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Amitriptyline 5%/Ketamine 1%/Ketoprofen 5%/Lidocaine 1% Transdermal Gel

This formulation is a combination of Amitriptyline 5%, Ketamine 1%, Ketoprofen 5%, and Lidocaine 1% 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 cases of neuropathic pain. Ketamine, an NMDA receptor antagonist, is used for its potent analgesic effects. Ketoprofen, a nonsteroidal anti-inflammatory drug (NSAID), is used for its anti-inflammatory and analgesic properties. Lidocaine, a local anesthetic, provides immediate relief from pain and discomfort.

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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.
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.
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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
Ketamine Hydrochloride
Ketoprofen
Lidocaine Hydrochloride
Topical Gel
652f416177ebd365cce98a25

Formula Information

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This formulation is a compounded transdermal gel containing Amitriptyline 5%, Ketamine 1%, Ketoprofen 5%, and Lidocaine 1%. 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. It works by increasing the levels of certain chemicals in the brain that help elevate mood and reduce the sensation of pain. Ketamine, a powerful anesthetic, provides rapid pain relief by blocking the NMDA receptors in the brain which are responsible for transmitting pain signals. Ketoprofen is a nonsteroidal anti-inflammatory drug (NSAID) that reduces inflammation and pain by inhibiting the production of prostaglandins, substances in the body that cause inflammation. Lidocaine is a local anesthetic that works by causing temporary numbness in the area where it is applied, thereby reducing pain and discomfort.

This formulation is used to treat a variety of disease states. It can be used for neuropathic pain conditions such as post-herpetic neuralgia, diabetic neuropathy, and trigeminal neuralgia. Furthermore, it can be used for palliative care in cancer patients to manage pain and improve quality of life.

It is important to note that this formulation should be used as directed by a healthcare provider. The gel should be applied to the affected area in the amount and frequency prescribed. It should not be used on broken or irritated skin, and contact with eyes and mucous membranes should be avoided. Side effects may include skin irritation at the application site, drowsiness, dry mouth, and constipation. If any of these side effects persist or worsen, or if you experience any serious side effects such as rapid heartbeat, severe dizziness, or difficulty urinating, contact your healthcare provider immediately.

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 assist you.

Drug Interactions

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This formulation combines four active ingredients: Amitriptyline, Ketamine, Ketoprofen, and Lidocaine, each with its own mechanism of action and potential for drug interactions. It is important to note that while this formulation is applied topically, systemic absorption can still occur, leading to potential interactions with other medications taken orally or intravenously.

Amitriptyline is a tricyclic antidepressant that works by increasing the levels of certain chemicals in the brain that help improve mood, pain, and sleep. It can interact with MAO inhibitors, SSRIs, anticholinergic drugs, and certain antihypertensive medications. Concurrent use with these medications can lead to serious side effects such as serotonin syndrome, increased heart rate, and severe blood pressure changes.

Ketamine is an NMDA receptor antagonist used for its analgesic and anesthetic properties. It can interact with CNS depressants, opioids, and certain antipsychotic medications. These interactions can lead to increased sedation, respiratory depression, and changes in blood pressure and heart rate.

Ketoprofen is a nonsteroidal anti-inflammatory drug (NSAID) that works by reducing hormones that cause inflammation and pain in the body. It can interact with anticoagulants, antiplatelet drugs, other NSAIDs, and certain antihypertensive medications. These interactions can increase the risk of bleeding, kidney damage, and blood pressure changes.

Lidocaine is a local anesthetic that works by blocking nerve signals in your body. It can interact with other local anesthetics and certain antiarrhythmic drugs, leading to increased risk of systemic toxicity.

This formulation is primarily used for the management of neuropathic pain, inflammatory pain, and localized pain syndromes. Amitriptyline and Ketamine work synergistically to modulate the perception of pain, while Ketoprofen reduces inflammation and Lidocaine provides immediate local anesthesia. The transdermal route allows for targeted treatment, reducing systemic side effects and improving patient compliance.

It is crucial for patients and prescribers to consider all potential drug interactions before starting this medication. Always inform your healthcare provider of all the medications you are currently taking, including prescription drugs, over-the-counter medications, and dietary supplements. If you have any questions or concerns, please do not hesitate to reach out to us at Bayview Pharmacy.

How Does it Work

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The Amitriptyline 5%/Ketamine 1%/Ketoprofen 5%/Lidocaine 1% 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 is 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 to help manage chronic pain conditions.

Ketamine, a NMDA receptor antagonist, works by blocking the N-Methyl-D-aspartate receptor in the brain, which plays a role in pain signaling. By blocking this receptor, ketamine helps to reduce the sensation of pain.

Ketoprofen is a nonsteroidal anti-inflammatory drug (NSAID) that works by reducing the production of prostaglandins, chemicals that cause inflammation, pain, and fever in the body. Ketoprofen is used in this formulation for its anti-inflammatory and analgesic properties.

Lidocaine, a local anesthetic, works by blocking sodium channels in the nerve cells, preventing the initiation and conduction of nerve impulses. This results in a numbing effect at the site of application, providing immediate relief from pain.

When combined in a transdermal gel, these four active ingredients work together to provide comprehensive pain relief. The gel formulation allows for targeted application, ensuring that the medication is delivered directly to the area of pain. The pump mechanism allows for easy and precise dosing, ensuring that the correct amount of medication is applied each time.

This formulation can be used to treat a variety of disease states, including neuropathic pain, fibromyalgia, post-herpetic neuralgia, and other conditions associated with chronic pain. It is important to note that while this formulation can help manage symptoms, it does not cure the underlying disease. Therefore, it should be used as part of a comprehensive treatment plan under the supervision of a healthcare provider.

If you have any questions about this formulation, or if you would like more information on how it can be used to manage specific disease states, please do not hesitate to reach out to us. We are here to help and provide you with the information you need to make informed decisions about your healthcare.

Other Uses

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The Amitriptyline 5%/Ketamine 1%/Ketoprofen 5%/Lidocaine 1% Transdermal Gel formulation is primarily used for pain management, typically chronic nerve-related pain. The active ingredients in this formulation have known analgesic, anti-inflammatory and anesthetic properties that offer relief for these painful conditions. However, apart from this, there might be several other potentially beneficial uses.

A secondary use can be in the management of migraines and cluster headaches. Amitriptyline, a tricyclic antidepressant, has been shown to potentially be beneficial in preventing migraines and reducing the frequency and severity of such recurrent headaches. It's crucial to remember, though, that this should be done under professional medical supervision, as its effects on migraines aren't entirely understood yet.

Furthermore, this combination could also be used for post-herpetic neuralgia (PHN), an uncomfortable or painful condition that can occur after shingles. Lidocaine, a local anesthetic, helps to numb the area and offer temporary relief from the pain caused by PHN. Meanwhile, amitriptyline and ketamine's pain-modulating effects can augment this relief.

Other potential uses could be in managing pain associated with fibromyalgia (a disorder characterized by widespread musculoskeletal pain), diabetic peripheral neuropathy, post-surgical pain, and other similar chronic pain conditions. Always it's important to remember that individual patient responses can vary and that all medication use should be under the guidance of a healthcare professional.

Patients and prescribers wanting further information on other possible uses for this formulation, or with any questions regarding the formulation, are encouraged to reach out to us. Our team of knowledgeable compounding pharmacists at Bayview Pharmacy will be happy to assist. Your complete understanding and safety are our top priorities.

Frequently Asked Questions

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What is Amitriptyline 5%/Ketamine 1%/Ketoprofen 5%/Lidocaine 1% Transdermal Gel?

This is a semisolid formulation that contains four active ingredients. The gel is dispensed through a pump mechanism which allows for precise application directly onto the skin for targeted treatment.

How does the pump mechanism work?

The pump mechanism is designed for easy and precise application. It dispenses a set amount of gel each time it is pressed, ensuring consistent dosing.

How should I use this gel?

You should apply this gel exactly as directed by your healthcare provider. Generally, it involves placing a specific amount onto the skin in the targeted area.

Can I apply this gel anywhere on the body?

The gel should be applied only to the area of the body directed by your healthcare provider, as it is intended for targeted treatment.

What does the gel feel like?

Being a semisolid formulation, the product has a gel-like consistency. This should provide a cooling effect upon application.

Does the gel need to be refrigerated?

You should store this product according to the instructions provided by your healthcare provider or pharmacist. If no instructions are provided, store it at room temperature and away from heat and moisture.

How does this formulation help manage my pain?

Each of the ingredients in this formulation serves a specific purpose. Amitriptyline and ketamine are used for their analgesic properties, Ketoprofen acts as a nonsteroidal anti-inflammatory drug, and Lidocaine is a local anesthetic. Collectively, they work towards managing your pain.

Are there any side effects?

All medicines can cause side effects. Some potential side effects of this formulation might include skin irritation at the application site, or an allergic reaction. If you notice any side effects, contact your healthcare provider.

What if I miss a dose?

If you miss a dose, apply it as soon as you remember. If it's close to the time of your next dose, skip the missed dose and return to your regular dosing schedule. Do not apply extra gel to make up for a missed dose.

Is it safe to use this gel for an extended period?

This will depend on your specific circumstances and should be discussed with your healthcare provider. Do not exceed the recommended duration of therapy without proper medical advice.

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 5%/Ketamine 1%/Ketoprofen 5%/Lidocaine 1% Transdermal Gel
Topical Gel
60 g
controlled

Apply topically to affected area(s)