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Formulas

Clonidine HCl 0.2%/Gabapentin 6%/Imipramine HCl 3%/Ketamine HCl 11.5%/Tetracaine 2% Topical Cream

FDA-approved generic
Dose form
Topical Gel
Active ingredients
Clonidine Hydrochloride
Gabapentin
Imipramine Hydrochloride
Ketamine Hydrochloride
Tetracaine Hydrochloride

This formulation is a compounded topical cream containing Clonidine HCl 0.2%, Gabapentin 6%, Imipramine HCl 3%, Ketamine HCl 11.5%, and Tetracaine 2%. It is a semisolid formulation dispensed through a pump mechanism, which allows for easy and precise application on the skin. The cream has a gel-like consistency, designed for targeted treatment or absorption of the active ingredients.

The combination of these active ingredients is used to treat a variety of disease states. Clonidine HCl is an alpha-2 adrenergic agonist used for pain and hypertension. Gabapentin is an anticonvulsant and nerve pain medication used to treat seizures and pain caused by shingles. Imipramine HCl is a tricyclic antidepressant used to treat depression and bedwetting. Ketamine HCl is a general anesthetic used for starting and maintaining anesthesia. Tetracaine is a local anesthetic used to numb different parts of the body.

Together, these ingredients work synergistically to provide relief from neuropathic pain, post-herpetic neuralgia, peripheral neuropathy, and other related conditions.

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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.
Clonidine Hydrochloride
Gabapentin
Imipramine Hydrochloride
Ketamine Hydrochloride
Tetracaine Hydrochloride
Topical Gel
653eef346fa96d1fd3e693b7

Formula Information

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This formulation is a compounded topical cream containing Clonidine HCl 0.2%, Gabapentin 6%, Imipramine HCl 3%, Ketamine HCl 11.5%, and Tetracaine 2%. It is a semisolid formulation dispensed through a pump mechanism, which allows for easy and precise application on the skin. The cream is designed to deliver targeted treatment or absorption of active ingredients in a gel-like consistency.

Each of the active ingredients in this formulation plays a crucial role in managing various disease states. Clonidine HCl, a centrally acting alpha-agonist hypotensive agent, is often used to manage hypertension but in this formulation, it is used for its potential analgesic properties. Gabapentin, an anticonvulsant, is used for its ability to treat nerve pain. Imipramine HCl, a tricyclic antidepressant, is included for its potential to help manage chronic pain, particularly neuropathic pain. Ketamine HCl, an NMDA receptor antagonist, is used for its potent analgesic properties. Lastly, Tetracaine, a local anesthetic, is used to provide temporary relief of pain and itching.

This unique combination of ingredients works synergistically to provide relief from various types of pain, including neuropathic pain, post-herpetic neuralgia, allodynia, and complex regional pain syndrome. The topical application allows for targeted treatment, reducing systemic side effects often associated with oral administration of these medications. It is important to note that this formulation should be used under the guidance of a healthcare provider and the patient should follow the prescribed dosage and application instructions to ensure safety and efficacy.

As compounding pharmacists, we are committed to providing high-quality, personalized medications to meet the unique needs of our patients. We are always available to answer any questions or concerns you may have about this formulation. Please do not hesitate to reach out to us.

Drug Interactions

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This compounded formulation contains several active ingredients, each with its own potential for drug interactions. Clonidine HCl, a centrally acting alpha-agonist hypotensive agent, may interact with other antihypertensive drugs, leading to an additive effect and potentially causing hypotension. It may also interact with CNS depressants, potentially enhancing their sedative effects. Patients should be advised to avoid abrupt discontinuation of clonidine, as this can lead to rebound hypertension.

Gabapentin, an anticonvulsant and analgesic, may interact with antacids, as they can reduce the bioavailability of gabapentin. It is recommended to administer gabapentin at least 2 hours after taking an antacid. Gabapentin may also interact with opioids, increasing the risk of respiratory depression. Patients should be monitored for symptoms of respiratory depression if these drugs are used together.

Imipramine HCl, a tricyclic antidepressant, may interact with other antidepressants, leading to an increased risk of serotonin syndrome. It may also interact with anticholinergic drugs, potentially enhancing their effects. Patients should be monitored for symptoms of anticholinergic toxicity if these drugs are used together. Imipramine may also interact with CYP2D6 inhibitors, potentially increasing the plasma concentrations of imipramine.

Ketamine HCl, a general anesthetic, may interact with other CNS depressants, potentially enhancing their effects. It may also interact with drugs that induce or inhibit CYP3A4, potentially affecting the metabolism of ketamine. Patients should be monitored for changes in the efficacy or side effects of ketamine if these drugs are used together.

Tetracaine, a local anesthetic, may interact with other local anesthetics, potentially leading to an additive effect and increasing the risk of systemic toxicity. It may also interact with drugs that are known to cause methemoglobinemia, potentially increasing the risk of this condition.

This formulation is intended for topical use and is designed to provide targeted treatment for various disease states. The combination of these active ingredients can provide analgesic, anticonvulsant, antidepressant, and anesthetic effects, making it potentially useful in the management of conditions such as neuropathic pain, postherpetic neuralgia, and certain types of depression. However, the potential for drug interactions should be carefully considered when prescribing this formulation. If you have any questions about this formulation or its potential interactions, please do not hesitate to reach out to us.

How Does it Work

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This unique formulation combines five active ingredients: Clonidine HCl, Gabapentin, Imipramine HCl, Ketamine HCl, and Tetracaine, each with its own mechanism of action to provide a comprehensive treatment approach. The cream is designed to be applied topically, directly to the skin, where it can be absorbed into the body to provide targeted relief.

Clonidine HCl is an alpha-2 adrenergic agonist that works by stimulating receptors in the brain that reduce nerve signal transmission. This can help to reduce sensations of pain. Gabapentin is a drug that was originally designed to mimic the neurotransmitter GABA. It is believed to work by blocking certain channels in nerves to reduce pain signals. Imipramine HCl is a tricyclic antidepressant that increases the concentrations of norepinephrine and serotonin, and inhibits the action of acetylcholine. It helps to elevate mood and reduce feelings of pain.

Ketamine HCl is a powerful anesthetic that works by blocking the NMDA receptors in the brain, which play a role in pain signaling. This can provide significant pain relief. Tetracaine is a local anesthetic that works by blocking nerve signals in your body. It numbs the skin and surrounding area.

The cream is dispensed through a pump mechanism, which allows for easy and precise application. The semisolid formulation ensures that the cream stays where it is applied, allowing for targeted treatment. The active ingredients are then absorbed through the skin, where they can begin to work. This method of application also reduces the risk of systemic side effects that can occur with oral medications.

This formulation can be used to treat a variety of disease states. It can provide relief from neuropathic pain, which can be caused by conditions such as diabetes, shingles, or injury. It can also be used to treat fibromyalgia, a condition characterized by widespread musculoskeletal pain. Additionally, it can be used to manage the pain associated with conditions such as arthritis or cancer.

If you have any questions about this formulation, how it works, or how it can be used to treat specific conditions, please don't hesitate to reach out to us. We are here to provide the information you need to make informed decisions about your health.

Other Uses

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This specific combination of medications - Clonidine HCl 0.2%/Gabapentin 6%/Imipramine HCl 3%/Ketamine HCl 11.5%/Tetracaine 2% in a topical cream form - is often formulated for managing and treating neuropathic pain and other conditions involving severe chronic pain. However, the individual components of this compounded medication have a range of uses, which may broaden the functional applications of this formulation.

For instance, Clonidine, a medication traditionally used for managing hypertension, could also be used off-label for withdrawal symptoms from opioids, alcohol, and nicotine. Gabapentin, generally prescribed for nerve pain and seizures, could be applied for restless leg syndrome, hot flashes, anxiety, and insomnia. Imipramine, most known for its use in depressive disorders and bed-wetting in children, may also offer relief from chronic pain, migraines, and irritable bowel syndrome. Ketamine, a powerful analgesic and anesthetic, can be potentially utilized in topical form to manage refractory depression or complex regional pain syndrome (CRPS). Tetracaine, a local anesthetic, primarily used to numb the specific area of the body, is also used in ophthalmology to numb the surface of the eye.

It's important to note that any off-label use of this formulation should be done under the guidance and monitoring of a medical professional. The resulting combined effect of these medications in a single compounded application may differ considerably from the sum of the parts and could be individual-specific, based on various factors like the patient's medical history, lifestyle, concurrent medications, and the specifics of their condition. Always share all relevant information with your healthcare provider to ensure safe usage.

If you have any questions or need additional information about this formulation or any other pharmaceutical compound, feel free to reach out to us at Bayview Pharmacy. As a team of knowledgeable compounding pharmacists, we strive to provide complete, accurate, and timely information to both patients and healthcare providers.

Frequently Asked Questions

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What is the Clonidine HCl 0.2%/Gabapentin 6%/Imipramine HCl 3%/Ketamine HCl 11.5%/Tetracaine 2% Topical Cream?

This is a specially compounded cream which contains different active ingredients (Clonidine, Gabapentin, Imipramine, Ketamine, and Tetracaine) in specified ratios. Each of these ingredients has properties that help in managing pain and other conditions. It is a semi solid formulation specially designed to provide easy, targeted application via a pump mechanism.

How is this cream applied?

This cream is applied topically on the skin, preferably at the specific region where relief is required. Its specialized pump mechanism ensures an easy and precise application.

What is the consistency of this cream?

The cream has a gel-like consistency. This allows for a comfortable application and absorption of ingredients.

How does this cream work?

The different active ingredients within the cream each have therapeutic properties that help manage pain, inflammation and other conditions when applied. They are absorbed through the skin in order to exert their effects.

Who can use this cream?

This cream is typically prescribed by healthcare professionals, so its usage would be under their direction. It is used to manage particular conditions in patients, mostly related to pain and inflammation.

Can this cream cause any side effects?

Like all medications, the use of this cream might come with a potential for side effects. These can vary depending on individual response. It's advisable to consult your healthcare provider about potential side effects before starting this treatment.

What is the role of the pump mechanism?

The pump mechanism facilitates easy and precise dosing of the cream for application. This allows for better targeting of the treatment area and helps in regulating the amount of ingredients applied on the skin.

How often should the cream be used?

The frequency and dosage of using the cream will depend on your health care provider's advice. It's important to follow the instructions provided for best results.

Is this a prescription medication?

Yes, this is a prescription medication. It should only be used under the guidance and direction of a healthcare professional. Remember to follow their directions closely.

Can I use this cream with other medicines?

Before using with other medicines, you should consult your healthcare provider. This is due to potential interactions between the active ingredients in the cream and other medicinal products you may be taking.

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.

Clonidine HCl 0.2%/Gabapentin 6%/Imipramine HCl 3%/Ketamine HCl 11.5%/Tetracaine 2% Topical Cream
Topical Gel
60 g
controlled

Apply topically to affected area(s)