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Amitriptyline HCl 2%/Baclofen 2%/Gabapentin 5%/Ketamine HCl 11.5%/Lidocaine HCl 5% Topical Gel

This formulation is a compounded topical gel containing Amitriptyline HCl 2%, Baclofen 2%, Gabapentin 5%, Ketamine HCl 11.5%, and Lidocaine HCl 5%. 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 combination of these active ingredients is designed to treat a variety of disease states. Amitriptyline HCl is a tricyclic antidepressant used to relieve symptoms of depression. Baclofen is a muscle relaxer and an antispastic agent. Gabapentin is used to treat nerve pain and seizures. Ketamine HCl is a potent analgesic used for the management of acute and chronic pain. Lidocaine HCl is a local anesthetic that works by causing temporary numbness/loss of feeling in the skin and mucous membranes.

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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
Gabapentin
Ketamine Hydrochloride
Lidocaine Hydrochloride
Baclofen
Topical Gel
652f4c6978d1cf95637eba1a

Formula Information

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This formulation is a compounded topical gel containing Amitriptyline HCl 2%, Baclofen 2%, Gabapentin 5%, Ketamine HCl 11.5%, and Lidocaine HCl 5%. 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 effectively for targeted treatment.

Amitriptyline HCl 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. Gabapentin is an anticonvulsant and nerve pain medication, often used to treat nerve pain conditions such as postherpetic neuralgia and diabetic neuropathy. Ketamine HCl is a potent analgesic that can provide relief from severe, chronic pain. Lidocaine HCl is a local anesthetic that works by causing temporary numbness/loss of feeling in the skin and mucous membranes.

This combination of medications in a topical gel form is designed to provide targeted relief from various types of pain, including neuropathic pain, muscle spasms, and severe chronic pain. The topical application allows for the active ingredients to be absorbed directly at the site of pain, potentially reducing systemic side effects often associated with oral administration of these medications.

It is important for patients to use this medication as directed by their healthcare provider. The gel should be applied to the affected area(s) as instructed, and patients should wash their hands immediately after application unless the hands are the area being treated. Patients should also avoid touching their eyes, nose, or mouth until after their hands have been washed.

As with any medication, this formulation may cause side effects. These can include skin irritation at the application site, drowsiness, dizziness, and dry mouth. If any of these side effects persist or worsen, patients should contact their healthcare provider promptly.

Prescribers should consider the individual patient's condition and medical history when deciding to use this formulation. It is important to monitor the patient's response to the medication and adjust the treatment plan as necessary.

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 here to assist you.

Drug Interactions

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This compounded formulation contains several active ingredients, each with its own potential for drug interactions. It's important to note that while these interactions are possible, they may not always occur. The risk can depend on several factors including dose, duration of therapy, and individual susceptibility.

Amitriptyline HCl is a tricyclic antidepressant that can interact with other medications that affect serotonin levels, such as selective serotonin reuptake inhibitors (SSRIs), serotonin and norepinephrine reuptake inhibitors (SNRIs), and monoamine oxidase inhibitors (MAOIs). Combining these medications can increase the risk of serotonin syndrome, a potentially life-threatening condition. Amitriptyline can also interact with anticholinergic drugs, increasing the risk of side effects such as dry mouth, constipation, and confusion.

Baclofen is a muscle relaxant and antispastic agent. It can interact with other central nervous system depressants, including alcohol, benzodiazepines, and opioids, leading to increased sedation and potentially dangerous respiratory depression. Baclofen can also interact with medications that affect kidney function, as it is primarily excreted by the kidneys.

Gabapentin is an anticonvulsant and nerve pain medication. It can interact with antacids containing magnesium or aluminum, as they can reduce the absorption of gabapentin. Gabapentin can also increase the effects of other central nervous system depressants, including alcohol, antihistamines, and opioids.

Ketamine HCl is a general anesthetic. It can interact with other central nervous system depressants, leading to increased sedation and potentially dangerous respiratory depression. Ketamine can also interact with medications that affect liver function, as it is primarily metabolized by the liver.

Lidocaine HCl is a local anesthetic. It can interact with other local anesthetics and medications that are similar in structure, such as antiarrhythmic drugs. These interactions can increase the risk of systemic toxicity. Lidocaine can also interact with medications that affect liver function, as it is primarily metabolized by the liver.

This formulation is intended for topical use, which can reduce the risk of systemic drug interactions. However, systemic absorption can still occur, especially if the medication is applied to broken or inflamed skin, or used over a large area. Therefore, it's important to use this medication as directed by your healthcare provider, and to inform them of all other medications you are taking, including prescription, over-the-counter, and herbal products.

This formulation is used to treat various disease states, including neuropathic pain, muscle spasms, and certain types of depression. The combination of active ingredients works to alleviate pain, relax muscles, and improve mood. However, the effectiveness of this formulation can vary depending on the individual and the specific condition being treated.

If you have any questions about this formulation or its potential interactions, please don't hesitate to reach out to us.

How Does it Work

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This topical gel formulation combines five active ingredients: Amitriptyline HCl, Baclofen, Gabapentin, Ketamine HCl, and Lidocaine HCl. Each of these ingredients plays a unique role in managing pain and discomfort associated with various disease states.

Amitriptyline HCl is a tricyclic antidepressant that works by increasing the levels of certain chemicals in the brain that help improve mood, pain, and sleep. In this formulation, it is used for its analgesic properties to help manage chronic pain.

Baclofen is a muscle relaxer and an antispastic agent. It works by helping to relax the muscles and reduce muscle spasm, stiffness, and pain. It is particularly useful in conditions where spasticity and muscle spasms are a problem.

Gabapentin is an anticonvulsant and nerve pain medication. It works by calming down nerve activity to reduce pain, and discomfort. It is often used in the management of neuropathic pain.

Ketamine HCl is a powerful anesthetic that provides pain relief by blocking the NMDA receptors in the brain and spinal cord, which play a significant role in modulating pain. In this formulation, it is used for its potent analgesic properties.

Lidocaine HCl is a local anesthetic that works by causing temporary numbness/loss of feeling in the skin and mucous membranes. It works by blocking nerve signals in your body and is used to reduce pain or discomfort caused by skin irritations.

When applied topically, this formulation allows for targeted treatment, delivering the active ingredients directly to the area of discomfort or pain. The gel-like consistency ensures easy and precise application, and the pump mechanism allows for controlled dispensing of the medication.

This formulation can be used to manage pain associated with various disease states, including neuropathic pain, fibromyalgia, post-herpetic neuralgia, and other conditions characterized by nerve or muscle pain. It is important to note that the effectiveness of this formulation can vary depending on the individual patient's condition and response to treatment.

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

Other Uses

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This combination of Amitriptyline HCl, Baclofen, Gabapentin, Ketamine HCl, and Lidocaine HCl in a topical gel formulation is primarily used in pain management - particularly for neuropathic pain and conditions such as postherpetic neuralgia, diabetic neuropathy, and other conditions associated with nerve injury or inflammation. However, there may be other off-label uses for this gel-based therapy.

Amitriptyline is a tricyclic antidepressant which, when used topically, can decrease pain perception. Baclofen, a muscle relaxant, helps in relaxing stiff muscles and reducing muscle spasms. It also blocks nerve signals from muscles to the brain. Ketamine HCl is mainly used as anesthesia in this gel but it also has potential roles for chronic pain control especially in those resistant to other therapies. Lidocaine is well known for its local anesthetic activity and has been successfully used to manage burns, wounds, and skin conditions causing discomfort on the surface of the skin.

Aside from pain management, this formulation could potentially be used for conditions such as vulvodynia, a chronic condition producing discomfort in the vulvar area for which there is no identifiable cause. Depression and anxiety, prevalent in chronic pain sufferers, might also be alleviated through the antidepressant properties of Amitriptyline. Furthermore, the muscle relaxant properties of Baclofen could theoretically provide relief for select patients with muscle tension or spasticity related to conditions such as traumatic brain injury and cerebral palsy. This formulation must always be used under the direction and supervision of a health care provider.

This formulation could potentially be used as well in veterinary medicine for treating animals suffering from certain pain conditions. For instance, Lidocaine and Ketamine have been used topically in horses and dogs for pain control.

Patients and prescribers are encouraged to discuss potential off-label uses with their healthcare team, including their pharmacist and doctor, before using the medication in this way. Off-label use should always be based on sound clinical judgment and thorough assessment of risk vs. benefit. Please do not hesitate to reach out to us for any questions or further information.

Frequently Asked Questions

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What is the purpose of this compound formulation?

This compound formulation is intended to serve as a topical anesthetic and analgesic. The combined effects of Amitriptyline HCl, Baclofen, Gabapentin, Ketamine HCl, and Lidocaine HCl provide targeted pain relief when applied to the skin.

How should I apply this formulation?

The formulation is dispensed through a pump mechanism making application easy and precise. Apply it neatly and evenly on the skin to ensure optimal absorption of the active ingredients.

Do I need to rub the gel into the skin?

Is this compound formulation safe to use?

Yes, this compound formulation is developed to be safe for topical use. However, as with all medications, any specific medical questions or concerns should be discussed with your healthcare provider.

What are the potential side-effects of this formulation?

Side-effects can vary depending on the individual, however, some may experience redness, itchiness, or light burning sensation at the site of application. If any severe or persistent side-effects occur, please consult your healthcare provider.

How should I store this formulation?

The formulation should be stored in a cool, dry place out of direct sunlight. Please keep it out of reach of children.

What is the texture of this product?

This formulation is a semisolid gel, which facilitates easy and precise application on the skin for targeted pain relief and absorption of active ingredients.

Can I use this formulation with other medications?

While it should be safe to use with other medications, you should always consult with your healthcare provider before starting any new treatments, especially if you're currently on other medications.

What should I do if I miss a dose?

If you miss a dose, apply it as soon as you remember. If it's near the time for your next dose, skip the missed dose and proceed with your regular dosing schedule. Do not double up doses to compensate for a missed one.

How quickly does the formulation work?

The onset of relief can vary based on individual factors, including the severity and location of the pain. Generally, you can expect to feel results within a few hours of the initial application.

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 HCl 2%/Baclofen 2%/Gabapentin 5%/Ketamine HCl 11.5%/Lidocaine HCl 5% Topical Gel
Topical Gel
60 g
controlled

Apply topically to affected area(s)