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Amitriptyline 2%/Baclofen 2%/Clonidine 0.1%/Gabapentin 6%/Ketamine 10% Transdermal Gel

Find relief with a custom-compounded transdermal gel from Bayview Pharmacy. Designed to help manage neuropathic pain, fibromyalgia, and migraines.
For prescribers
Prescription details
RxThis formula
Dose formSee below
Quantity____
SigAs directed by prescriber
Refills____
PharmacyBayview Pharmacy, Warwick RI, NCPDP 4106882
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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, NY, NJ, NH, FL and ME.
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This medication requires a prescription from your doctor

Licensed to fill prescriptions for patients in RI, MA, CT, NY, NJ, NH, FL and ME.

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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
Clonidine Hydrochloride
Gabapentin
Ketamine Hydrochloride
Baclofen
Topical Gel
652f3e50486fcd963f24081b

Formula Information

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This formulation is a compounded transdermal gel containing Amitriptyline 2%, Baclofen 2%, Clonidine 0.1%, Gabapentin 6%, and Ketamine 10%. 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 directly into the targeted area, providing localized relief.

Amitriptyline is a tricyclic antidepressant that is used in this formulation for its analgesic properties, particularly in neuropathic pain. Baclofen is a muscle relaxant and antispasmodic agent, used to relieve muscle spasms, pain, and stiffness. Clonidine, an alpha-2 adrenergic agonist, is included for its potential to manage neuropathic pain and its sedative properties. Gabapentin is an anticonvulsant and nerve pain medication that is used to treat seizures and pain caused by shingles. Lastly, Ketamine, an NMDA receptor antagonist, is used for its potent analgesic effects.

This formulation is particularly useful in managing various disease states that involve chronic pain, such as fibromyalgia, neuropathic pain, and complex regional pain syndrome (CRPS). It can also be used in the management of post-herpetic neuralgia and other conditions that cause severe nerve pain. The combination of these medications in a transdermal gel allows for targeted treatment, potentially reducing systemic side effects often associated with oral administration of these medications.

It is important to note that this is a compounded medication, meaning it is made specifically for the patient based on a prescription from a healthcare provider. The strength and combination of ingredients can be adjusted to meet the unique needs of each patient. As with any medication, it is important to use this product as directed by your healthcare provider and report any side effects or adverse reactions immediately.

If you have any questions about this formulation, its uses, or how it may benefit you, please do not hesitate to reach out to us at Bayview Pharmacy. Our knowledgeable team of compounding pharmacists is here to help.

Drug Interactions

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This compounded formulation contains Amitriptyline, Baclofen, Clonidine, Gabapentin, and Ketamine. Each of these active ingredients has its own potential for drug interactions, which can be amplified when used in combination. It's crucial for patients and prescribers to be aware of these potential interactions to ensure safe and appropriate use of this medication.

Amitriptyline is a tricyclic antidepressant that can interact with MAO inhibitors, SSRIs, anticholinergic drugs, and certain antihypertensive medications. Concurrent use with these drugs can lead to serious side effects such as serotonin syndrome, increased heart rate, and elevated blood pressure. It's also important to avoid alcohol while using amitriptyline, as it can increase the medication's sedative effects.

Baclofen is a muscle relaxant and antispastic agent. It can interact with other central nervous system depressants like opioids, benzodiazepines, and alcohol, leading to increased sedation and potentially dangerous respiratory depression. Baclofen can also interact with antihypertensive drugs, potentially causing a significant drop in blood pressure.

Clonidine is an antihypertensive medication that can interact with beta-blockers, causing a rebound hypertension if either medication is discontinued abruptly. It can also interact with CNS depressants, leading to increased sedation. Additionally, certain antidepressants can reduce the effectiveness of clonidine.

Gabapentin is an anticonvulsant and nerve pain medication. It can interact with antacids, reducing the absorption of gabapentin. It can also interact with opioids, leading to increased sedation and respiratory depression. Alcohol can increase the nervous system side effects of gabapentin such as dizziness, drowsiness, and difficulty concentrating.

Ketamine is a general anesthetic that can interact with CNS depressants, leading to increased sedation and potentially dangerous respiratory depression. It can also interact with certain medications for Parkinson's disease, potentially causing hallucinations and confusion.

This formulation is designed to be applied topically, which can reduce the risk of systemic drug interactions. However, it's still important to be aware of potential interactions, especially if the patient is using other medications topically or has compromised skin integrity which could increase systemic absorption.

This formulation is often used to treat conditions such as neuropathic pain, fibromyalgia, and certain types of chronic pain.

If you have any questions about this formulation or potential drug interactions, please don't hesitate to reach out to us. We're here to help ensure that you and your patients are using this medication safely and effectively.

How Does it Work

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This formulation is a combination of five active ingredients: Amitriptyline, Baclofen, Clonidine, Gabapentin, and Ketamine, each playing a unique role in managing various disease states. The medication is designed to be applied topically, directly to the skin, where it is absorbed into the body to provide targeted treatment.

Amitriptyline is a tricyclic antidepressant that works by increasing the levels of certain chemicals in the brain that help improve mood, relieve pain, and promote sleep. It is often used in the management of neuropathic pain and fibromyalgia.

Baclofen is a muscle relaxer and an antispastic agent. It works by restoring the balance of certain natural substances (GABA) in the brain. Baclofen is used to treat muscle symptoms caused by multiple sclerosis, including spasm, pain, and stiffness.

Clonidine is an alpha-2 adrenergic agonist that works by relaxing blood vessels and decreasing heart rate. It is often used to treat high blood pressure, but in this formulation, it is used for its potential to manage neuropathic pain and reduce the symptoms of withdrawal from opioids.

Gabapentin is an anticonvulsant that works by reducing the number of pain signals that are sent out by damaged nerves in the body. It is used to manage postherpetic neuralgia and to control seizures in people with epilepsy.

Ketamine is a general anesthetic that works by blocking certain receptors in the brain to maintain a state of unconsciousness. In this formulation, it is used in a much lower dose to help manage chronic pain, particularly neuropathic pain, which can be resistant to other treatments.

The transdermal gel formulation allows for the medication to be absorbed through the skin directly into the bloodstream, providing targeted relief at the site of pain. The pump mechanism allows for easy and precise application of the medication.

It is important to use this medication under the guidance of a healthcare provider, as each of these medications can have side effects and interactions with other medications.

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

Other Uses

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This compound, while most commonly utilized for pain management in chronic conditions, also has several other applications. The combination of Amitriptyline, Baclofen, Clonidine, Gabapentin, and Ketamine, each with unique therapeutic properties, is employed primarily to manage neuropathic and musculoskeletal pain associated with conditions including fibromyalgia, postherpetic neuralgia, and various forms of arthritis. Nevertheless, it may also be used off-label in certain cases.

For example, Amitriptyline, originally an antidepressant, has demonstrated efficacy in managing tension-type headaches and migraines, as well as post-traumatic stress disorder and insomnia due to its calming effect. Baclofen, on the other hand, is a muscle relaxant and an antispastic agent, often used for treating muscle symptoms caused by multiple sclerosis, including spasm, pain, and stiffness. As a result, this combination might be useful to manage these conditions topically, especially for patients who cannot ingest these medications orally or need more localized relief.

Furthermore, Clonidine, originally used to manage hypertension, may play a role in managing withdrawal symptoms from opioids. Because it's available in this compound in a topical form, it may provide a novel way to manage withdrawal symptoms. Gabapentin, typically prescribed for nerve pain and seizures, may be supportive in managing hot flashes in menopausal patients.

It's also worth mentioning that Ketamine, an analgesic and anesthetic, has recently been investigated for its potential anti-depressant properties in resistant cases, although use in this context should be carefully considered and monitored due to the abuse potential.

It's crucial to note that while these are potential uses of this compound, many are off-label and may not be extensively researched in a topical formation. Therefore, always consult with a knowledgeable prescriber before starting any new treatment. All medications possess potential side effects and should be used judiciously. If you have any questions or need more information about this formulation or its possible uses, please don't hesitate to reach us.

Frequently Asked Questions

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What is this compounded formulation?

This compounded formulation is a mixture of Amitriptyline 2%, Baclofen 2%, Clonidine 0.1%, Gabapentin 6%, and Ketamine 10% in a transdermal gel form. The various drugs within the compound offer different treatment effects, potentially providing pain relief, muscle relaxation, and other therapeutic benefits.

What is the use of this formulation?

This formulation is designed to provide pain relief and relaxation of muscles and nerves, it is often used for the management of neuropathic pain or other conditions as prescribed by a healthcare provider.

How should this gel be applied?

This semisolid formulation is dispensed through a pump mechanism for easy and precise application. You should apply it to the affected area as prescribed by your medical professional.

Is it safe to use this formulation?

Yes, it is safe to use this formulation as prescribed by your healthcare provider. However, you should always consult with your healthcare provider prior to beginning any new medication or therapeutic regimen.

Can I use this formulation in any part of the body?

This compound is intended for topical use on the skin above the affected area. While generally safe for most skin areas, it is best to use as directed by your healthcare provider. Avoid sensitive areas such as eyes or open wounds.

What is the purpose of the different percentages of drugs in the formulation?

Each drug in the formulation has a specific purpose, and the listed percentages represent the amount of each drug relative to the total formulation. These percentages were determined by a healthcare provider and pharmacist to provide optimal treatment outcomes.

What are the functions of each of these drugs in the formulation?

Amitriptyline is used to help relieve nerve pain, Baclofen is a muscle relaxer and an antispastic agent, Clonidine is used to manage withdrawal symptoms associated with opioid addiction, Gabapentin is used to relieve nerves pain, and Ketamine has a moderate level of pain relief. The combination of these drugs provides a comprehensive treatment for conditions such as neuropathic pain.

What consistency does the gel have?

The gel has a semi-solid, gel-like consistency, that is designed for easy and precise application to the skin.

Is this a form of pain relief?

Yes, the combination of drugs in this formulation is commonly used for the management of neuropathic pain or other chronic pain conditions.

Is this available over the counter?

No, this is a compounded medication and thus requires a prescription from a licensed healthcare provider.

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, NY, NJ, NH, FL, and ME. 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 2%/Baclofen 2%/Clonidine 0.1%/Gabapentin 6%/Ketamine 10% Transdermal Gel
Topical Gel
60 g
controlled

Apply topically to affected area(s)