This formulation is a compounded topical gel containing Amitriptyline HCl 4%, Diclofenac Na 4%, Gabapentin 8%, Ketamine HCl 13.8%, Lidocaine HCl 2.5%, and Tramadol HCl 4%. 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 for its analgesic properties, Diclofenac Na is a nonsteroidal anti-inflammatory drug (NSAID) used to reduce pain and inflammation, Gabapentin is used to treat nerve pain, Ketamine HCl is a potent analgesic, Lidocaine HCl is a local anesthetic, and Tramadol HCl is an opioid analgesic. Together, these ingredients work synergistically to provide relief from conditions such as neuropathic pain, chronic pain, and inflammation.

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This formulation is a compounded topical gel containing Amitriptyline HCl 4%, Diclofenac Na 4%, Gabapentin 8%, Ketamine HCl 13.8%, Lidocaine HCl 2.5%, and Tramadol HCl 4%. It is designed to be applied directly to the skin for targeted treatment, offering a unique combination of active ingredients to manage various disease states. The gel is dispensed through a pump mechanism, which allows for easy and precise application.
Amitriptyline HCl is a tricyclic antidepressant that can help manage chronic pain, particularly neuropathic pain. Diclofenac Na is a nonsteroidal anti-inflammatory drug (NSAID) that reduces pain and inflammation. Gabapentin is an anticonvulsant that can also treat nerve pain. Ketamine HCl is a powerful anesthetic that can provide rapid pain relief. Lidocaine HCl is a local anesthetic that can numb the skin and surrounding tissues, reducing pain and discomfort. Tramadol HCl is a strong painkiller used to treat severe pain.
When combined in a topical gel, these ingredients can provide comprehensive pain management. The gel formulation allows for targeted application, which can reduce systemic side effects often associated with oral medications. This makes it a suitable option for patients who have difficulty swallowing pills or who prefer to avoid systemic side effects.
This formulation can be used to treat a variety of disease states, including neuropathic pain, chronic pain, inflammation, and certain types of arthritis. It may also be beneficial for patients with fibromyalgia, shingles, or other conditions that cause severe or chronic pain. As with any medication, it's important to use this product under the supervision of a healthcare provider, who can monitor your response and adjust your treatment as necessary.
Please note that this is a compounded medication, which means it is made specifically for you based on a prescription from your healthcare provider. It is not a commercially available product and should be used only under the direction of a healthcare provider who is familiar with your medical history and current health status.
If you have any questions about this formulation, how to use it, or what to expect, please don't 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 health.
This topical gel formulation contains a combination of Amitriptyline HCl, Diclofenac Na, Gabapentin, Ketamine HCl, Lidocaine HCl, and Tramadol HCl. Each of these active ingredients has its own potential for drug interactions, which can be amplified when used in combination. It's important for patients and prescribers to be aware of these potential interactions to ensure safe and appropriate use of this medication.
Amitriptyline HCl, a tricyclic antidepressant, can interact with other antidepressants, antipsychotics, certain antihistamines, and drugs that affect serotonin levels. It can also interact with certain heart medications and increase the risk of side effects such as irregular heartbeat.
Diclofenac Na, a nonsteroidal anti-inflammatory drug (NSAID), can interact with other NSAIDs, blood thinners, certain blood pressure medications, and certain heart medications. It can also increase the risk of stomach bleeding when used with alcohol or corticosteroids.
Gabapentin, an anticonvulsant and nerve pain medication, can interact with antacids, opioids, certain antiviral medications, and drugs that slow the central nervous system. It can also increase the risk of side effects such as drowsiness and dizziness.
Ketamine HCl, an anesthetic, can interact with other anesthetics, certain psychiatric medications, and drugs that affect serotonin levels. It can also increase the risk of side effects such as hallucinations and confusion.
Lidocaine HCl, a local anesthetic, can interact with other local anesthetics, certain heart medications, and certain seizure medications. It can also increase the risk of side effects such as irregular heartbeat and seizures.
Tramadol HCl, an opioid pain medication, can interact with other opioids, certain antidepressants, certain antifungal medications, and drugs that affect serotonin levels. It can also increase the risk of side effects such as respiratory depression and serotonin syndrome.
This formulation is typically used to treat conditions such as neuropathic pain, post-herpetic neuralgia, fibromyalgia, and other conditions involving chronic pain. The combination of these medications works to numb the affected area, reduce inflammation, and alter the perception of pain to provide relief.
It's important to inform your healthcare provider of all medications you are currently taking, including prescription drugs, over-the-counter medications, and dietary supplements, to avoid potential drug interactions. If you have any questions or concerns about this medication, please don't hesitate to reach out to us.
This topical gel formulation combines several active ingredients, each with its own unique mechanism of action, to provide a comprehensive approach to pain management. The formulation is designed to be applied directly to the skin, allowing for targeted treatment and absorption of the active ingredients.
Amitriptyline HCl is a tricyclic antidepressant that works by increasing the levels of certain chemicals in the brain that help improve mood, pain threshold, and sleep.
Diclofenac Na is a nonsteroidal anti-inflammatory drug (NSAID) that works by reducing substances in the body that cause pain and inflammation. It's commonly used to treat mild to moderate pain, or signs and symptoms of osteoarthritis or rheumatoid arthritis.
Gabapentin is an anticonvulsant that is often used to treat nerve pain. It works by affecting the chemicals and nerves in the body that are involved in the cause of seizures and some types of pain.
Ketamine HCl is a powerful anesthetic that provides pain relief by blocking the NMDA receptor, a type of glutamate receptor, in the brain. This blocking action helps to decrease pain sensations.
Lidocaine HCl is a local anesthetic that works by causing temporary numbness/loss of feeling in the skin and mucous membranes. It does this by blocking the nerve signals in your body.
Tramadol HCl is a strong painkiller that works in two ways. It binds to the μ-opioid receptor on nerves (the same mechanism that is used by opioids) and it also inhibits the reuptake of serotonin and norepinephrine, which inhibits pain signals traveling along the nerves to the brain.
Together, these ingredients work synergistically to provide comprehensive pain relief. The gel formulation allows for targeted application, which can be particularly beneficial for localized pain. It also allows for a lower systemic absorption, which can reduce the risk of systemic side effects.
If you have any questions about this formulation, please don't hesitate to reach out to us. We're here to help.
This potent multi-agent pain-relief gel, comprising Amitriptyline HCl, Diclofenac Na, Gabapentin, Ketamine HCl, Lidocaine HCl, and Tramadol HCl, is typically indicated for patients battling persistent pain related to conditions such as neuropathy, fibromyalgia, and post-operative incisional pain. However, its mechanism of action suggests it may also find utility in other medical situations.
For instance, this topical gel may provide relief from various chronic pain conditions where conventional oral medication is ineffective or leads to systemic side effects. This may include patients with osteoarthritis, diabetic neuropathy, post-herpetic neuralgia, migraine-related allodynia, and those experiencing musculoskeletal pain caused by muscle strains, sprains, or sport injuries.
In addition, this compounded medication may be explored by healthcare providers for its potential role in managing patients diagnosed with interstitial cystitis, a condition characterized by chronic pelvic pain. The gel’s active ingredients can potentially soothe bladder wall inflammation and thus bring much-needed relief to afflicted patients. Furthermore, certain cases of refractory chronic cough, which resists conventional treatment and involves a peripheral neuropathic mechanism, may also benefit from this formulation.
Nonetheless, though these alternate uses show promising potential, they are based on the individual components of the compounded medication and their known therapeutic effects. The actual efficacy of the combination itself in these indications will require more rigorous clinical investigation. It's crucial that prescribing providers weigh the risk-to-benefit ratio for each patient's unique clinical scenario and advocate for patient education regarding potential side effects and proper application techniques.
Such decisions should involve a detailed individual patient assessment, review of medical history, and consideration of other pharmacologic and non-pharmacologic options. Moreover, we strongly encourage compounded product utilization to be guided by a clinician's professional judgment and a strong pharmacist-patient-prescriber relationship.
If you have any questions about this information or need further guidance, please don't hesitate to reach out to us at Bayview Pharmacy. We are here to help.
It specifically contains Amitriptyline HCl, Diclofenac Na, Gabapentin, Ketamine HCl, Lidocaine HCl, and Tramadol HCl. It is designed to act locally at the site of pain when applied to the skin.
This medication should be applied topically to the skin, directly over the area of pain. It is dispensed through a pump mechanism which ensures easy and precise application.
The medication is a semisolid formulation with a gel-like consistency. This allows it to spread easily on the skin making application simple and efficient.
Each active ingredient in the medication has a unique mechanism of action. By combining multiple ingredients, the formulation allows for a more comprehensive approach to pain management.
Yes, this compounded formulation is a prescription medicine and should be used under the guidance of a healthcare professional.
Side effects can vary depending on individual reaction. They may include skin irritations like redness, itching, or rash. Other systemic side effects are less common due to the topical nature of the medication, but may include dizziness, nausea or vomiting. If you experience any side effects, contact your healthcare provider immediately.
Using other topical medications on the same area of skin where you have applied this compounded formulation could interfere with its absorption or cause negative interactions. Always consult with your healthcare provider before combining treatments.
The medication should be stored at room temperature, away from heat and direct sunlight. Keep the container tightly closed when not in use to maintain the integrity of the formulation.
If you miss a dose, apply it as soon as you remember. However, if it's near the time for your next dose, skip the missed dose and return to your normal dosing schedule. Never double dose to catch up.
Always wash your hands before and after applying this medication. Avoid touching your eyes, mouth, or other mucous membranes with the gel. And, never cover the treated area with a bandage or heating pad unless directed by your healthcare provider.
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.
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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, 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.
Apply topically to affected area(s)