketoprofen, a nonsteroidal anti-inflammatory drug (NSAID), contributes to the formulation by reducing inflammation and pain. It works by inhibiting the cyclooxygenase (COX) enzymes, which are involved in the synthesis of prostaglandins, compounds that mediate inflammation and pain. By decreasing the production of these inflammatory mediators, Ketoprofen helps alleviate pain and swelling, making it effective for conditions involving inflammation, such as arthritis or musculoskeletal injuries.

Lidocaine, a local anesthetic, provides immediate pain relief by blocking sodium channels in the neuronal cell membrane. This action prevents the initiation and conduction of nerve impulses, effectively numbing the area of application. Lidocaine's rapid onset of action makes it particularly beneficial for providing quick relief from acute pain episodes.

The gel-like consistency of this formulation ensures that the active ingredients are evenly distributed and absorbed through the skin, allowing for localized treatment with minimal systemic exposure. This targeted approach can help reduce the risk of systemic side effects often associated with oral administration of these medications. The pump mechanism further enhances the ease of use, allowing patients to apply the gel with precision and consistency, ensuring optimal therapeutic outcomes.

This compounded formulation is particularly suited for patients experiencing chronic pain conditions, such as neuropathic pain, arthritis, or localized musculoskeletal pain, where a multimodal approach to pain management is beneficial. By combining these four active ingredients, the formulation addresses multiple pathways involved in pain perception and inflammation, providing comprehensive relief.

If you have any questions about this formulation or its use, please reach out to us at Bayview Pharmacy. Our team of compounding pharmacists is here to assist you with any inquiries or concerns you may have.

The Amitriptyline HCl 20 mg/g, Gabapentin 60 mg/g, Ketoprofen 100 mg/g, and Lidocaine 100 mg/g topical gel is a versatile formulation that can be utilized for a variety of off-label uses beyond its primary indications. This compounded gel is designed to deliver a synergistic effect by combining the analgesic, anti-inflammatory, and anesthetic properties of its active ingredients, making it a valuable option for managing complex pain conditions. While it is commonly prescribed for neuropathic pain, musculoskeletal pain, and inflammatory conditions, this formulation may also be considered for other uses where localized pain relief and inflammation reduction are desired.

For patients experiencing chronic pain conditions such as fibromyalgia or complex regional pain syndrome (CRPS), this topical gel can offer targeted relief by delivering medication directly to the affected area, potentially reducing the need for systemic medications and minimizing associated side effects. Additionally, it may be beneficial for patients with post-surgical pain or those recovering from injuries, as the combination of active ingredients can help manage pain and inflammation, promoting a more comfortable recovery process.

In sports medicine, this formulation can be used to address acute injuries such as sprains, strains, and tendonitis, providing athletes with a non-invasive option to manage pain and inflammation while maintaining mobility. Furthermore, the gel may be applied to areas affected by arthritis, offering relief from joint pain and stiffness, which can improve the quality of life for individuals with degenerative joint diseases.

For prescribers, this compounded gel offers the flexibility to tailor treatment to the specific needs of the patient, allowing for adjustments in the concentration of active ingredients based on the severity of symptoms and patient response. The pump mechanism ensures precise dosing and ease of application, enhancing patient compliance and treatment efficacy. It is important for prescribers to consider the patient's overall medication regimen and potential interactions when incorporating this topical gel into their treatment plan.

Patients should be advised to apply the gel as directed by their healthcare provider, typically to clean, dry skin, and to avoid contact with mucous membranes or broken skin. As with any medication, monitoring for adverse reactions is essential, and patients should report any unusual symptoms to their healthcare provider promptly. If you have any questions or need further information about this formulation, please reach out to us at Bayview Pharmacy.