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Clonidine HCl 0.2%/Gabapentin 6%/Ketamine HCl 15%/Lidocaine 5% Transdermal Gel

This formulation is a combination of Clonidine HCl 0.2%, Gabapentin 6%, Ketamine HCl 15%, and Lidocaine 5% in a transdermal gel. 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 formulation is used to treat a variety of disease states. Clonidine HCl is often used for hypertension and attention deficit hyperactivity disorder (ADHD). Gabapentin is used to treat nerve pain and seizures. Ketamine HCl is used for pain management, particularly in cases of chronic or severe pain. Lidocaine is a local anesthetic used to relieve pain and discomfort caused by skin irritations or conditions such as sunburn, insect bites, poison ivy, and minor cuts, scratches, or burns.

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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, NY, NJ, NH, FL and ME.
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, NY, NJ, NH, FL and ME.

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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.
Clonidine Hydrochloride
Gabapentin
Ketamine Hydrochloride
Lidocaine Hydrochloride
Topical Gel
653ef10bdfa91e3dfdd499d8

Formula Information

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This formulation is a compounded transdermal gel containing Clonidine HCl 0.2%, Gabapentin 6%, Ketamine HCl 15%, and Lidocaine 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 of the formulation ensures that the active ingredients are absorbed effectively into the skin for targeted treatment.

Clonidine HCl is an alpha-2 adrenergic agonist that is commonly used to treat high blood pressure. In this formulation, it is used for its potential analgesic properties and its ability to potentiate the effects of other analgesics. Gabapentin is an anticonvulsant that is often used to treat nerve pain. It works by stabilizing electrical activity in the brain and affecting the way the nerves send messages to the brain.

Ketamine HCl is a powerful anesthetic that is used in this formulation for its analgesic and anti-inflammatory properties. It works by blocking the NMDA receptors in the brain, which play a role in pain sensation. Lidocaine is a local anesthetic that works by blocking nerve signals in your body. It is used in this formulation to provide immediate relief from pain and discomfort.

This formulation is particularly useful in treating various disease states that involve chronic pain, such as neuropathic pain, fibromyalgia, and complex regional pain syndrome. The transdermal route of administration allows for targeted treatment, reducing systemic side effects and improving patient compliance.

It is important to note that this is a compounded medication, meaning it is made specifically for the patient based on a doctor's prescription. It is not a commercially available product and should only be used under the supervision of a healthcare professional. As with any medication, it is important to use this formulation as directed by your healthcare provider and report any side effects or adverse reactions immediately.

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 help.

Drug Interactions

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This formulation combines Clonidine HCl, Gabapentin, Ketamine HCl, and Lidocaine in a transdermal gel. 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.

Clonidine HCl is an alpha-2 adrenergic agonist that can interact with other medications that affect blood pressure or heart rate, such as beta-blockers, calcium channel blockers, and other alpha-2 adrenergic agonists. Combining Clonidine with these medications can lead to additive effects, potentially causing excessively low blood pressure or slow heart rate. Clonidine can also interact with tricyclic antidepressants, potentially reducing the effectiveness of Clonidine.

Gabapentin, an anticonvulsant and nerve pain medication, can interact with antacids containing magnesium or aluminum, which can reduce the absorption of Gabapentin. It's recommended to take Gabapentin at least 2 hours after taking an antacid. Gabapentin can also increase the effects of other CNS depressants, such as opioids, antihistamines, and alcohol, potentially leading to increased sedation or respiratory depression.

Ketamine HCl, a powerful anesthetic and analgesic, can interact with other CNS depressants, such as opioids, benzodiazepines, and alcohol, potentially leading to increased sedation or respiratory depression. Ketamine can also interact with medications that affect heart rate or blood pressure, potentially leading to additive effects.

Lidocaine, a local anesthetic, has fewer potential drug interactions, but can interact with other local anesthetics or medications that are metabolized by the liver, potentially leading to increased levels of these medications in the body.

This formulation is designed to provide targeted treatment for various disease states, including neuropathic pain, post-herpetic neuralgia, and complex regional pain syndrome. The combination of these active ingredients works synergistically to provide both immediate and long-term pain relief, while the transdermal delivery system allows for targeted application and minimizes systemic side effects.

It's important for patients and prescribers to discuss all medications, supplements, and over-the-counter products being used to avoid potential drug interactions. If you have any questions about this formulation or potential drug interactions, please reach out to us at Bayview Pharmacy. We are here to help ensure safe and appropriate use of this medication.

How Does it Work

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This formulation combines four active ingredients: Clonidine HCl, Gabapentin, Ketamine HCl, and Lidocaine, each with a unique mechanism of action to provide relief from various disease states. The formulation is designed to be applied topically, allowing for targeted treatment and absorption through the skin.

Clonidine HCl is an alpha-2 adrenergic agonist that works by stimulating receptors in the brain that reduce nerve signal transmission. This results in a decrease in nerve signals that cause pain and inflammation, providing relief from symptoms. The 0.2% concentration in this formulation ensures that the medication is delivered at a therapeutic level without causing unwanted side effects.

Gabapentin is an anticonvulsant and nerve pain medication. It works by stabilizing electrical activity in the nervous system and reducing the release of neurotransmitters that transmit pain signals in the brain and nerves. At a 6% concentration, Gabapentin provides significant pain relief, particularly for conditions such as neuropathic pain.

Ketamine HCl is a powerful anesthetic that works by blocking the NMDA receptors in the brain and spinal cord, which play a significant role in modulating pain.

Lidocaine is a local anesthetic that works by blocking sodium channels in the nerve cells, preventing the initiation and conduction of nerve impulses. This results in a numbing effect at the site of application, providing immediate relief from pain.

The semisolid formulation dispensed through a pump mechanism facilitates easy and precise application on the skin. The gel-like consistency allows for targeted treatment, ensuring that the active ingredients are absorbed directly into the affected area. This not only enhances the effectiveness of the medication but also minimizes the risk of systemic side effects.

By combining four active ingredients with different mechanisms of action, it provides comprehensive pain relief and reduces inflammation, improving the quality of life for patients suffering from these conditions.

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

Other Uses

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This specific formulation, which combines Clonidine HCl 0.2%, Gabapentin 6%, Ketamine HCl 15%, and Lidocaine 5% in a semisolid gel form, can also be used for the management of other conditions besides those initially intended. Firstly, it can have potential benefits in the treatment of various chronic pain conditions, such as neuropathic pain, fibromyalgia, and post-herpetic neuralgia. The combination of these four active components targets different pain pathways, potentially providing a more broad-spectrum relief from chronic pain conditions.

The Gabapentin component, in particular, possesses anticonvulsant properties, meaning this transdermal gel could be beneficial for managing certain neurological conditions such as epilepsy. Additionally, Gabapentin is known to help with the symptoms of peripheral and central neuropathic pain, providing relief from discomfort in a variety of patient populations. Ketamine, another component, is an NMDA receptor antagonist, which can potentially treat central sensitization, a condition often associated with chronic pain disorders.

Meanwhile, Clonidine, an alpha-2 adrenergic agonist, is commonly used to treat hypertension but has also been used off-label for withdrawal symptoms from opioids, alcohol, nicotine, and benzodiazepines. Finally, Lidocaine, a local anesthetic, can provide temporary relief from pain or discomfort from minor burns, abrasions, and cuts, as well as insect bites and even hemorrhoids.

Please note, as with all medication, this formulation should not be used without prescriber guidance. The effectiveness and safety of the gel for these additional applications have not been comprehensively established through rigorous clinical trials. It should be also recognized that every patient is unique and may respond differently to the medication. Further, the safety profile for each individual ingredient should be assessed for potential risks or side-effects before this compound is used off-label.

If you need further information or have any other queries about this formulation, whether you are a patient or healthcare professional, please do not hesitate to reach out to us at Bayview Pharmacy. We would be pleased to assist you further.

Frequently Asked Questions

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What is the composition of this compounded transdermal gel?

This compounded gel consists of Clonidine HCl 0.2%, Gabapentin 6%, Ketamine HCl 15%, and Lidocaine 5%. These active ingredients are combined in a gel-like consistency for absorption through the skin.

How is this compounded transdermal gel dispensed?

The gel is dispensed via a pump mechanism. This allows for easy and precise application of the gel to the targeted area on the skin.

What is the purpose of each active ingredient in the compounded formulation?

Each active ingredient serves a specific purpose. Clonidine is typically used to manage high blood pressure, Gabapentin is often used for nerve-based pain, Ketamine can have anesthetic effects, and Lidocaine is a local anesthetic that helps to reduce pain and discomfort.

Should I apply the gel to intact or broken skin?

The gel should be applied to intact skin. Applying it to broken or irritated skin may increase the chance of absorbing more of the medication into your body, potentially leading to unwanted side effects.

What should I do in case of an accidental overdose?

Seek immediate medical attention if you suspect an overdose. Notably, symptoms of an overdose might include slow heartbeats, severe drowsiness, slow or shallow breathing, or fainting.

Are there any side effects associated with this transdermal gel?

As with any medication, side effects may occur. These can include irritation at the site of application, dizziness, dry mouth, or fatigue. Always consult your healthcare provider for a complete list of potential side effects.

How is this compounded gel stored?

The compounded gel should be stored at room temperature, out of sight and reach of children. Avoid exposure to heat or direct sunlight.

Can I stop using this medication abruptly?

Do not stop using this medication abruptly unless directed by your healthcare provider. There may be withdrawal symptoms if the medication is suddenly stopped.

Can I use this transdermal gel while pregnant or breastfeeding?

Before starting the use of this gel, it's essential to consult with your healthcare provider if you are pregnant, planning to become pregnant, or breastfeeding. Your healthcare provider will evaluate the benefits versus risks to make an informed decision.

Can I use this compounded transdermal gel with other medications?

Before starting the gel, ensure you inform your healthcare provider about any other medications or supplements you are using. Some drugs may interact with the active ingredients of this gel and could cause unwanted effects.

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, 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.

Clonidine HCl 0.2%/Gabapentin 6%/Ketamine HCl 15%/Lidocaine 5% Transdermal Gel
Topical Gel
60 g
controlled

Apply topically to affected area(s)