This topical gel combines four active pharmaceutical ingredients—Gabapentin 6%, Ketamine 10%, Ketoprofen 10%, and Lidocaine 4%—to provide a multimodal approach to pain management. Each component contributes a unique mechanism of action to address various types of pain, potentially offering relief for patients suffering from chronic pain conditions.

The formulation is delivered as a semisolid gel dispensed through a pump mechanism, facilitating easy and precise application on the skin. This design ensures targeted delivery of the active ingredients to the affected area, promoting effective absorption and localized treatment. The gel-like consistency allows for smooth application without leaving residue, enhancing patient comfort and adherence to the treatment regimen.

Gabapentin acts on calcium channels to inhibit excitatory neurotransmitter release, making it effective in managing neuropathic pain. Ketamine, an NMDA receptor antagonist, provides analgesic effects by blocking glutamate transmission involved in pain signaling. Ketoprofen, a non-steroidal anti-inflammatory drug (NSAID), reduces inflammation and alleviates pain by inhibiting cyclooxygenase enzymes necessary for prostaglandin synthesis. Lidocaine, a local anesthetic, blocks sodium channels to prevent nerve impulse conduction, offering immediate pain relief at the site of application.

This combination gel may be beneficial for conditions such as neuropathic pain, musculoskeletal pain, arthritis, and other localized pain syndromes. By delivering multiple analgesic agents directly to the site of pain, the formulation aims to enhance pain relief while minimizing systemic side effects often associated with oral medications. The synergy of these agents addresses different pain pathways, potentially improving overall efficacy in pain management.

Patients using this topical gel should apply it as directed by their healthcare provider, typically applying a measured dose to the affected area. It offers

Gabapentin 6%/Ketamine 10%/Ketoprofen 10%/Lidocaine 4% Topical Gel is a compounded formulation designed for targeted application on the skin, providing localized treatment for pain and inflammation. This formulation combines multiple active ingredients, each with distinct mechanisms of action, to address various aspects of pain management. Gabapentin is primarily used for neuropathic pain, ketamine is an NMDA receptor antagonist with analgesic properties, ketoprofen is a nonsteroidal anti-inflammatory drug (NSAID) that reduces inflammation and pain, and lidocaine is a local anesthetic that provides numbing effects. While this combination can be effective for treating conditions such as neuropathic pain, musculoskeletal pain, and inflammatory conditions, it is important to consider potential drug interactions.

Gabapentin, when used systemically, has minimal drug interactions due to its renal excretion and lack of significant metabolism. However, when used topically, systemic absorption is generally low, reducing the risk of interactions. Nonetheless, caution should be exercised when used concurrently with other central nervous system (CNS) depressants, as gabapentin may enhance their effects, potentially leading to increased sedation or respiratory depression.

Ketamine, although primarily used intravenously or intramuscularly, can have systemic effects even when applied topically, especially in higher concentrations. It may interact with other CNS depressants, such as benzodiazepines, opioids, or alcohol, potentially leading to enhanced sedative effects. Additionally, ketamine may interact with medications that affect the cytochrome P450 enzyme system, particularly CYP3A4 inhibitors or inducers, which could alter its metabolism and efficacy.

Ketoprofen, as an NSAID, may interact with other medications that affect renal function, such as ACE inhibitors, angiotensin II receptor blockers, or diuretics, potentially increasing the risk of renal impairment. It may also increase the risk of bleeding when used with anticoagulants or antiplatelet agents. Although systemic absorption from topical application is generally lower than oral administration, these interactions should still be considered, especially in patients with compromised renal function or those on multiple medications.

Lidocaine, when used topically, is generally well-tolerated with minimal systemic absorption. However, caution is advised when used with other local anesthetics or antiarrhythmic drugs, as additive effects on cardiac conduction may occur. Additionally, patients with severe hepatic impairment may experience increased systemic exposure to lidocaine, necessitating careful monitoring.

For both patients and prescribers, it is crucial to consider the overall medication regimen and the potential for interactions, especially in patients with complex medical histories or those taking multiple medications. Monitoring for signs of increased sedation, respiratory depression, renal impairment, or bleeding is advised. If you have any questions or concerns about potential drug interactions with this formulation, please reach out to us for further guidance and support.

The Gabapentin 6%/Ketamine 10%/Ketoprofen 10%/Lidocaine 4% Topical Gel is a compounded formulation designed to deliver a synergistic combination of active ingredients directly to the site of pain or inflammation. This semisolid gel is dispensed through a pump mechanism, allowing for easy and precise application on the skin, ensuring targeted treatment and optimal absorption of the active ingredients. The gel-like consistency facilitates even distribution over the affected area, enhancing the therapeutic effects of the formulation.

Gabapentin, a structural analog of the neurotransmitter gamma-aminobutyric acid (GABA), is included in this formulation for its ability to modulate the activity of certain calcium channels in the nervous system. By inhibiting these channels, gabapentin can reduce the release of excitatory neurotransmitters, thereby diminishing neuropathic pain signals. This makes it particularly effective in treating conditions characterized by nerve pain, such as postherpetic neuralgia or diabetic neuropathy.

Ketamine, an NMDA receptor antagonist, is utilized in this formulation for its potent analgesic properties. By blocking NMDA receptors, ketamine can prevent the transmission of pain signals in the central nervous system, providing relief from chronic pain conditions. Its inclusion in the topical gel allows for localized action, minimizing systemic side effects often associated with oral or intravenous administration.

Ketoprofen, a nonsteroidal anti-inflammatory drug (NSAID), is incorporated for its ability to inhibit the cyclooxygenase (COX) enzymes, which play a crucial role in the inflammatory process. By reducing the production of prostaglandins, ketoprofen effectively alleviates inflammation and pain associated with conditions such as arthritis or musculoskeletal injuries. The topical application of ketoprofen ensures that its anti-inflammatory effects are concentrated at the site of application, reducing the risk of gastrointestinal side effects commonly seen with oral NSAIDs.

Lidocaine, a local anesthetic, is included in the formulation to provide immediate pain relief by blocking sodium channels in the neuronal cell membrane. This action prevents the initiation and conduction of nerve impulses, resulting in temporary numbness and alleviation of pain. The presence of lidocaine in the gel offers rapid onset of action, making it an ideal component for managing acute pain episodes.

This compounded topical gel is particularly beneficial for patients who require a multifaceted approach to pain management, as it combines the unique mechanisms of action of each active ingredient to address different aspects of pain and inflammation. The formulation is suitable for a variety of disease states, including neuropathic pain, inflammatory conditions, and localized musculoskeletal pain. By applying the gel directly to the affected area, patients can achieve targeted relief with minimal systemic exposure, reducing the likelihood of adverse effects.

For prescribers, this formulation offers a customizable option for patients who may not respond adequately to conventional therapies or who experience intolerable side effects from oral medications. The ability to adjust the concentration of each active ingredient allows for personalized treatment plans tailored to the specific needs of each patient.

If you have any questions or require further information about this formulation, please do not hesitate to reach out to us at Bayview Pharmacy. Our team of compounding pharmacists is here to assist you with any inquiries you may have.

The Gabapentin 6%/Ketamine 10%/Ketoprofen 10%/Lidocaine 4% 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 combination of active ingredients directly to the site of application, providing localized relief and minimizing systemic exposure. While it is commonly used for managing neuropathic pain, musculoskeletal pain, and inflammatory conditions, there are several other potential applications that may benefit patients and prescribers seeking alternative therapeutic options.

One potential use of this formulation is in the management of post-herpetic neuralgia, a condition characterized by persistent pain following a shingles outbreak. The combination of gabapentin and ketamine can help modulate nerve pain, while lidocaine provides immediate numbing relief. Additionally, the anti-inflammatory properties of ketoprofen may assist in reducing any residual inflammation associated with the condition. This gel may also be considered for patients with complex regional pain syndrome (CRPS), where the multimodal approach of this formulation can address the diverse symptoms associated with this challenging condition.

Furthermore, this topical gel may be beneficial for patients experiencing pain associated with diabetic neuropathy. The synergistic effects of gabapentin and ketamine can help alleviate the burning and tingling sensations often reported by these patients. The inclusion of lidocaine offers rapid onset of action, which can be particularly useful for acute flare-ups. For patients with osteoarthritis, the anti-inflammatory action of ketoprofen, combined with the analgesic effects of the other components, may provide relief from joint pain and improve mobility.

In addition to these uses, the formulation may be explored for its potential in managing pain associated with fibromyalgia, a condition characterized by widespread musculoskeletal pain. The gel's ability to deliver multiple active ingredients directly to the affected areas can help target the localized pain and discomfort experienced by fibromyalgia patients. Moreover, the formulation's pump mechanism ensures precise dosing, which is crucial for maintaining consistent therapeutic levels and minimizing the risk of side effects.

It is important for both patients and prescribers to consider the individual needs and medical history of the patient when exploring these alternative uses. As with any compounded medication, the efficacy and safety of this formulation for off-label uses should be evaluated on a case-by-case basis. If you have any questions or require further information about this formulation, please reach out to us at Bayview Pharmacy. Our team of compounding pharmacists is here to assist you in optimizing patient care through personalized medication solutions.