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Amitriptyline HCl 20 mg/g/Gabapentin 60 mg/g/Ketamine HCl 50 mg/g Topical Gel

FDA-approved generic
Dose form
Topical Gel
Active ingredients
Amitriptyline Hydrochloride
Gabapentin
Ketamine Hydrochloride

This topical gel formulation combines Amitriptyline HCl 20 mg/g, Gabapentin 60 mg/g, and Ketamine HCl 50 mg/g, designed for targeted treatment of neuropathic pain and fibromyalgia.

A semisolid formulation dispensed through a pump mechanism, facilitating easy and precise application on the skin for targeted treatment or absorption of active ingredients in a gel-like consistency.

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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, NJ, NH, FL, ME and PA. New York patients are served on a limited basis while nonresident registration is pending.
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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Requires a prescription from your own provider. Bayview is a pharmacy and does not prescribe.
Ships within 1 to 2 business days after pharmacist verification
HSA and FSA eligible
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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.

For prescribersSign in for prescription details and order forms.
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
Topical Gel
Service area

Can we ship this formula to your state?

Bayview fills prescriptions for patients in Connecticut, Florida, Maine, Massachusetts, New Hampshire, New Jersey, Pennsylvania and Rhode Island. New York patients are served on a limited basis while nonresident pharmacy registration is pending.

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Formula Information

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This compounded topical gel combines Amitriptyline HCl 20 mg/g, Gabapentin 60 mg/g, and Ketamine HCl 50 mg/g to provide a multifaceted approach to pain management, particularly targeting neuropathic pain conditions. The semisolid formulation is dispensed through a convenient pump mechanism, allowing for precise dosing and easy application directly onto the skin for targeted treatment.

Amitriptyline HCl is a tricyclic antidepressant that, when applied topically, may help modulate pain signals by inhibiting the reuptake of neurotransmitters such as serotonin and norepinephrine. This action can enhance the descending inhibitory pathways in the nervous system, potentially reducing the sensation of pain in affected areas.

Applied topically, gabapentin may decrease neuronal excitability and inhibit the release of excitatory neurotransmitters. This mechanism may reduce pain associated with conditions like diabetic neuropathy, post-herpetic neuralgia, and other nerve-related pain syndromes.

Ketamine HCl, an NMDA receptor antagonist, is known for its analgesic properties. Topical application of ketamine can help inhibit the activation of NMDA receptors, which play a key role in the development of central sensitization and chronic pain. By blocking these receptors, ketamine may prevent the amplification of pain signals, offering relief in conditions unresponsive to traditional therapies.

The combination of these three agents in a topical gel allows for synergistic effects, potentially enhancing overall pain relief while minimizing systemic absorption and associated side effects. The localized delivery targets the site of pain directly, which may improve efficacy and reduce the risk of adverse reactions commonly seen with oral medications.

For patients, this formulation offers the convenience of a non-invasive treatment option that can be easily incorporated into daily routines. The pump mechanism ensures accurate dosing, and the gel formulation absorbs quickly without leaving a residue. This may improve adherence to the treatment plan and enhance quality of life by managing pain more effectively.

Prescribers may consider this compounded gel for patients who experience inadequate relief from standard therapies or who cannot tolerate systemic medications due to side effects or contraindications. The topical route may reduce the potential for drug interactions and systemic toxicity, making it a suitable option for a wide range of patients with neuropathic pain conditions.

Patients should use this medication as directed by their healthcare provider. It is important to apply the gel only to intact skin and to avoid contact with eyes, mouth, or other mucous membranes. Hands should be washed thoroughly after each application to prevent accidental spread of the medication.

If you have any questions about this compounded topical gel or if you are considering it as part of a pain management regimen, please reach out to us. Our team at Bayview Pharmacy is here to provide support and answer any inquiries you may have.

Drug Interactions

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The topical gel formulation containing Amitriptyline HCl, Gabapentin, and Ketamine HCl is designed for targeted application on the skin, allowing for localized treatment and absorption of these active ingredients. While this formulation is applied topically, it is important to consider potential drug interactions, especially for patients who may be using other medications concurrently. Understanding these interactions is crucial for both patients and prescribers to ensure safe and appropriate use of the gel.

Amitriptyline HCl, a tricyclic antidepressant, can interact with other medications that affect serotonin levels, such as selective serotonin reuptake inhibitors (SSRIs), serotonin-norepinephrine reuptake inhibitors (SNRIs), and monoamine oxidase inhibitors (MAOIs). Although the systemic absorption of amitriptyline from a topical application is generally lower than oral administration, caution is advised when patients are using other serotonergic drugs due to the risk of serotonin syndrome, a potentially life-threatening condition. Additionally, amitriptyline may enhance the sedative effects of central nervous system depressants, including alcohol, benzodiazepines, and opioids, which could lead to increased drowsiness or respiratory depression.

Gabapentin, an anticonvulsant and neuropathic pain agent, may interact with other central nervous system depressants, potentially leading to additive sedative effects. Patients using gabapentin in combination with opioids, benzodiazepines, or alcohol should be monitored for signs of excessive sedation or respiratory depression. Although the topical application of gabapentin is less likely to cause significant systemic interactions, prescribers should remain vigilant, especially in patients with compromised skin integrity that might increase absorption.

Ketamine HCl, an NMDA receptor antagonist, is known for its anesthetic and analgesic properties. When used topically, systemic absorption is typically minimal; however, interactions with other medications that affect the central nervous system should still be considered. Ketamine may potentiate the effects of other CNS depressants, such as opioids and benzodiazepines, leading to enhanced sedation or respiratory depression. Additionally, ketamine may interact with medications that affect the cardiovascular system, such as antihypertensives, potentially altering blood pressure control.

Patients and prescribers should also be aware of the potential for local skin reactions at the site of application, which could be exacerbated by concurrent use of other topical agents. It is advisable to avoid applying other topical medications or cosmetics on the same area to prevent interactions that could affect the absorption or efficacy of the gel formulation.

For patients with complex medication regimens or those with underlying health conditions, it is essential to consult with healthcare providers to evaluate the risk of interactions and adjust treatment plans accordingly. If you have any questions or concerns about the use of this topical gel formulation and potential drug interactions, please reach out to us at Bayview Pharmacy for further guidance and support.

How Does it Work

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The Amitriptyline HCl 20 mg/g, Gabapentin 60 mg/g, and Ketamine HCl 50 mg/g topical gel is a compounded formulation designed to provide targeted relief for various neuropathic pain conditions. This semisolid gel is dispensed through a pump mechanism, allowing for easy and precise application directly onto the skin. The gel-like consistency ensures that the active ingredients are absorbed efficiently at the site of application, maximizing therapeutic effects while minimizing systemic exposure and potential side effects.

Amitriptyline HCl is a tricyclic antidepressant that, when used topically, can help alleviate pain by modulating the transmission of pain signals in the nervous system. It works by inhibiting the reuptake of neurotransmitters such as serotonin and norepinephrine, which play a crucial role in pain perception. By increasing the levels of these neurotransmitters in the synaptic cleft, amitriptyline can enhance the body's natural pain-relief mechanisms, providing relief from chronic pain conditions.

Gabapentin is an anticonvulsant medication that is often used to treat neuropathic pain. When applied topically, gabapentin can help reduce pain by binding to specific calcium channels on nerve cells, which decreases the release of excitatory neurotransmitters involved in pain signaling. This action helps to stabilize nerve activity and reduce the sensation of pain.

Ketamine HCl is an NMDA receptor antagonist that has potent analgesic properties. In topical form, ketamine can help manage pain by blocking the NMDA receptors, which are involved in the amplification and maintenance of pain signals. By inhibiting these receptors, ketamine can reduce central sensitization and hyperalgesia, providing significant pain relief for patients with complex regional pain syndrome and other chronic pain disorders.

The combination of these three active ingredients in a topical gel formulation allows for a multimodal approach to pain management. Each component targets different pathways in the pain signaling process, providing a synergistic effect that enhances overall pain relief. This formulation is particularly beneficial for patients who may not tolerate oral medications well or who require localized treatment to manage their symptoms effectively.

For both patients and prescribers, this compounded topical gel offers a customizable and targeted treatment option for managing neuropathic pain. The pump mechanism ensures consistent dosing and ease of use, making it a convenient choice for daily application. As with any medication, it is important to follow the prescribed instructions and consult with a healthcare professional if there are any questions or concerns regarding its use. If you have any questions, please reach out to us at Bayview Pharmacy for further assistance.

Frequently Asked Questions

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What is the purpose of Amitriptyline HCl, Gabapentin, and Ketamine HCl in this topical gel?

This compounded topical gel combines Amitriptyline HCl, Gabapentin, and Ketamine HCl to provide targeted relief from pain. Amitriptyline is often used for its analgesic properties, Gabapentin is used to treat nerve pain, and Ketamine is known for its pain-relieving and anti-inflammatory effects.

How should I apply this topical gel?

The gel should be applied to clean, dry skin. Dispense the gel using the pump mechanism and apply it to the affected area, gently massaging it in until fully absorbed. Follow your healthcare provider's instructions regarding the amount and frequency of application.

Can I use this gel on broken or irritated skin?

It is generally advised not to apply the gel to broken or irritated skin unless directed by a healthcare professional. Doing so may increase the risk of irritation or adverse effects.

How does the pump mechanism work?

The pump mechanism is designed to dispense a precise amount of gel with each pump, ensuring consistent dosing and easy application. Simply press down on the pump to release the gel.

Are there any side effects associated with this topical gel?

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.

Can I use this gel in conjunction with other medications?

Before using this gel with other medications, consult your healthcare provider to ensure there are no potential interactions or contraindications.

How should I store this topical gel?

Store the gel at room temperature, away from direct sunlight and moisture. Keep it out of reach of children and pets.

Is this topical gel suitable for all skin types?

While the gel is formulated for topical use, individuals with sensitive skin should perform a patch test before full application. If irritation occurs, discontinue use and consult a healthcare provider.

How long does it take for the gel to work?

The onset of relief can vary depending on the individual and the severity of the condition being treated. Some users may experience relief within a few hours, while others may require several applications over a few days.

Can I use this gel during pregnancy or while breastfeeding?

If you are pregnant or breastfeeding, consult your healthcare provider before using this gel to ensure it is safe for you and your baby.

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.

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, 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.

Amitriptyline HCl 20 mg/g/Gabapentin 60 mg/g/Ketamine HCl 50 mg/g Topical Gel
Topical Gel
60 g
controlled

Apply topically to affected area(s)

Three times daily