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Amitriptyline 2%/Clonidine 0.2%/Ketoprofen 10%/Lidocaine 10% Transdermal Gel

Customized at Bayview Pharmacy, this compounded transdermal gel is designed to help manage neuropathic pain, fibromyalgia, migraines, and chronic back pain.
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, 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
Ketoprofen
Lidocaine Hydrochloride
Topical Gel
652fdf5cf5effac6f49d064e

Formula Information

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This formulation is a compounded transdermal gel containing Amitriptyline 2%, Clonidine 0.2%, Ketoprofen 10%, and Lidocaine 10%. 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 that the active ingredients are absorbed directly into the affected area, providing targeted treatment.

It works by increasing the levels of certain chemicals in the brain that help improve mood, sleep, and the body's response to pain. It works by relaxing and widening blood vessels, which can decrease the severity of pain.

Ketoprofen is a nonsteroidal anti-inflammatory drug (NSAID) that works by reducing hormones that cause inflammation and pain in the body. It is commonly used to relieve pain, swelling, and joint stiffness caused by arthritis. Lidocaine is a local anesthetic that works by blocking nerve signals in your body. It is used to relieve postherpetic neuralgia, a type of nerve pain caused by shingles or herpes zoster virus.

This compounded formulation is particularly beneficial for patients suffering from neuropathic pain, fibromyalgia, chronic pain syndromes, postherpetic neuralgia, and migraines. The combination of these four active ingredients provides a multi-modal approach to pain management, targeting different pain pathways and providing relief from various types of pain.

It is important to note that this formulation should be used as directed by a 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, dry mouth, or constipation. If any of these effects persist or worsen, patients should inform their healthcare provider promptly.

For prescribers, this formulation offers a non-invasive, targeted treatment option that can be customized to meet the unique needs of each patient. It can be a valuable tool in the management of chronic and neuropathic pain conditions, particularly in patients who have not responded to traditional oral medications or who cannot tolerate their side effects.

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

Drug Interactions

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This compounded formulation contains Amitriptyline, Clonidine, Ketoprofen, and Lidocaine, all of which are active ingredients that work synergistically to manage various pain conditions such as Neuropathic Pain, Fibromyalgia, Chronic Pain Syndromes, Postherpetic Neuralgia, and Migraines. However, it's important to be aware of potential drug interactions that may occur with other medications you may be taking.

Amitriptyline, a tricyclic antidepressant, can interact with MAO inhibitors, SSRIs, anticholinergic drugs, and certain antihypertensive medications. It's crucial to avoid alcohol while using this medication as it can increase drowsiness and dizziness. Clonidine, an alpha-2 adrenergic agonist, can interact with beta-blockers, digitalis, and certain antidepressants. Abrupt discontinuation of Clonidine can lead to a rapid increase in blood pressure, so it's important to follow your healthcare provider's instructions when discontinuing this medication.

Ketoprofen, a nonsteroidal anti-inflammatory drug (NSAID), can interact with anticoagulants, aspirin, other NSAIDs, and certain high blood pressure medications. It's important to avoid alcohol while using this medication as it can increase the risk of stomach bleeding. Lidocaine, a local anesthetic, can interact with certain heart medications and other local anesthetics. It's important to inform your healthcare provider if you have any heart conditions or are taking any heart medications.

While this formulation is designed for transdermal application and has a lower risk of systemic side effects, it's still important to inform your healthcare provider of all the medications you are currently taking, including over-the-counter medications, vitamins, and herbal supplements. This will help your healthcare provider to monitor for drug interactions and adjust your treatment plan accordingly.

This formulation works by targeting the pain at its source. Amitriptyline and Clonidine work by blocking pain signals from the nerves to the brain. Ketoprofen reduces inflammation at the site of pain, and Lidocaine numbs the specific area, providing immediate relief.

Remember, it's important to use this medication exactly as prescribed by your healthcare provider. Do not apply more than the recommended dose, and avoid applying this medication to broken or irritated skin. If you experience any side effects or have any concerns, contact your healthcare provider immediately.

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

How Does it Work

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The Amitriptyline 2%/Clonidine 0.2%/Ketoprofen 10%/Lidocaine 10% Transdermal Gel is a unique formulation designed to provide targeted relief for a variety of pain conditions. This gel is applied topically, directly to the area of pain, allowing for localized treatment and reducing the potential for systemic side effects.

Amitriptyline, a tricyclic antidepressant, works by increasing the levels of certain chemicals in the brain that help improve mood, sleep, and the body's response to pain. In this formulation, it is used for its analgesic properties, particularly in neuropathic pain and fibromyalgia.

Clonidine is an alpha-2 adrenergic agonist that is traditionally used to treat high blood pressure. However, in this formulation, it is used for its ability to block pain signals in the nervous system, making it particularly useful in treating neuropathic pain and migraines.

Ketoprofen is a nonsteroidal anti-inflammatory drug (NSAID) that works by reducing hormones that cause inflammation and pain in the body.

Lidocaine is a local anesthetic that works by blocking nerve signals in your body. It is used to reduce pain or discomfort caused by skin irritations such as sunburn, insect bites, poison ivy, poison oak, poison sumac, and minor cuts, scratches, or burns. In this formulation, it provides immediate, localized relief from pain.

The gel formulation allows for easy and precise application, and the pump mechanism ensures that the correct dose is dispensed each time. The gel is absorbed through the skin, directly targeting the area of pain and reducing the potential for systemic side effects. This makes it an excellent option for patients who are unable to take oral medications or who prefer a topical treatment option.

As with any medication, it is important to use this product as directed by your healthcare provider. If you have any questions about this formulation or how to use it, please reach out to us at Bayview Pharmacy. Our team of knowledgeable compounding pharmacists is here to help.

Other Uses

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Aside from the mentioned conditions, this combination therapy of Amitriptyline, Clonidine, Ketoprofen, and Lidocaine may potentially provide symptomatic relief from other chronic pain conditions. It could be utilized as adjunctive therapy for Diabetic Peripheral Neuropathy, providing a reduction in pain and discomfort caused by nerve damage due to diabetes. In some instances, the formulation may prove beneficial in the management of Complex Regional Pain Syndrome (CRPS), a chronic pain condition that typically affects a limb, by reducing inflammation and activating pain relief pathways.

The constituents of this compound also make it a potential therapeutic candidate for conditions that are not primarily pain-related. Owing to the anticholinergic properties of Amitriptyline, the gel can serve as an off-label treatment for Hyperhidrosis, providing symptomatic relief through reducing the activity of sweat glands. The inclusion of Clonidine, a known anti-hypertensive agent, could offer some symptomatic relief in managing withdrawal symptoms from opioids, smoking, or other substances, although this use should always be under the close supervision of a healthcare provider.

Additionally, this transdermal formulation might prove beneficial in managing the discomfort and localized pain attributed to conditions like Osteoarthritis and Rheumatoid Arthritis. Lidocaine, a local anesthetic, and Ketoprofen, an anti-inflammatory drug, could help in mitigating the localized pain and inflammation associated with these conditions.

It's crucial to note that all these possible uses are subject to individual patient response, and the outcomes can vary. The exact dosage and application site would need to be determined by a healthcare provider after taking into account the patient's overall health, other medical conditions, and current medications. Patients are strongly advised against self-medicating and should always consult with their healthcare provider before using this formulation for any conditions other than what it's prescribed for. It is also important to note that this product is intended for topical use only and should not be ingested or applied near the eyes or other sensitive mucus membranes.

If you have any questions or would like further clarification on the potential applications of this formulation, feel free to reach out to us at Bayview Pharmacy. Our team of skilled compounding pharmacists is always here to assist you with any information you may need.

Frequently Asked Questions

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What is this compounded formulation of Amitriptyline/Clonidine/Ketoprofen/Lidocaine?

This is a transdermal gel containing a mixture of four active ingredients: Amitriptyline 2%, Clonidine 0.2%, Ketoprofen 10%, and Lidocaine 10%. This formulation is designed to be applied directly on the skin for targeted treatment or absorption.

How does the pump mechanism work?

The pump mechanism of this gelled formulation allows you to apply the exact quantity of medicine needed. Simply press down on the pump to dispense the gel, and it will provide an easy and precise application each time.

Why is the medicine formulated as a semisolid gel?

The semisolid gel formulation allows for a controlled release of the active ingredients through the skin, while the gel-like consistency ensures ease of application and increases the comfort for the patient.

How should I apply this transdermal gel?

Apply the medication directly to the area of the skin as instructed by your healthcare provider, then gently massaging it in until it is fully absorbed. Make sure your skin is clean and dry before applying.

Why is this medication a combination of four active ingredients?

This combination offers the benefits of each individual drug, providing a broad spectrum of effects. Amitriptyline can help relieve certain types of pain, clonidine can treat high blood pressure and attention deficit hyperactivity disorder (ADHD), ketoprofen can reduce inflammation and pain, and lidocaine provides numbing for the treated area.

Are there any specific precautions I should be aware of?

Avoid contact with eyes, mouth, or open wounds. Do not use on sunburned, windburned, dry, chapped, irritated, or broken skin. Consult your healthcare provider for more detail.

What should I do if I experience any side effects?

If you experience side effects like rash, itching/swelling, severe dizziness, or trouble breathing, immediately contact your healthcare provider or seek medical attention.

Can I use other topical medications along with this transdermal gel?

Before using any other topical medications along with this compound, it is best to discuss it with your healthcare provider to avoid any potential interactions or adverse reactions.

How should I store this compound?

You should store this compounded medication at room temperature, avoid freezing, and keep it away from children and pets.

Can I shower or swim immediately after applying this gel?

It is recommended to wait for the gel to be fully absorbed into the skin before showering or swimming. This ensures maximum effectiveness and reduces the chance of the medication washing off.

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.

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%/Clonidine 0.2%/Ketoprofen 10%/Lidocaine 10% Transdermal Gel
Topical Gel
60 g
controlled

Apply topically to affected area(s)