Check out our most popular compounded medications! Get Started
Dashboard
Formulas

Amitriptyline 10%/Ketamine 5%/Lidocaine 5%/Prilocaine 5% Transdermal Gel

FDA-approved generic
Dose form
Topical Gel
Active ingredients
Amitriptyline Hydrochloride
Ketamine Hydrochloride
Lidocaine Hydrochloride
Prilocaine Hydrochloride

This formulation is a combination of Amitriptyline 10%, Ketamine 5%, Lidocaine 5%, and Prilocaine 5% in a transdermal gel. It is a semisolid formulation dispensed through a pump mechanism, which allows for easy and precise application on the skin. The gel-like consistency ensures targeted treatment or absorption of the active ingredients.

The formulation is designed to treat a variety of disease states. Amitriptyline, a tricyclic antidepressant, is used for its analgesic properties, particularly in the management of neuropathic pain. Ketamine, an NMDA receptor antagonist, is used for its potent analgesic effects. Lidocaine and Prilocaine, both local anesthetics, provide immediate relief from pain and discomfort.

View more
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 and ME. 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.
Starting at
Get started as a patient
Get Started
This medication requires a prescription from your doctor

Licensed to fill prescriptions for patients in RI, MA, CT, NJ, NH, FL and ME. 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.
Amitriptyline Hydrochloride
Ketamine Hydrochloride
Lidocaine Hydrochloride
Prilocaine Hydrochloride
Topical Gel
652f24b69a83c2b5099c8e40

Formula Information

A small arrow pointing down

This formulation is a compounded transdermal gel containing Amitriptyline 10%, Ketamine 5%, Lidocaine 5%, and Prilocaine 5%. It is a semisolid formulation that is dispensed through a pump mechanism, allowing for easy and precise application on the skin. The gel-like consistency ensures that the active ingredients are absorbed effectively into the skin for targeted treatment.

Amitriptyline is a tricyclic antidepressant that is used in this formulation for its analgesic properties. It works by increasing the levels of certain chemicals in the brain that help elevate mood and reduce the sensation of pain. Ketamine, on the other hand, is a powerful anesthetic that provides rapid pain relief by blocking the NMDA receptors in the brain and spinal cord, which are involved in transmitting pain signals.

Lidocaine and Prilocaine are both local anesthetics that work by causing temporary numbness/loss of feeling in the skin and surrounding tissues. They are used in this formulation to provide immediate, localized pain relief. The combination of these four active ingredients provides both immediate and long-term pain relief.

This formulation can be used to treat a variety of disease states that involve chronic pain, including neuropathic pain, fibromyalgia, post-herpetic neuralgia, and certain types of arthritis. It can also be used to manage pain associated with certain types of cancer, as well as pain resulting from nerve damage due to diabetes (diabetic neuropathy).

It is important to note that this formulation should be used exactly as prescribed by your healthcare provider. The dose and frequency of use will depend on the individual patient's condition and response to treatment. Side effects may include skin irritation at the application site, dizziness, drowsiness, or changes in mood or behavior. If any of these side effects persist or worsen, contact your healthcare provider immediately.

As compounding pharmacists, we are committed to providing personalized medication solutions to meet the unique needs of each patient. If you have any questions about this formulation or how it can be used to manage your specific condition, please do not hesitate to reach out to us at Bayview Pharmacy. We are here to help.

Drug Interactions

A small arrow pointing down

This compounded formulation contains Amitriptyline, Ketamine, Lidocaine, and Prilocaine. These active ingredients work synergistically to provide pain relief, particularly for neuropathic pain conditions. Amitriptyline is a tricyclic antidepressant that has been shown to reduce pain signals in the central nervous system. Ketamine is an NMDA receptor antagonist that can help reduce neuropathic pain and potentiate the effects of opioids. Lidocaine and Prilocaine are local anesthetics that provide topical numbing to the application area, reducing pain signals at the site.

While this formulation is designed to minimize systemic absorption and focus treatment at the site of application, some drug interactions may still occur. Amitriptyline can interact with MAO inhibitors, SSRIs, anticholinergic drugs, and certain heart medications. It's important to inform your healthcare provider if you're taking any of these medications. Additionally, consuming alcohol or grapefruit juice while using this formulation may increase the concentration of Amitriptyline in your blood, potentially leading to increased side effects.

Ketamine may interact with CNS depressants, opioids, and certain psychiatric medications. It's crucial to inform your healthcare provider if you're taking any of these medications. Lidocaine and Prilocaine may interact with other local anesthetics or medications metabolized by the liver. If you're using other topical medications, it's important to apply them at different times to avoid potential interactions.

It's also important to note that this formulation should not be used in patients with a known allergy to any of the ingredients. Patients with certain heart conditions, liver disease, or a history of seizures should use this medication with caution. Pregnant or breastfeeding women should consult their healthcare provider before using this formulation.

As with any medication, it's important to use this formulation as directed by your healthcare provider. If you experience any unusual side effects, discontinue use and contact your healthcare provider immediately. Always inform your healthcare provider of all medications you're currently taking, including over-the-counter drugs, supplements, and herbal products, to avoid potential interactions.

If you have any questions about this formulation or its potential interactions, please don't hesitate to reach out to us at Bayview Pharmacy. Our knowledgeable team of compounding pharmacists is here to assist you.

How Does it Work

A small arrow pointing down

The Amitriptyline 10%/Ketamine 5%/Lidocaine 5%/Prilocaine 5% Transdermal Gel is a unique formulation that combines four active ingredients, each with its own mechanism of action, to provide targeted relief from various disease states. This formulation is designed to be applied topically, directly to the skin, where it can be absorbed into the body to exert its therapeutic effects.

Amitriptyline, a tricyclic antidepressant, works by increasing the levels of certain chemicals in the brain that help elevate mood and reduce pain perception. In this formulation, it is used for its analgesic properties, particularly in the management of neuropathic pain. It is believed to work by blocking the reuptake of serotonin and norepinephrine, two neurotransmitters involved in pain signaling.

Ketamine, an NMDA receptor antagonist, is used for its potent analgesic and anti-inflammatory properties. It works by blocking the NMDA receptors in the brain and spinal cord, which play a key role in transmitting pain signals. By blocking these receptors, ketamine can help reduce the perception of pain.

Lidocaine and Prilocaine are both local anesthetics that work by blocking sodium channels in the nerve cells, preventing the initiation and conduction of nerve impulses. This results in a loss of sensation in the area where the gel is applied, providing immediate relief from pain.

The combination of these four active ingredients in a transdermal gel formulation allows for targeted application and absorption, providing relief directly at the site of pain. The gel formulation also allows for a controlled release of the active ingredients, ensuring a sustained therapeutic effect.

This formulation is particularly useful in the management of conditions such as neuropathic pain, post-herpetic neuralgia, fibromyalgia, and other conditions where pain is a predominant symptom. It can also be used in the management of localized pain conditions such as osteoarthritis.

As with any medication, it is important to use this formulation as directed by your healthcare provider. If you have any questions about this formulation or its use, please do not hesitate to reach out to us at Bayview Pharmacy. Our team of knowledgeable compounding pharmacists is always here to help.

Other Uses

A small arrow pointing down

Aside from its primary use for pain management and nerve-related disorders, the Amitriptyline 10%/Ketamine 5%/Lidocaine 5%/Prilocaine 5% transdermal gel may also serve other therapeutic functions. Under the direction of a healthcare provider, this formulation can potentially be used to manage conditions such as certain types of chronic itch, post-herpetic neuralgia, and peripheral neuropathy.

By delivering analgesic, anesthetic, and antidepressant compounds directly through the skin into the area of concern, this formulation can potentially alleviate discomfort arising from these conditions. The inclusion of Amitriptyline, a tricyclic antidepressant, offers potential benefits for those suffering from persistent itch, often associated with conditions such as dermatitis or pruritus. Additionally, the combination of Lidocaine and Prilocaine, both local anesthetics, may help soothe neuralgia and neuropathy-associated pain by numbing the targeted area, thus reducing nerve signal transmission to the brain.

Moreover, Ketamine, an NMDA receptor antagonist, may play a crucial role in managing chronic pain and hastening the recovery of nerve function in patients with peripheral neuropathy. That said, the off-label use of this transdermal gel should be strictly supervised by a healthcare provider, as several factors such as the patient's overall health condition, severity and type of disease, drug interactions, and patient's response to treatment need to be considered.

Patients should also be made aware that while there are potentially beneficial other uses of this transdermal gel, its use for non-indicated conditions may not be covered by insurance. As with any medication, potential side-effects, interactions, and contraindications should be discussed prior to its use. As always, if there are any questions regarding this formulation and its use, we at Bayview Pharmacy are here to help, so please feel free to reach out to us.

Frequently Asked Questions

A small arrow pointing down

What exactly is Amitriptyline/Ketamine/Lidocaine/Prilocaine Transdermal Gel?

This product is a compounded prescription medication. It is a semisolid formulation dispensable via a pump mechanism. The gel contains Amitriptyline 10%, Ketamine 5%, Lidocaine 5%, and Prilocaine 5% – all active ingredients for pain management and anesthesia.

How does the transdermal gel work?

The gel is applied onto the skin, usually over the area where the patient experiences pain. The active ingredients get absorbed through the skin to provide targeted treatment.

What is the advantage of the pump mechanism in this product?

The pump mechanism allows you to easily dispense the precise amount of gel needed. This reduces chances of overdosing or underdosing and thereby ensuring appropriate treatment.

How often should I apply this transdermal gel?

This should be determined by your healthcare provider. Always follow their instructions to ensure optimal treatment results.

What should I do if I forgot to apply the gel at the required time?

If you miss a dose, use it as soon as you remember. If it is near the time of the next dose, skip the missed dose. Do not double the dose to catch up. Always consult your healthcare provider for more guidance.

Are there any side effects associated with this gel?

All medications can cause side effects. Possible side effects of this gel include skin irritation or a burning sensation at the application site. If these persist or worsen, consult your healthcare provider immediately.

Can I use the gel on broken or irritated skin?

It is not recommended to apply this gel on broken or irritated skin as it may increase the risk of systemic absorption and possible side effects. Contact your healthcare provider for guidance if you have concerns.

Can I use other medications while using this transdermal gel?

Always inform your healthcare provider about all other medications you're currently taking. Some medications may interact with the components of this gel.

Can anyone use this gel?

This gel is a prescription medication. It should only be used under direct supervision of a healthcare provider. It is also not recommended for children or pregnant and breastfeeding women without their physician's advice.

Can I stop using the gel once my pain ceases?

Do not stop using the gel until directed by your healthcare provider. Even if your symptoms improve, premature discontinuation might lead to a relapse.

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, and ME; 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.

Amitriptyline 10%/Ketamine 5%/Lidocaine 5%/Prilocaine 5% Transdermal Gel
Topical Gel
60 g
controlled

Apply topically to affected area(s)