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Amitriptyline HCl 4%/Diclofenac Na 2%/Ketamine HCl 3.45%/Lidocaine HCl 5% Topical Gel

Customized at Bayview Pharmacy, this compounded topical gel is tailored to help manage neuropathic pain, fibromyalgia, and chronic back pain. Learn more today!
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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
Diclofenac Sodium
Ketamine Hydrochloride
Lidocaine Hydrochloride
Topical Gel
65306059832bbc4b0b5b82bc

Formula Information

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This formulation is a compounded topical gel containing Amitriptyline HCl 4%, Diclofenac Na 2%, Ketamine HCl 3.45%, and Lidocaine HCl 5%. It is a semisolid formulation that is 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. It works by increasing the levels of certain chemicals in the brain that help elevate mood and reduce the sensation of pain. Diclofenac Na is a nonsteroidal anti-inflammatory drug (NSAID) that reduces substances in the body that cause pain and inflammation. Ketamine HCl is a NMDA receptor antagonist that provides pain relief by blocking the signals from the peripheral to the central nervous system. Lidocaine HCl is a local anesthetic that works by causing temporary numbness/loss of feeling in the skin and mucous membranes.

This formulation is used to treat various disease states that involve pain and inflammation. It can be used for conditions such as neuropathic pain, osteoarthritis, rheumatoid arthritis, and other conditions that cause chronic pain.

For patients, it is important to apply this medication as directed by your healthcare provider. Avoid contact with eyes, mouth, and other mucous membranes. If you experience any adverse reactions such as rash, itching, redness, or swelling at the application site, discontinue use and contact your healthcare provider immediately.

For prescribers, please consider the patient's overall health status, potential drug interactions, and individual response to treatment when prescribing this formulation. Regular follow-ups are recommended to monitor the patient's progress 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 always here to assist you.

Drug Interactions

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This topical gel formulation combines Amitriptyline HCl, Diclofenac Na, Ketamine HCl, and Lidocaine HCl, each of which has its own potential drug interactions. It's important to note that the risk of systemic interactions is generally lower with topical formulations compared to oral medications, but it's still crucial to be aware of potential interactions.

Amitriptyline HCl is a tricyclic antidepressant that can interact with MAO inhibitors, SSRIs, anticholinergic drugs, and certain antihypertensive medications. It can also increase the effects of alcohol and other CNS depressants. Diclofenac Na, a nonsteroidal anti-inflammatory drug (NSAID), can interact with anticoagulants, antiplatelet drugs, other NSAIDs, and certain antihypertensives. It can also increase the risk of gastrointestinal bleeding when taken with alcohol or corticosteroids.

Ketamine HCl is a general anesthetic that can interact with CNS depressants, including alcohol, benzodiazepines, and opioids. It can also interact with certain antihypertensives and increase the effects of neuromuscular blocking agents. Lidocaine HCl, a local anesthetic, can interact with antiarrhythmic drugs and certain other local anesthetics.

This formulation is designed to provide targeted treatment for a variety of conditions. Amitriptyline HCl can help manage neuropathic pain, while Diclofenac Na can reduce inflammation and pain. Ketamine HCl can provide general pain relief, and Lidocaine HCl can provide local numbing to the application area. This combination can be particularly useful for conditions like osteoarthritis, rheumatoid arthritis, and certain neuropathic pain conditions.

It's important for patients to inform their healthcare provider of all medications they are currently taking, including prescription drugs, over-the-counter medications, and dietary supplements. This will help the provider assess the risk of potential drug interactions. Patients should also avoid alcohol while using this formulation due to the potential for increased CNS depression and gastrointestinal bleeding.

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 four active ingredients: Amitriptyline HCl, Diclofenac Na, Ketamine HCl, and Lidocaine HCl. Each of these ingredients plays a unique role in managing pain and inflammation.

Amitriptyline HCl 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. When applied topically, Amitriptyline HCl can provide targeted pain relief without the systemic side effects associated with oral administration.

Diclofenac Na is a nonsteroidal anti-inflammatory drug (NSAID) that works by reducing substances in the body that cause pain and inflammation. As a topical agent, Diclofenac Na can provide localized relief from pain and swelling, making it particularly useful for conditions like osteoarthritis.

Ketamine HCl is a powerful anesthetic that works by blocking certain receptors in the brain that are responsible for transmitting pain signals. When used in a topical formulation, Ketamine HCl can provide profound pain relief without the systemic effects or potential for abuse associated with oral or injectable forms.

Lidocaine HCl is a local anesthetic that works by blocking nerve signals in your body. It is used topically 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, Lidocaine HCl provides immediate, localized pain relief.

Together, these four ingredients provide a multi-modal approach to pain management, addressing both the perception of pain in the brain and the inflammatory response in the body. As a topical gel, it can be applied directly to the area of discomfort, providing targeted relief with minimal systemic side effects.

If you have any questions about this formulation or how it may benefit you, 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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The formulation of Amitriptyline HCl 4%/Diclofenac Na 2%/Ketamine HCl 3.45%/Lidocaine HCl 5% Topical Gel, in its semisolid, gel-like consistency and easy-application pump mechanism, goes beyond treating localized pain conditions. It uniquely combines active ingredients to serve as a multi-modal approach to managing varying areas of discomfort.

In some cases, this specialized formulation may be used for some forms of neuropathic pain such as diabetic neuropathy or post-herpetic neuralgia, offering targeted relief in a non-systemic manner. Amitriptyline, a tricyclic antidepressant, has been used off-label for chronic and neuropathic pain for years; its inclusion may bring added relief for such conditions. Lidocaine is a local anesthetic, potentially helping numb the area to decrease immediate pain sensation. Ketamine, an NMDA receptor antagonist, is beneficial in providing analgesia. Diclofenac is an NSAID, and can reduce inflammation and alleviate pain.

Additionally, this topical gel may provide comfort for certain dermatological conditions that involve inflammation and discomfort. Diclofenac has also been known to reduce skin inflammation, while Lidocaine provides overall numbing effect, hence it may be beneficial for skin conditions such as psoriasis or eczema.

Furthermore, the medication could potentially be used off-label to ease discomfort from conditions like fibromyalgia or myofascial pain syndrome. The multi-faceted, combined mechanisms of the ingredients provide an advantageous approach in managing such complex conditions.

Keep in mind that although these are other uses, the approximately indicated formulation is highly potent and is built for specific indications. Therefore, it should only be used under direct supervision and prescription by a qualified healthcare provider. Always consult your health provider for your particular medical condition.

If you or your medical provider have any questions with respect to this formulation or its potential uses, don't hesitate to reach out to us at Bayview Pharmacy. Our knowledgeable team of compounding pharmacists are always here to guide you through your journey to better health.

Frequently Asked Questions

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What is the formulation of this topical gel?

The formulation is a semi-solid mixture that contains Amitriptyline HCl 4%, Diclofenac Na 2%, Ketamine HCl 3.45%, and Lidocaine HCl 5%.

How do I apply the gel?

The gel is dispensed through a pump mechanism, facilitating easy and precise application to desired areas on the skin.

What is the texture of the formulation?

The formulation has a gel-like consistency that allows for smooth application on the skin.

Can this gel be applied all over the body?

This gel is intended for targeted treatment, so it should be applied only on affected areas as directed by your healthcare professional.

Is this gel absorbed into the skin?

Yes, the active ingredients in the gel are designed to be absorbed by the skin at the area of application for targeted treatment.

Can I use this formulation with other topical products?

Before using other topical products in conjunction with this formulation, consult your healthcare provider to avoid unwanted interactions.

What is the purpose of this compounded formulation?

This compounded formulation combines several active ingredients meant to provide targeted treatment for diverse conditions. Please consult with your healthcare provider for your specific treatment protocol.

What precautions should I observe when using this topical gel?

Avoid applying the gel to open wounds, sensitive areas, and the eyes or mouth. It should only be used as directed by your healthcare provider.

How does the pump mechanism work?

The pump mechanism allows for easy and precise application of the gel. It ensures that the right amount of product is dispensed each time.

Can this compounded formulation cause any side effects?

Like any medication, this compounded formulation may cause side effects. If you experience any abnormal symptoms after using this formulation, consult your healthcare provider immediately.

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.

Related Formulas

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 4%/Diclofenac Na 2%/Ketamine HCl 3.45%/Lidocaine HCl 5% Topical Gel
Topical Gel
60 g
controlled

Apply topically to affected area(s)