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Gabapentin 10%/Ketamine HCl 11.5%/Ketoprofen 10%/Lidocaine HCl 10% Transdermal Gel

FDA-approved generic
Dose form
Topical Gel
Active ingredients
Gabapentin
Ketamine Hydrochloride
Ketoprofen
Lidocaine Hydrochloride

The Gabapentin 10%/Ketamine HCl 11.5%/Ketoprofen 10%/Lidocaine HCl 10% Transdermal Gel is a specialized medication designed for the management of neuropathic pain and complex regional pain syndrome (CRPS). This unique formulation combines four active pharmaceutical ingredients, each with distinct mechanisms of action, to provide synergistic effects for pain relief.

Gabapentin is an anticonvulsant that is commonly used to treat neuropathic pain, while Ketamine HCl, an NMDA receptor antagonist, provides analgesic properties, particularly in neuropathic pain states. Ketoprofen is a nonsteroidal anti-inflammatory drug (NSAID) that offers anti-inflammatory and analgesic effects, and Lidocaine HCl is a local anesthetic that helps to numb the affected area, providing immediate topical pain relief.

The gel is formulated for transdermal delivery, allowing the active ingredients to penetrate the skin and reach the affected area directly. The semisolid formulation is dispensed through a pump mechanism, which ensures easy and precise application. This dosage form is particularly beneficial for patients who require localized pain management without the systemic side effects associated with oral medications.

By combining these four agents in a transdermal gel, this formulation is particularly suited for patients suffering from neuropathic pain and CRPS, providing a multimodal approach to pain management with the convenience of topical application.

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For prescribers
Prescription details
RxThis formula
Dose formSee below
Quantity____
SigAs directed by prescriber
Refills____
PharmacyBayview Pharmacy, Warwick RI, NCPDP 4106882
Copy prescription detailsOrder form
Controlled substance: e-prescribe (EPCS) from your EHR. Faxed and phoned prescriptions cannot be accepted for this preparation.
Send it from your EHR, or fax to (401) 284-4506. How to e-prescribe this formula
Licensed to fill prescriptions for patients in RI, MA, CT, NJ, NH, FL, ME and PA. New York patients are served on a limited basis while nonresident registration is pending.
To prescribe, you must be a verified prescriber.
To prescribe, you must be in a state where we hold an active out-of-state pharmacy license.
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This medication requires a prescription from your doctor

Licensed to fill prescriptions for patients in RI, MA, CT, NJ, NH, FL, ME and PA. New York patients are served on a limited basis while nonresident registration is pending.

For prescribersSign in for prescription details and order forms.
Compounded preparations are prepared by Bayview pursuant to a prescription for an individual patient. They are not FDA-approved and have not been evaluated by FDA for safety or effectiveness.
Gabapentin
Ketamine Hydrochloride
Ketoprofen
Lidocaine Hydrochloride
Topical Gel
65ad6b5eba575f50059c95a8

Formula Information

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Our custom-compounded transdermal gel combines Gabapentin, Ketamine HCl, Ketoprofen, and Lidocaine HCl in a unique formulation designed to manage pain through a multimodal approach. Gabapentin, an anticonvulsant, is often used to treat neuropathic pain by modulating the nervous system's response to pain. Ketamine HCl, an NMDA receptor antagonist, provides analgesic effects, particularly in chronic pain conditions that have not responded to other treatments. Ketoprofen, a nonsteroidal anti-inflammatory drug (NSAID), offers anti-inflammatory and analgesic properties. Lidocaine HCl, a local anesthetic, provides immediate relief from pain by blocking nerve signals in the body.

This semisolid formulation is dispensed through a pump mechanism, which allows for easy and precise application directly to the skin. The transdermal delivery system is designed for targeted treatment, ensuring that the active ingredients are absorbed at the site of pain, which can lead to a reduction in systemic side effects compared to oral medications. This gel-like consistency ensures that the medication stays in place, providing a localized effect while minimizing discomfort during application.

The combination of these four active ingredients in a transdermal gel form is particularly suited for patients experiencing various types of pain, including neuropathic pain, inflammatory conditions, and refractory pain that has not responded to other analgesics. By using a multimodal approach, this formulation can address different pain pathways simultaneously. It is important for prescribers to consider the patient's medical history, current medications, and potential drug interactions when prescribing this compounded medication.

Patients should be instructed on the proper use of the transdermal gel, including the amount to apply and the frequency of application as determined by their healthcare provider. They should also be made aware of potential side effects, such as local skin reactions or systemic effects, although the latter are less common with transdermal applications. It is crucial for patients to follow the prescribed regimen and to communicate any concerns or adverse effects to their healthcare provider promptly.

For more detailed information or if you have any questions regarding this compounded formulation, please do not hesitate to reach out to us at Bayview Pharmacy. Our team of compounding pharmacists is dedicated to providing personalized care and support to both patients and prescribers to ensure the safe and appropriate use of our compounded medications.

Drug Interactions

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The transdermal gel formulation containing Gabapentin, Ketamine HCl, Ketoprofen, and Lidocaine HCl is designed for topical application and may offer localized relief from pain without the systemic side effects associated with oral administration. However, it is important to consider potential drug interactions when using this compound, especially if the patient is taking other medications or has underlying health conditions.

Gabapentin, an anticonvulsant and neuropathic pain agent, may interact with antacids containing aluminum or magnesium, as they can reduce the absorption of gabapentin and decrease its effectiveness. Caution is advised when combining gabapentin with central nervous system (CNS) depressants such as opioids, benzodiazepines, or alcohol, as this may increase CNS depression and drowsiness.

Ketamine HCl, an NMDA receptor antagonist used for its anesthetic and analgesic properties, can also cause additive CNS depression when used concurrently with other CNS depressants. Additionally, there is a potential for increased blood pressure and heart rate if ketamine is combined with stimulant medications or sympathomimetic drugs.

Ketoprofen, a nonsteroidal anti-inflammatory drug (NSAID), may interact with anticoagulants like warfarin, increasing the risk of bleeding. It can also reduce the effectiveness of antihypertensive drugs and may increase the nephrotoxicity of ACE inhibitors and diuretics. Concurrent use of other NSAIDs or corticosteroids should be approached with caution due to the increased risk of gastrointestinal ulceration or bleeding.

Lidocaine HCl, a local anesthetic, may interact with antiarrhythmic drugs such as mexiletine or amiodarone, potentially leading to additive cardiac effects. Caution is also advised when using other local anesthetics or medications that can increase lidocaine levels in the blood, such as cimetidine or beta-blockers.

It is crucial for patients to inform their healthcare provider of all medications, supplements, and herbal products they are currently using before starting treatment with this transdermal gel. The healthcare provider should assess for potential interactions and adjust therapy as necessary. Monitoring for adverse effects, such as excessive sedation, gastrointestinal issues, or signs of cardiac or renal dysfunction, is recommended. If you have any questions or require further information regarding this formulation and its potential interactions, please reach out to us at Bayview Pharmacy.

How Does it Work

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The Gabapentin 10%/Ketamine HCl 11.5%/Ketoprofen 10%/Lidocaine HCl 10% Transdermal Gel is a compounded medication designed to deliver a combination of active ingredients directly through the skin to the site of pain or discomfort. This semisolid formulation is dispensed through a pump mechanism, which allows for easy and precise application. The gel-like consistency ensures that the medication stays in place and facilitates absorption through the skin.

Gabapentin is an anticonvulsant medication that is also used to treat neuropathic pain. In this transdermal formulation, gabapentin works by modulating the activity of certain neurotransmitters in the nervous system, which helps to reduce the sensation of pain. Ketamine HCl, a medication primarily used for anesthesia, also has analgesic properties. When applied topically, ketamine can block NMDA receptors, which are involved in the transmission of pain signals, thus providing relief from chronic pain.

Ketoprofen is a nonsteroidal anti-inflammatory drug (NSAID) that works by inhibiting the production of prostaglandins, substances in the body that are involved in inflammation and pain. By reducing inflammation at the site of application, ketoprofen can help alleviate localized pain and swelling. Lidocaine HCl is a local anesthetic that provides immediate pain relief by blocking sodium channels, which are necessary for the conduction of pain signals along nerves.

The combination of these four active ingredients in a transdermal gel allows for a multimodal approach to pain management. This can be particularly beneficial for patients suffering from conditions such as neuropathic pain, complex regional pain syndrome (CRPS), or fibromyalgia, where multiple mechanisms of pain may be at play. The transdermal route of administration ensures that the medication bypasses the gastrointestinal tract, reducing the potential for systemic side effects and providing targeted relief at the site of application.

It is important for both patients and prescribers to understand that this compounded medication should be used as directed by a healthcare professional, and it is essential to adhere to the prescribed dosing regimen. The pump mechanism is calibrated to dispense a specific amount of gel with each actuation, ensuring consistent dosing. Patients should apply the gel to clean, intact skin and avoid contact with eyes, mucous membranes, and open wounds. Hands should be washed thoroughly after application unless the hands are the site of treatment.

If you have any questions about this formulation or its use in treating specific disease states, please reach out to us at Bayview Pharmacy. Our team of compounding pharmacists is here to provide guidance and support to ensure the safe and appropriate use of this medication.

Other Uses

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The Gabapentin 10%/Ketamine HCl 11.5%/Ketoprofen 10%/Lidocaine HCl 10% Transdermal Gel formulation is primarily known for managing neuropathic pain and other types of chronic pain. Apart from its primary indication, this unique combination of medications in a transdermal gel base may offer alternative therapeutic benefits for various off-label uses. Given the individual properties of each active ingredient, this gel has the potential to be utilized in complex regional pain syndrome, post-herpetic neuralgia, and fibromyalgia, where multiple mechanisms of pain may coexist and a multimodal approach to pain management is advantageous.

Gabapentin's modulatory effect on neurotransmitters might provide relief in certain types of anxiety disorders and restless leg syndrome when systemic treatments are contraindicated or poorly tolerated. Ketoprofen, a nonsteroidal anti-inflammatory drug, could help reduce localized inflammation that may be secondary to conditions like arthritis or tendonitis. Meanwhile, lidocaine, as a local anaesthetic, might be effective for numbing localized areas experiencing acute pain from minor procedures or injuries. It is important to note, however, the use of transdermal gel preparations for conditions beyond chronic pain is less documented, and such use would be at the prescriber's discretion and based on their professional judgment.

Moreover, a transdermal gel formulation may be particularly beneficial for patients who have difficulty swallowing or prefer to avoid systemic side effects associated with oral medication. The synergistic effect of the combination might also allow for lower doses of each medication, potentially minimizing the risk of side effects commonly seen with systemic administration.

It is imperative that any off-label application of this combination gel be discussed with a healthcare professional to assess appropriateness, potential interactions with other medications, and overall patient safety. For tailored advice and potential alternative uses of this formulation, both patients and prescribers are encouraged to reach out to our knowledgeable team of compounding pharmacists here at Bayview Pharmacy for more information.

Frequently Asked Questions

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What is the purpose of this transdermal gel?

This compounded transdermal gel is designed to deliver a combination of Gabapentin, Ketamine HCl, Ketoprofen, and Lidocaine HCl through the skin to provide targeted relief from pain and inflammation. The medications in the gel work synergistically to control pain through different mechanisms.

How do I use the transdermal gel?

The gel is applied topically to the affected area of the skin. It is dispensed through a pump mechanism which makes it easy to apply a controlled dose. Use the gel as directed by your healthcare provider, and do not apply more than the recommended amount.

How often should I apply this gel?

The frequency of application will be determined by your healthcare provider based on your individual needs and condition. Follow their instructions carefully and do not adjust the frequency without consulting them.

Are there any side effects associated with this transdermal gel?

As with any medication, there may be potential side effects. Common side effects can include local skin irritation, redness, or rash. If you experience any severe or persistent side effects, contact your healthcare provider immediately.

Can this gel be used by anyone?

This gel is formulated for patients with specific pain management needs and should be used under the guidance of a healthcare provider. It may not be suitable for everyone, particularly those with allergies to any of the active ingredients or certain skin conditions.

How should I store the compounded transdermal gel?

Store the gel at room temperature, away from heat and direct sunlight. Keep the container tightly closed when not in use. Make sure the gel is kept out of reach of children and pets.

What should I do if I miss a dose?

If you miss a dose, apply the gel as soon as you remember. However, if it is almost time for your next dose, skip the missed dose and continue with your regular dosing schedule. Do not double the dose to catch up.

Can I bandage or cover the area after applying the gel?

Do not cover the treated area with a bandage or occlusive dressing unless advised by your healthcare provider, as this may increase the absorption of the medication, potentially leading to increased side effects.

How long does it take for the gel to work?

The onset of action can vary based on individual response and the condition being treated. Some patients may feel relief shortly after application, while others may take longer. Consult with your healthcare provider for more information on what to expect.

Is it safe to use this gel with other medications?

This gel may interact with other medications or products you are using. It is essential to discuss all your current medications and topical treatments with your healthcare provider to ensure safety and avoid potential interactions.

What should I avoid while using this transdermal gel?

Avoid using other topical products on the same area where the gel was applied unless your healthcare provider approves their use. Additionally, you should avoid exposing the treated area to direct sunlight or heat sources as this can affect the medication's efficacy.

About this compounded preparation

This formulation is compounded by Bayview Pharmacy on a prescriber's order for an individual patient. It is not an FDA-approved drug product, and the FDA has not evaluated it for safety, effectiveness, or manufacturing quality.

The conditions listed on this page are indications prescribers have ordered this preparation for. They are not FDA-approved indications, and listing them is not a statement that this preparation is effective for them.

A valid prescription is required. Availability depends on Bayview's licensure in your state. This page is general information, not medical advice — discuss your situation with a licensed healthcare provider.

This preparation is a controlled substance. Additional prescribing, refill, and shipping restrictions apply, and the states Bayview can dispense it to are narrower than for non-controlled preparations.

Formulas and/or material listed are not to be interpreted as a promise, guarantee or claim of therapeutic efficacy or safety. The information contained herein is not intended to replace or substitute for conventional medical care, or encourage its abandonment. Every patient is unique, and formulas should be adjusted to meet their individual needs.

No compounded medications are reviewed by the FDA for safety or efficacy.
For prescribers

How to e-prescribe this formula

Controlled substance: e-prescribe only (EPCS). Faxed, phoned, and handwritten prescriptions cannot be filled. Rhode Island law (R.I. Gen. Laws § 21-28-3.18) requires Schedule II to V prescriptions to be transmitted electronically.
1

Find Bayview in your EHR's pharmacy directory

Search by NCPDP 4106882, or by name and ZIP: Bayview Pharmacy, Warwick, RI 02886. Select it as the destination pharmacy and save it as a favorite. Click any value to copy it.

NCPDP4106882NPI1750455143Address3844 Post Rd, Warwick, RI 02886Phone(401) 284-4505Fax(401) 284-4506
2

Enter the formula as a compound

Compounded preparations have no NDC, so this formula will not appear in your EHR's drug search. Use your system's compound, non-formulary, or free-text prescription entry and name the preparation exactly as written in step 3. If your EHR forces you to pick a listed drug, pick the closest entry for the active ingredient and put the full formula in the prescription body (the Sig or directions field), not in Notes to Pharmacy.

Compounded preparations have no NDC and will not appear in your drug search. For EPCS to validate, select a drug entry your EHR recognizes as controlled, usually the bulk powder entry for the active ingredient (for example Ketamine (bulk) powder, not a branded product), then put the full formula from step 3 in the prescription body. A free-text entry that does not validate as controlled will be rejected by your EPCS module.

3

Copy the prescription details

RxFormula name
Dose formDose form
Quantity________
SigAs directed by prescriber
Refills____
PharmacyBayview Pharmacy, Warwick RI, NCPDP 4106882
Copy prescription details

Quantity and directions are starting points for this dose form, not treatment recommendations. Dosing remains the prescriber's responsibility.

4

Send it

Transmit from your EHR. For this non-controlled preparation we also accept fax to (401) 284-4506 and phoned orders at (401) 284-4505. Order forms are on the formulation pages and in the prescriber portal.

Transmit with two-factor authentication through your EPCS-enabled EHR. No order form is offered for this preparation; e-prescribing guides for our controlled preparations are on the formulation pages.

Do not use Notes to Pharmacy for the formula. Some EHRs keep that field internal and never transmit it. A prescription that arrives without the formula is delayed while we call your office.

Licensed to dispense in RI, MA, CT, NJ, NH, FL, ME, and PA; New York is served on a limited basis while nonresident registration is pending. Compounded preparations are not FDA-approved. A valid prescription is required. Full guide, including steps by EHR: How to e-prescribe to Bayview. Questions about this formula: call (401) 284-4505.

Gabapentin 10%/Ketamine HCl 11.5%/Ketoprofen 10%/Lidocaine HCl 10% Transdermal Gel
Topical Gel
60 g
controlled

Apply topically to affected area(s)