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Dexamethasone 10 mg/ml/Diphenhydramine HCL 25 mg/ml/Lorazepam 1 mg/ml Topical Gel

Customized at Bayview Pharmacy, this compounded topical gel may help manage chemotherapy-induced nausea, mucositis, pruritus, anxiety, and chronic pain.
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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.
Dexamethasone
Diphenhydramine Hydrochloride
Lorazepam
Topical Cream
654e8e65afa05fcfc6645f8a

Formula Information

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The Dexamethasone 10 mg/ml/Diphenhydramine HCL 25 mg/ml/Lorazepam 1 mg/ml Topical Gel is a compounded medication that combines the anti-inflammatory properties of Dexamethasone, the antihistamine effects of Diphenhydramine HCL, and the anxiolytic and sedative effects of Lorazepam. This unique formulation is designed to be applied topically and is dispensed in a pump mechanism, which allows for a convenient, controlled, and hygienic application. The semisolid gel base facilitates the localized treatment of various conditions by enabling the absorption of active ingredients through the skin.

Dexamethasone is a potent corticosteroid that helps reduce inflammation and suppresses the immune response, making it useful in treating localized inflammatory conditions. Diphenhydramine HCL is an antihistamine that can alleviate itching and allergic reactions by blocking histamine receptors. Lorazepam, a benzodiazepine, is included for its ability to relieve anxiety and provide sedation, which can be beneficial in managing stress-related symptoms associated with skin conditions.

This combination gel is particularly suited for conditions where both inflammation and allergic reactions are present, and where anxiety exacerbates the condition. It may be prescribed for localized dermatoses, eczema, or other inflammatory skin conditions where a reduction in itching, inflammation, and anxiety-related scratching is desired. The inclusion of Lorazepam in the formulation also makes it a potential option for treating localized muscle spasms or areas of tension that could benefit from its relaxing effects.

Patients should be advised that this medication is for topical use only and should be applied as directed by their healthcare provider. The pump mechanism dispenses a measured dose, ensuring consistent application. Patients should be aware of the potential side effects of each active ingredient and should contact their healthcare provider if they experience any adverse reactions. As with all medications, it is important to use this gel under the supervision of a healthcare professional who can monitor its effectiveness and safety.

Prescribers considering this formulation should assess the patient's medical history and current medications to avoid potential drug interactions, especially given the systemic absorption of Lorazepam. The use of this gel should be part of a comprehensive treatment plan that may include other medications or therapies. For any questions or additional information regarding this formulation, please reach out to us at Bayview Pharmacy. Our team of compounding pharmacists is committed to providing support and guidance to ensure the safe and appropriate use of this compounded medication.

Drug Interactions

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The topical gel formulation containing Dexamethasone 10 mg/ml, Diphenhydramine HCL 25 mg/ml, and Lorazepam 1 mg/ml is a unique combination of a corticosteroid, an antihistamine, and a benzodiazepine, respectively. This combination is intended for localized treatment and may be used for conditions such as severe allergic reactions, inflammation, anxiety, and pruritus (itching) associated with various dermatologic conditions. However, it is essential to consider potential drug interactions when using this topical gel.

Dexamethasone is a potent corticosteroid that can suppress the immune response and reduce inflammation. It may interact with other medications that also affect the immune system, such as other corticosteroids, immunosuppressants, or vaccines. Caution should be exercised when using this gel in conjunction with systemic corticosteroids, as it may increase the risk of systemic corticosteroid side effects. Additionally, dexamethasone can interact with CYP3A4 substrates, inhibitors, or inducers, potentially altering the metabolism of these drugs.

Diphenhydramine HCL is an antihistamine that can cause sedation. It may enhance the sedative effects of central nervous system depressants, including alcohol, benzodiazepines, opioids, and other sedatives. Patients should be advised to avoid using other sedating medications or substances while using this gel. Diphenhydramine can also interact with anticholinergic drugs, increasing the risk of anticholinergic side effects such as dry mouth, urinary retention, and constipation.

Lorazepam is a benzodiazepine that has anxiolytic, sedative, and muscle relaxant properties. It can potentiate the effects of other central nervous system depressants, and caution is advised when used concurrently with medications such as opioids, barbiturates, and alcohol. Additionally, the use of lorazepam with other benzodiazepines or sedative-hypnotics should be approached with caution to avoid excessive sedation or respiratory depression. Lorazepam is metabolized by the liver, and interactions with drugs that affect hepatic enzymes, particularly CYP3A4, should be considered.

It is also important to note that the absorption of the active ingredients through the skin may be affected by the use of occlusive dressings, other topical medications, or skin barrier integrity. Patients should be instructed on the proper application of the gel and advised to inform their healthcare provider of all medications they are taking, including over-the-counter drugs and herbal supplements, to avoid potential interactions.

Given the complexity of this formulation, it is crucial for prescribers to evaluate the patient's complete medication profile for potential interactions. Patients should be monitored for signs of systemic corticosteroid effects, excessive sedation, or other adverse effects that may arise from the use of this topical gel. If you have any questions or require further information regarding this formulation and its use in treating specific disease states, please reach out to us at Bayview Pharmacy for assistance.

How Does it Work

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The Dexamethasone 10 mg/ml/Diphenhydramine HCL 25 mg/ml/Lorazepam 1 mg/ml Topical Gel is a compounded medication that combines the therapeutic effects of a corticosteroid, an antihistamine, and a benzodiazepine in a semisolid gel base for topical application. This unique formulation is designed to deliver medication directly to the site of discomfort or inflammation, providing targeted relief with potentially fewer systemic side effects compared to oral administration.

Dexamethasone is a potent synthetic corticosteroid with anti-inflammatory and immunosuppressant properties. When applied topically, dexamethasone works by inhibiting the release of substances in the body that cause inflammation. This can help to reduce swelling, redness, and pain in localized areas. It is commonly used in the treatment of various skin conditions, such as eczema or dermatitis, as well as for localized musculoskeletal pain and inflammation.

Diphenhydramine HCL is an antihistamine that blocks the action of histamine, a substance in the body that causes allergic symptoms like itching, swelling, and rashes. By including diphenhydramine in the formulation, the gel can help alleviate topical allergic reactions and provide relief from itching and discomfort associated with various dermatologic conditions.

Lorazepam, a benzodiazepine, is included for its anxiolytic and sedative properties. While lorazepam is commonly used orally for anxiety, in a topical formulation, it may help to provide a calming effect on localized neuropathic pain or as part of the management of certain types of seizures. The inclusion of lorazepam in this topical gel may also help to reduce stress-related symptoms that can exacerbate skin conditions.

The gel is dispensed in a pump mechanism, which allows for a controlled and measured dose with each application. This ensures consistent dosing and helps to prevent overuse of the medication. The semisolid gel base facilitates the absorption of the active ingredients through the skin and provides a convenient and less invasive method of drug delivery, which may be particularly beneficial for patients who have difficulty with oral medications.

This compounded formulation may be used in the management of various disease states where localized treatment is indicated. It can be particularly useful for patients with dermatologic conditions that have an inflammatory or allergic component, for localized musculoskeletal pain, or for certain types of localized neuropathic pain. The combination of active ingredients may also be beneficial in palliative care settings, where multiple symptoms need to be managed simultaneously.

As with any medication, it is important to use this compounded gel under the guidance of a healthcare professional. The specific indications, contraindications, and potential interactions with other medications should be carefully considered. If you have any questions or require further information about this formulation, please reach out to us at Bayview Pharmacy. Our team of compounding pharmacists is here to provide support and guidance to both patients and prescribers.

Other Uses

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While the primary use of the Dexamethasone 10 mg/ml/Diphenhydramine HCL 25 mg/ml/Lorazepam 1 mg/ml Topical Gel is often for managing symptoms such as inflammation, itching, anxiety, or insomnia associated with various dermatological conditions, this compound may also have additional uses. One such off-label use could include the management of localized pain or muscle spasms, where the anti-inflammatory property of dexamethasone, the anxiolytic effect of lorazepam, and the antihistamine effect of diphenhydramine could provide a multimodal approach to symptom relief. It is important to note that while these individual components have recognized pharmacological effects, the effectiveness of this specific combination for other uses has not been established in controlled clinical trials.

Potential utility may also be found in the palliative care setting, wherein patients with complex symptomatology that includes skin pain, pruritus, or anxiety may benefit from a topical formulation. This localized approach can be advantageous for patients who have difficulty with oral administration of medication or for whom systemic effects are undesirable. Furthermore, patients who experience nausea and vomiting and cannot tolerate oral medications may also benefit from this mode of administration as it bypasses the gastrointestinal tract.

Still, prescribers should exercise caution, as the safety and efficacy for these other uses have not been established, and off-label application should be considered only when the benefits outweigh the risks. As with any medication, the potential for systemic absorption and associated side effects, contraindications, and interactions with other medications should be taken into account.

Bayview Pharmacy is committed to providing high-quality compounded medications tailored to individual patient needs. If you have any questions or require further information about the potential other uses of this topical gel or about the compounding services we offer, please do not hesitate to reach out to us. Our team of knowledgeable compounding pharmacists is here to support healthcare providers and patients in achieving the best possible therapeutic outcomes with our custom medication solutions.

Frequently Asked Questions

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What is the purpose of this compounded topical gel?

The compounded topical gel containing Dexamethasone, Diphenhydramine HCl, and Lorazepam is formulated for localized treatment. It aims to combine the anti-inflammatory effects of Dexamethasone, the antihistamine effects of Diphenhydramine, and the anxiolytic and sedative effects of Lorazepam for application on the skin where absorption of these active ingredients can provide targeted relief.

How do you apply this topical gel?

The gel should be applied to the affected area of the skin as per the doctor's prescription or the recommended dosage. The pump mechanism allows for controlled application. Simply press the pump to dispense the gel, then gently spread it over the skin until it’s evenly distributed and absorbed.

Can this topical gel cause any side effects?

As with any medication, this topical gel may cause side effects, though not everyone will experience them. Common side effects might include skin irritation, redness, or itching at the site of application. More serious side effects are rare but may include systemic effects like drowsiness, mood changes, or increased risk of infection. If you experience any severe side effects, contact your healthcare provider immediately.

How many times a day should the gel be applied?

The frequency of application will depend on your specific condition and the guidance of your healthcare provider. It is important to follow the prescribed dosage and not apply more frequently than recommended.

Is this topical gel suitable for children?

Children may have more sensitive skin and a different response to the medication than adults. Use in children should be under the strict guidance of a healthcare provider and closely monitored for any adverse effects.

Are there any medications that could interact with this topical gel?

Yes, there could be interactions with other medications, particularly those that also affect the immune system, cause sedation, or have anticholinergic effects. It is essential to inform your healthcare provider about all the medications you are currently taking to avoid potential interactions.

What should I do if I miss a dose?

If you miss a dose, apply the gel as soon as you remember unless it’s almost time for your next dose. In that case, skip the missed dose and resume your normal dosing schedule. Do not double the dose to catch up.

How should I store this topical gel?

The gel should be stored at room temperature, away from direct sunlight and heat. Keep the container tightly closed when not in use. To maintain the integrity of the medication, do not freeze it and keep it out of reach of children and pets.

Can I apply other lotions or creams on top of this topical gel?

It is generally best to avoid using other topical products on the same area where the compounded gel has been applied, as they may alter the absorption or effects of the medication. Always consult with your healthcare provider before combining treatments.

What should I do if the gel gets into my eyes, nose, or mouth?

If the gel makes contact with your eyes, nose, or mouth, rinse the area thoroughly with water. Avoid touching these areas with hands that have gel on them. If you experience any persistent symptoms after rinsing, seek medical attention as needed.

Is it normal for the pump to dispense varying amounts of gel?

The pump is designed for controlled and consistent dispensing of the gel. If you notice inconsistent amounts, ensure that the pump is primed by pressing it a few times until it normalizes. If the pump continues to function improperly, contact your pharmacist for assistance.

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.

Related Formulas

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.

Dexamethasone 10 mg/ml/Diphenhydramine HCL 25 mg/ml/Lorazepam 1 mg/ml Topical Gel
Topical Cream
30 g
controlled

Apply topically to affected area(s)