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Cyclobenzaprine HCl 5 mg/mL/Ketamine HCl 46 mg/mL/Ketoprofen 100 mg/mL Topical Gel

FDA-approved generic
Dose form
Topical Gel
Active ingredients
Cyclobenzaprine Hydrochloride
Ketamine Hydrochloride
Ketoprofen

This Cyclobenzaprine HCl 5 mg/mL, Ketamine HCl 46 mg/mL, and Ketoprofen 100 mg/mL Topical Gel is a semisolid formulation designed for targeted treatment of musculoskeletal pain, neuropathic pain, and inflammation. It is dispensed through a pump mechanism, ensuring easy and precise application on the skin. The gel-like consistency allows for effective absorption of active ingredients, providing relief from pain and inflammation associated with conditions such as arthritis, fibromyalgia, and localized muscle spasms.

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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.
Starting at
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Requires a prescription from your own provider. Bayview is a pharmacy and does not prescribe.
Ships within 1 to 2 business days after pharmacist verification
HSA and FSA eligible
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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.
Cyclobenzaprine Hydrochloride
Ketamine Hydrochloride
Ketoprofen
Topical Gel
Service area

Can we ship this formula to your state?

Bayview fills prescriptions for patients in Connecticut, Florida, Maine, Massachusetts, New Hampshire, New Jersey, Pennsylvania and Rhode Island. New York patients are served on a limited basis while nonresident pharmacy registration is pending.

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Formula Information

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This compounded topical gel combines Cyclobenzaprine Hydrochloride (5 mg/mL), Ketamine Hydrochloride (46 mg/mL), and Ketoprofen (100 mg/mL) to provide a multifaceted approach to managing pain and inflammation. The semisolid formulation is designed for easy and precise application through a pump mechanism, allowing targeted delivery of active ingredients directly to the affected area.

Cyclobenzaprine Hydrochloride is a muscle relaxant that helps alleviate muscle spasms associated with acute, painful musculoskeletal conditions. By blocking nerve impulses sent to the brain, it assists in reducing muscle hyperactivity, leading to decreased pain and improved mobility.

Ketamine Hydrochloride, at a concentration of 46 mg/mL, acts as an N-methyl-D-aspartate (NMDA) receptor antagonist. It is utilized in pain management for its analgesic properties, particularly in neuropathic pain conditions. Topically applied ketamine may help reduce pain signaling in peripheral nerves, thereby diminishing pain perception without significant systemic effects.

Ketoprofen, a potent nonsteroidal anti-inflammatory drug (NSAID), is included at a concentration of 100 mg/mL to reduce inflammation and provide analgesic effects. By inhibiting cyclooxygenase enzymes (COX-1 and COX-2), ketoprofen decreases the synthesis of prostaglandins, which are mediators of inflammation and pain.

The combination of these three active ingredients in a topical gel allows for synergistic effects in managing pain and inflammation. The localized application minimizes systemic absorption, potentially reducing the risk of systemic side effects commonly associated with oral administration of these medications.

This formulation may be considered for patients experiencing localized musculoskeletal pain, neuropathic pain, or inflammatory conditions where topical therapy is appropriate. Prescribers may find it beneficial for patients who require a multimodal analgesic approach but need to avoid systemic side effects or have contraindications to oral medications.

Patients should apply the gel as directed by their healthcare provider, typically to clean, intact skin over the affected area. It is important to avoid contact with broken skin, eyes, and mucous membranes. Patients should monitor for any signs of skin irritation or allergic reactions and notify their healthcare provider if such effects occur.

Before using this compounded topical gel, patients should inform their healthcare provider of their full medical history, including any allergies, existing conditions, and

Drug Interactions

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This topical gel formulation combines Cyclobenzaprine HCl, Ketamine HCl, and Ketoprofen, each contributing to its therapeutic effects. Cyclobenzaprine is a muscle relaxant, Ketamine is an NMDA receptor antagonist with analgesic properties, and Ketoprofen is a nonsteroidal anti-inflammatory drug (NSAID). Together, they are used to manage conditions such as musculoskeletal pain, neuropathic pain, and inflammation. However, it is crucial to consider potential drug interactions when using this formulation.

Cyclobenzaprine, when absorbed systemically, can interact with central nervous system (CNS) depressants such as alcohol, benzodiazepines, and opioids, potentially enhancing their sedative effects. Patients should be advised to avoid or limit the use of these substances while using the gel. Additionally, Cyclobenzaprine may interact with monoamine oxidase inhibitors (MAOIs), leading to serious side effects such as hypertensive crisis. It is recommended to avoid concurrent use with MAOIs and to allow a 14-day washout period after discontinuing MAOIs before starting Cyclobenzaprine.

Ketamine, although primarily used for its analgesic properties in this formulation, can also interact with CNS depressants, potentially leading to enhanced sedation or respiratory depression. Patients should be monitored for signs of excessive sedation or respiratory issues, especially if they are using other CNS depressants. Ketamine may also interact with medications that affect the cytochrome P450 enzyme system, particularly CYP3A4 inhibitors or inducers, which can alter its metabolism and efficacy.

Ketoprofen, as an NSAID, can interact with other medications that increase the risk of gastrointestinal bleeding, such as anticoagulants (e.g., warfarin) and other NSAIDs. Patients should be advised to use caution when combining these medications. Additionally, Ketoprofen may reduce the antihypertensive effects of certain blood pressure medications, such as ACE inhibitors and beta-blockers, and may increase the risk of renal impairment when used with diuretics or other nephrotoxic agents.

It is important for both patients and prescribers to be aware of these potential interactions to ensure safe and appropriate use of the topical gel. Patients should inform their healthcare provider of all medications they are currently taking, including over-the-counter drugs and supplements, to assess for possible interactions. If you have any questions or concerns about using this formulation, please reach out to us for further guidance.

How Does it Work

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This compounded topical gel formulation combines Cyclobenzaprine HCl, Ketamine HCl, and Ketoprofen to provide a multifaceted approach to pain management and inflammation reduction. Each active ingredient plays a distinct role in addressing the symptoms associated with musculoskeletal pain, neuropathic pain, and inflammatory conditions, offering a comprehensive treatment option for patients.

Cyclobenzaprine HCl is a muscle relaxant that works by blocking nerve impulses, or pain sensations, that are sent to the brain. By doing so, it helps to alleviate muscle spasms and discomfort associated with acute musculoskeletal conditions. When applied topically, Cyclobenzaprine HCl can provide localized relief, minimizing systemic side effects that are often associated with oral administration.

Ketamine HCl is an NMDA receptor antagonist that has been shown to have analgesic properties, particularly in the treatment of neuropathic pain. By blocking the NMDA receptors, Ketamine HCl can help to modulate pain pathways and reduce the perception of pain. Its inclusion in this topical gel allows for targeted application, which can be particularly beneficial for patients experiencing localized neuropathic pain, as it may reduce the need for systemic pain medications.

Ketoprofen is a nonsteroidal anti-inflammatory drug (NSAID) that works by inhibiting the production of prostaglandins, which are chemicals in the body responsible for inflammation, pain, and fever. By reducing the levels of prostaglandins, Ketoprofen helps to decrease inflammation and alleviate pain. The topical application of Ketoprofen in this gel formulation allows for direct delivery to the affected area.

The semisolid gel formulation is designed for easy and precise application through a pump mechanism, ensuring that patients can apply the medication directly to the site of pain or inflammation. This targeted approach not only enhances the efficacy of the active ingredients but also reduces the risk of systemic side effects. The gel-like consistency ensures that the formulation is absorbed efficiently into the skin, allowing the active ingredients to penetrate the underlying tissues where they exert their therapeutic effects.

By combining these three active ingredients, the formulation addresses multiple pathways involved in pain and inflammation, providing a synergistic effect that can enhance patient outcomes. If you have any questions or need further information about this formulation, please reach out to us at Bayview Pharmacy.

Frequently Asked Questions

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What is the purpose of this compounded topical gel formulation?

This compounded topical gel is designed to deliver a combination of Cyclobenzaprine HCl, Ketamine HCl, and Ketoprofen directly to the skin for targeted treatment. It aims to provide localized relief from pain and inflammation while minimizing systemic side effects.

How should I apply the topical gel?

The gel should be dispensed through the pump mechanism and applied directly to the affected area of the skin. Use a gentle, circular motion to ensure even distribution and absorption of the active ingredients.

How often can I use this topical gel?

The frequency of application should be determined by your healthcare provider. Typically, it is applied 2-3 times daily, but follow the specific instructions provided with your prescription.

Can I use this gel on broken or irritated skin?

No, you should avoid applying the gel to broken, irritated, or infected skin. It is intended for use on intact skin only. Consult your healthcare provider if you have concerns about skin conditions.

What are the potential side effects of using this topical gel?

Common side effects may include mild skin irritation, redness, or itching at the application site. If you experience severe reactions or symptoms persist, contact your healthcare provider immediately.

Is this topical gel safe for use during pregnancy or breastfeeding?

The safety of this topical gel during pregnancy or breastfeeding has not been fully established. Consult your healthcare provider before using this product if you are pregnant or nursing.

Can I use this gel in conjunction with other medications?

Before using this gel with other medications, consult your healthcare provider to avoid potential interactions. They can provide guidance based on your specific medical history and current treatments.

How should I store the topical gel?

Store the gel at room temperature, away from direct sunlight and moisture. Keep it out of reach of children and pets to prevent accidental ingestion or misuse.

What should I do if I miss a dose?

If you miss a dose, apply it as soon as you remember. If it is close to the time for your next dose, skip the missed dose and resume your regular application schedule. Do not double the dose to catch up.

How long does it take to see results from using this topical gel?

The time it takes to see results can vary depending on the individual and the condition being treated. Some users may experience relief within a few days, while others may require longer use. Consult your healthcare provider if you have concerns about the effectiveness of the treatment.

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.

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.

Cyclobenzaprine HCl 5 mg/mL/Ketamine HCl 46 mg/mL/Ketoprofen 100 mg/mL Topical Gel
Topical Gel
60 g
controlled

Apply topically to affected area(s)

Three times daily