This Amitriptyline 2%/Gabapentin 4%/Ketoprofen 10% Topical Gel is a semisolid formulation designed for targeted treatment of neuropathic pain, arthritis, and localized musculoskeletal pain. It is dispensed through a pump mechanism, ensuring easy and precise application on the skin, allowing for effective absorption of active ingredients in a gel-like consistency.

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.
The Amitriptyline 2%/Gabapentin 4%/Ketoprofen 10% Topical Gel is a compounded medication designed to provide targeted relief from pain, particularly neuropathic and musculoskeletal pain. By combining three active ingredients with complementary mechanisms of action, this formulation aims to alleviate pain at the site of application, reducing systemic exposure and potential side effects associated with oral medications.
Amitriptyline is a tricyclic antidepressant that, when applied topically, can help modulate pain signals by inhibiting the reuptake of neurotransmitters such as serotonin and norepinephrine in peripheral nerves. This action can reduce neuropathic pain symptoms by decreasing the sensitization of nerve endings.
Gabapentin is an anticonvulsant that binds to voltage-gated calcium channels in neurons, reducing the release of excitatory neurotransmitters involved in pain transmission. Topical application of gabapentin can directly affect peripheral nerves, providing relief from neuropathic pain without the central side effects often seen with oral administration.
Ketoprofen is a non-steroidal anti-inflammatory drug (NSAID) that inhibits cyclooxygenase enzymes (COX-1 and COX-2), reducing the synthesis of prostaglandins involved in inflammation and pain. Topically applied ketoprofen can decrease inflammation at the site of application, alleviating pain associated with inflammatory conditions such as arthritis or muscle strains.
The formulation is delivered as a semisolid gel dispensed through a pump mechanism, allowing for precise dosing and easy application to the affected area. The gel base facilitates the absorption of the active ingredients through the skin into underlying tissues, ensuring that the medication reaches the targeted nerves and tissues where it is needed most.
This combination therapy is particularly beneficial for patients who cannot tolerate oral medications due to systemic side effects or those who require localized pain management. By applying the medication directly to the site of pain, patients may experience faster relief with fewer adverse effects compared to systemic treatments.
Patients should apply the prescribed amount of gel to clean, intact skin over the affected area, gently massaging it until fully absorbed. It is important to wash hands thoroughly before and after application to prevent unintentional contact with eyes or mucous membranes. Prescribers should consider this formulation for patients with localized neuropathic or inflammatory pain who may benefit from a multimodal topical approach.
If you have any questions about this medication or how to use it, please reach out to us for more information.
The Amitriptyline 2%/Gabapentin 4%/Ketoprofen 10% Topical Gel is a compounded formulation designed to provide localized relief for conditions such as neuropathic pain, musculoskeletal pain, and inflammatory conditions. While the topical application of this gel minimizes systemic exposure, it is still important to consider potential drug interactions, especially for patients who are concurrently using other medications or have underlying health conditions.
Amitriptyline, a tricyclic antidepressant, can interact with other medications that affect serotonin levels, such as SSRIs, SNRIs, and MAO inhibitors, potentially leading to serotonin syndrome. Although the risk is lower with topical application, caution is advised when patients are on systemic medications that influence serotonin pathways. Additionally, amitriptyline may enhance the sedative effects of CNS depressants, including alcohol, benzodiazepines, and opioids, which could lead to increased drowsiness or dizziness.
Gabapentin, an anticonvulsant, may interact with other CNS depressants, potentially leading to additive sedative effects. Patients should be monitored for increased sedation or dizziness if they are taking other medications with CNS depressant properties. Furthermore, antacids containing aluminum or magnesium can reduce the absorption of gabapentin if taken orally, although this is less of a concern with topical application. However, patients should be advised to maintain a consistent medication regimen to avoid fluctuations in drug levels.
Ketoprofen, a nonsteroidal anti-inflammatory drug (NSAID), can interact with other NSAIDs or aspirin, increasing the risk of gastrointestinal bleeding or ulceration. Although the topical route reduces systemic exposure, patients should be advised to use caution if they are taking oral NSAIDs concurrently. Additionally, ketoprofen may interact with anticoagulants such as warfarin, potentially enhancing their effects and increasing bleeding risk. Patients on anticoagulant therapy should be closely monitored for signs of bleeding.
Overall, while the topical application of this gel formulation reduces the likelihood of systemic drug interactions, it is crucial for both patients and prescribers to be aware of potential interactions with other medications. Patients should inform their healthcare providers of all medications they are taking, including over-the-counter drugs and supplements, to ensure safe and appropriate use of this compounded gel. If you have any questions or concerns about potential drug interactions, please reach out to us at Bayview Pharmacy for further guidance.
The Amitriptyline 2%/Gabapentin 4%/Ketoprofen 10% 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 that the active ingredients are absorbed efficiently for targeted treatment. The gel-like consistency ensures that the formulation remains in place, maximizing contact time with the skin and enhancing absorption.
Amitriptyline, a tricyclic antidepressant, is included in this formulation for its ability to modulate pain pathways. When applied topically, amitriptyline can help reduce neuropathic pain by inhibiting the reuptake of neurotransmitters such as serotonin and norepinephrine, which play a role in pain perception. This local application minimizes systemic exposure and potential side effects associated with oral administration.
Gabapentin, an anticonvulsant, is utilized for its efficacy in treating neuropathic pain. It works by binding to the alpha-2-delta subunit of voltage-gated calcium channels in the central nervous system, which reduces the release of excitatory neurotransmitters. When applied topically, gabapentin can provide localized pain relief by modulating abnormal nerve activity at the site of application, offering an alternative to oral administration that may reduce systemic side effects.
Ketoprofen, a nonsteroidal anti-inflammatory drug (NSAID), is included for its potent anti-inflammatory and analgesic properties. It works by inhibiting the cyclooxygenase (COX) enzymes, which are involved in the synthesis of prostaglandins, compounds that mediate inflammation and pain. The topical application of ketoprofen allows for direct delivery to the affected area, reducing inflammation and pain with minimal systemic absorption, thereby decreasing the risk of gastrointestinal and cardiovascular side effects commonly associated with oral NSAIDs.
This combination of amitriptyline, gabapentin, and ketoprofen in a topical gel formulation is particularly beneficial for patients suffering from conditions such as localized neuropathic pain, musculoskeletal pain, and inflammatory conditions. By delivering these active ingredients directly to the site of pain, the formulation provides targeted relief while minimizing systemic exposure and potential side effects. This makes it an attractive option for patients who may not tolerate oral medications well or who require additional localized pain management.
If you have any questions about this formulation or its use, please reach out to us at Bayview Pharmacy. Our team of knowledgeable compounding pharmacists is here to assist you with any inquiries or concerns you may have.
This topical gel is used for targeted treatment of localized pain and inflammation. It combines the effects of amitriptyline, gabapentin, and ketoprofen to help alleviate symptoms associated with conditions like neuropathic pain and arthritis.
The gel should be applied to clean, dry skin. Dispense the gel using the pump mechanism and gently rub it into the affected area until fully absorbed. Follow your healthcare provider's instructions regarding the amount and frequency of application.
No, you should not apply the gel to broken, irritated, or infected skin. Doing so may increase the risk of irritation or adverse effects. Consult your healthcare provider if you have concerns about skin conditions.
Some users may experience mild skin irritation, redness, or itching at the application site. If you experience severe reactions or symptoms persist, discontinue use and consult your healthcare provider.
The pump mechanism is designed to dispense a precise amount of gel with each use, ensuring consistent application. Simply press the pump to release the gel onto your hand or directly onto the affected area.
Before using this gel with other medications, consult your healthcare provider.
Store the gel at room temperature, away from direct sunlight and moisture. Keep it out of reach of children and pets to prevent accidental ingestion or misuse.
This gel is typically prescribed for adults. If you are considering its use for a child or adolescent, consult a healthcare provider to determine if it is appropriate and safe for their specific needs.
The onset of relief can vary depending on the individual and the condition being treated. Some users may experience relief within a few hours, while others may require several applications over a few days to notice significant improvement.
If you miss a dose, apply the gel as soon as you remember. If it is close to the time for your next dose, skip the missed dose and resume your regular application schedule. Do not double the dose to make up for a missed application.
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.
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.
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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.
Quantity and directions are starting points for this dose form, not treatment recommendations. Dosing remains the prescriber's responsibility.
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.
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.
Apply topically to affected area(s)