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Formulas

Bupivacaine HCL 2/Ketamine HCL 5/Lidocaine HCL 2 Transdermal Gel

FDA-approved generic
Dose form
Topical Gel
Active ingredients
Bupivacaine Hydrochloride
Ketamine Hydrochloride
Lidocaine Hydrochloride

The Bupivacaine HCL 2/Ketamine HCL 5/Lidocaine HCL 2 Transdermal Gel is a semisolid formulation that is dispensed through a pump mechanism. This design allows for easy and precise application on the skin, ensuring targeted treatment or absorption of the active ingredients. The gel-like consistency of the formulation enhances the comfort and ease of use for the patient.

This formulation is specifically designed to treat various disease states. Bupivacaine HCL is a local anesthetic that provides pain relief, Ketamine HCL is a potent analgesic that can help manage chronic pain, and Lidocaine HCL is another local anesthetic that numbs the skin and surrounding area.

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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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This medication requires a prescription from your doctor

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.
Bupivacaine Hydrochloride
Ketamine Hydrochloride
Lidocaine Hydrochloride
Topical Gel
6537ef06e19c83f509d7e76a

Formula Information

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This formulation combines Bupivacaine HCL 2%, Ketamine HCL 5%, and Lidocaine HCL 2% in a transdermal gel. Bupivacaine and Lidocaine are local anesthetics that work by blocking nerve signals in your body, providing relief from pain. Ketamine, on the other hand, is a powerful analgesic that can help manage both acute and chronic pain.

The gel is a semisolid formulation that is dispensed through a pump mechanism. This allows for easy and precise application on the skin, ensuring that the medication is delivered exactly where it's needed. The gel-like consistency also aids in the absorption of the active ingredients.

This formulation can be used to treat a variety of disease states. It can be used for post-operative pain management, reducing the need for systemic opioids and their associated side effects. It can also be used for chronic pain conditions such as neuropathic pain, fibromyalgia, and arthritis. Furthermore, it can be used in palliative care to manage pain in patients with terminal illnesses.

For patients, it's important to apply the gel as directed by your healthcare provider. Avoid contact with eyes, mouth, and open wounds. If you experience any side effects such as skin irritation, redness, or swelling, discontinue use and contact your healthcare provider immediately.

For prescribers, it's important to consider the patient's overall health status, other medications they may be taking, and their pain management needs when prescribing this formulation. Regular follow-ups are recommended to monitor the patient's response to treatment and adjust the dosage if necessary.

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

Drug Interactions

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The Bupivacaine HCL 2/Ketamine HCL 5/Lidocaine HCL 2 Transdermal Gel is a potent formulation designed to provide targeted pain relief. However, like all medications, it can interact with other drugs, potentially altering their effects or increasing the risk of adverse reactions. It is crucial for patients and prescribers to be aware of these potential interactions.

Bupivacaine, Ketamine, and Lidocaine are all local anesthetics. They work by blocking nerve signals in your body, which can help to numb the area and reduce pain. However, they can interact with other local anesthetics, potentially leading to an increased risk of side effects such as nervous system and cardiovascular system toxicity. Therefore, it is important to inform your healthcare provider if you are using any other local anesthetics.

These medications can also interact with certain antiarrhythmic drugs (like Amiodarone), beta-blockers, and calcium channel blockers. These interactions can potentially lead to changes in heart rhythm or blood pressure. If you are taking any of these medications, it is important to discuss this with your healthcare provider.

Ketamine can interact with CNS depressants, including opioids, benzodiazepines, and alcohol. These interactions can lead to an increased risk of respiratory depression, sedation, and potentially, overdose. It is crucial to avoid the use of these substances while using this formulation.

Furthermore, the use of this formulation with monoamine oxidase inhibitors (MAOIs) or within two weeks of stopping such treatment can lead to serious side effects, including high blood pressure, hyperthermia, and serotonin syndrome. Therefore, it is important to inform your healthcare provider if you are taking any MAOIs.

It is also important to note that this formulation can interact with certain laboratory tests, potentially causing false test results. Make sure laboratory personnel and all your doctors know you use this drug.

This is not a complete list of potential drug interactions. Other medications, including over-the-counter drugs, herbal products, and dietary supplements, can also interact with this formulation. It is important to keep a list of all the products you use and share this information with your healthcare provider and pharmacist.

Remember, drug interactions can be managed or prevented by regular monitoring, dose adjustments, or alternative therapy. Always consult your healthcare provider or pharmacist before starting, stopping, or changing the dosage of any medications.

If you have any questions about the potential drug interactions with Bupivacaine HCL 2/Ketamine HCL 5/Lidocaine HCL 2 Transdermal Gel, please do not hesitate to reach out to us.

How Does it Work

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This formulation is designed to be applied topically, directly to the skin, where it is absorbed into the body to exert its therapeutic effects.

Bupivacaine HCL is a local anesthetic that works by blocking nerve impulses in your body, thereby reducing pain and discomfort. It is a long-acting anesthetic, providing prolonged relief from pain. It works by inhibiting the transmission of pain signals to the brain, thereby reducing the sensation of pain.

Ketamine HCL, on the other hand, is a powerful analgesic and anesthetic. It works by blocking the NMDA receptors in the brain and spinal cord, which play a key role in transmitting pain signals. By blocking these receptors, Ketamine HCL can effectively reduce the perception of pain.

Lidocaine HCL is another local anesthetic that works by blocking nerve signals in your body. It is a fast-acting anesthetic, providing immediate relief from pain. It works by inhibiting the transmission of pain signals to the brain, thereby reducing the sensation of pain.

The combination of these three medications in a transdermal gel formulation allows for targeted treatment of pain. The gel is applied directly to the area of pain, allowing for localized treatment and reducing the risk of systemic side effects. The gel formulation also allows for sustained release of the medications, providing long-lasting relief from pain.

By providing targeted, localized, and sustained relief from pain, this formulation can significantly improve the quality of life for patients suffering from these conditions.

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

Other Uses

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Bupivacaine HCL 2/Ketamine HCL 5/Lidocaine HCL 2 Transdermal Gel, a semi-solid formulation intended for transdermal administration, has a broad range of applications other than what it's traditionally used for, due to the pharmacological properties of its individual constituents.

Bupivacaine and Lidocaine, both being local anesthetics, work by blocking nerve signals in your body, while Ketamine, an NMDA receptor antagonist, not only works as an anesthetic but also has analgesic and anti-inflammatory properties. Therefore, this formulation has the potential to benefits patients experiencing conditions that involve nerve pain and inflammation.

One possible use of this formulation could be to manage post-surgical pain. It may be applied to the surgical wound site to numb the area, reduce inflammation and promote healing. It may also be utilized in laser skin treatments or minor dermatological procedures to numb the skin and reduce discomfort.

Additionally, this gel might be beneficial for patients who suffer from chronic pain complaints such as fibromyalgia, neuropathic pain, or complex regional pain syndrome (CRPS), by providing targeted relief. Also, patients suffering from peripheral neuropathy due to conditions like diabetes may benefit from the analgesic properties of this formulation.

Furthermore, physicians might wish to explore this formulation for those experiencing musculoskeletal pain, such as arthritis, tendonitis, or bursitis, as it may provide temporary relief by blocking pain signals from the affected area to the brain.

It's important to note these alternative uses are not typically the standard of care for these conditions, but may be considered when other treatment options aren't effective, are contraindicated, or if patients prefer a transdermal delivery system. As always, usage should be under the guidance of a healthcare provider.

Always remember, individualized treatment is crucial. Every patient is unique, and the formulation may need to be adjusted according to individual patient needs and response. We'd like to remind prescribers and patients to consult with a compounding pharmacist to discuss the possibilities of this unique formulation and dosage system.

If you have any questions or need further information about this formulation and its manifold applications, do not hesitate to reach out to us at Bayview Pharmacy. Our knowledgeable team of compounding pharmacists is always here to assist you.

Frequently Asked Questions

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What is Bupivacaine HCL 2/Ketamine HCL 5/Lidocaine HCL 2 Transdermal Gel?

The gel is a compounded formulation combining Bupivacaine, Ketamine, and Lidocaine in a semisolid form. The compound is dispensed through a pump mechanism to facilitate easy and precise application on the skin for targeting the treatment or absorption of active ingredients.

How should I apply the Bupivacaine HCL 2/Ketamine HCL 5/Lidocaine HCL 2 Transdermal Gel?

The gel should be applied to the skin as directed by your healthcare provider. It is dispensed through a pump mechanism that ensures an easy and accurate application.

Do I need to rub the gel into the skin after applying it?

No, after applying the gel to the skin in a thin layer, you just need to leave it to be absorbed. There is no need to rub it in.

What is the purpose of the gel-like consistency?

The gel-like consistency allows for a smooth application on the skin and aids in the absorption of the active ingredients. It also prevents the formulation from running or leaking after application.

What happens if I miss a dose?

If you miss a dose, apply it as soon as you remember. If it is near the time to use again, skip the missed dose. Do not use double the amount to make up for the missed dose.

Does Bupivacaine HCL 2/Ketamine HCL 5/Lidocaine HCL 2 Transdermal Gel have any side effects?

As with any medication, this gel can cause side effects. Consult your healthcare provider or pharmacist for detailed information. Always report any adverse reactions right away.

Can this gel be used with other medications?

Inform your healthcare provider of all the medications you are currently using. They can guide you on whether this gel can be used with your other medications.

How long should I use Bupivacaine HCL 2/Ketamine HCL 5/Lidocaine HCL 2 Transdermal Gel?

You should use the gel as long as directed by your healthcare provider. Do not stop using it or change the dosage without professional medical advice.

Should I use this gel if I'm pregnant or breastfeeding?

If you're pregnant or breastfeeding, discuss this with your healthcare provider before using this gel to fully understand the potential risks and benefits.

How should I store Bupivacaine HCL 2/Ketamine HCL 5/Lidocaine HCL 2 Transdermal Gel?

Store this medication at room temperature, away from heat, light and moisture. Keep it out of the reach of children and pets.

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, 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.

Bupivacaine HCL 2/Ketamine HCL 5/Lidocaine HCL 2 Transdermal Gel
Topical Gel
60 g
controlled

Apply topically to affected area(s)