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The Diphenhydramine 25 mg/Haloperidol 1 mg/Lorazepam 1 mg per mL Transdermal Gel is a specialized medication designed for the management of symptoms associated with various disease states, including chronic pain, severe agitation, and terminal restlessness. This semisolid formulation is dispensed through a pump mechanism, which ensures easy and precise application directly onto the skin, allowing for targeted treatment.
The gel-like consistency of the formulation facilitates the transdermal absorption of the active ingredients. Diphenhydramine, an antihistamine, can help alleviate allergic reactions and provide sedative effects. Lorazepam, a benzodiazepine, is included for its anxiolytic and sedative properties, which can be beneficial in treating anxiety and insomnia associated with the aforementioned conditions.
This combination of medications in a transdermal delivery system is particularly useful for patients who may have difficulty swallowing oral medications or where an intravenous route is not practical. The transdermal gel allows for a steady absorption of the medications, potentially reducing the risk of peak-trough fluctuations and side effects associated with oral or injectable routes.
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.
The transdermal gel formulation containing diphenhydramine, haloperidol, and lorazepam is a complex medication that requires careful consideration of potential drug interactions. Diphenhydramine is an antihistamine commonly used for its sedative and antiemetic properties. Haloperidol is an antipsychotic with indications for the treatment of schizophrenia and acute psychosis, as well as for control of tics and vocal utterances in Tourette's disorder. Lorazepam is a benzodiazepine used for its anxiolytic, sedative, and anticonvulsant properties. When these medications are combined in a transdermal gel, they can be used for the management of symptoms such as severe agitation, anxiety, and insomnia, particularly in palliative care settings.
It is crucial to be aware of the potential for additive central nervous system (CNS) depression when this combination gel is used concurrently with other CNS depressants. These include opioids, barbiturates, other benzodiazepines, anxiolytics, sedatives, hypnotics, muscle relaxants, general anesthetics, and antipsychotics. The concomitant use of these agents can increase the risk of respiratory depression, profound sedation, hypotension, profound dizziness, and potentially coma. Patients should be closely monitored for signs of excessive CNS depression, and dosage adjustments may be necessary.
Anticholinergic drugs can interact with diphenhydramine, leading to increased anticholinergic effects such as dry mouth, urinary retention, constipation, and confusion. Special caution is advised in the elderly or in patients with pre-existing conditions that may be exacerbated by anticholinergic activity. Additionally, the use of diphenhydramine with monoamine oxidase inhibitors (MAOIs) can lead to increased anticholinergic effects or even a hypertensive crisis, and therefore, it is generally recommended to avoid this combination.
Haloperidol can interact with medications that prolong the QT interval, such as certain antiarrhythmics, macrolide antibiotics, and some antipsychotics. This can increase the risk of cardiac arrhythmias, including torsades de pointes. Patients with a history of cardiac abnormalities, electrolyte disturbances, or those on medications that affect electrolyte balance should be monitored closely. Additionally, haloperidol may antagonize the effects of dopamine agonists and levodopa, which is important to consider in patients with Parkinson's disease.
Lorazepam, when used with other medications that affect the gamma-aminobutyric acid (GABA) system, such as other benzodiazepines, alcohol, and certain anticonvulsants, can lead to enhanced sedation and respiratory depression. Caution is advised when prescribing this transdermal gel to patients who are on these medications. Furthermore, the use of lorazepam with opioids can result in profound sedation, respiratory depression, coma, and death. As such, if this combination is required, patients should be under close medical supervision.
It is also important to consider the impact of individual patient factors such as age, liver and kidney function, and other comorbidities when assessing the risk of drug interactions. This transdermal gel should be used with caution in patients with hepatic or renal impairment, as these conditions can affect the metabolism and excretion of the active ingredients, potentially leading to increased plasma levels and a higher risk of adverse effects.
Patients and prescribers should be aware that this is not an exhaustive list of all potential drug interactions. It is essential to review all current medications, including over-the-counter drugs and herbal supplements, with a healthcare provider before starting treatment with this transdermal gel. If you have any questions or require further information regarding drug interactions with this formulation, please reach out to us at Bayview Pharmacy for assistance.
The transdermal gel formulation containing Diphenhydramine 25 mg per mL, Haloperidol 1 mg per mL, and Lorazepam 1 mg per mL is designed to deliver these medications through the skin directly into the bloodstream. This mode of delivery is particularly useful for patients who may have difficulties with oral administration or for those who require a steady release of medication over time. The gel is dispensed through a pump mechanism, which ensures that each dose is measured accurately, providing consistent and precise dosing for the patient.
Diphenhydramine is an antihistamine that works by blocking the action of histamine, a substance in the body that causes allergic symptoms. It is also known for its sedative properties and can be used to manage mild forms of Parkinson's disease due to its anticholinergic effects. Haloperidol is an antipsychotic medication that works by affecting the actions of chemicals in the brain. Lorazepam is a benzodiazepine that acts on the central nervous system to produce a calming effect. It is used to treat anxiety disorders, insomnia, and can be helpful in the management of seizure disorders.
When compounded together in a transdermal gel, these medications can be used to manage a variety of symptoms including anxiety, agitation, and allergic reactions. The transdermal route allows for the medication to be absorbed through the skin, bypassing the gastrointestinal tract, which can be beneficial for patients with nausea, vomiting, or gastrointestinal disorders that may impair absorption of oral medications. Additionally, this route can reduce the risk of first-pass metabolism by the liver, potentially leading to more efficient drug delivery.
The gel formulation is designed to be applied to a small area of skin that is clean and intact. The medication is then absorbed through the skin and enters the circulatory system. The use of a transdermal gel can also provide a localized effect, which may be beneficial for certain conditions where targeted therapy is desired.
It is important for patients and prescribers to understand that the effectiveness and safety of this compounded formulation depend on proper dosing and application. Patients should follow the specific instructions provided by their healthcare provider or pharmacist regarding how much gel to apply and how often to apply it. As with any medication, there may be potential side effects, and patients should be monitored for any adverse reactions.
If you have any questions about this transdermal gel formulation or its use in treating specific disease states, please reach out to us at Bayview Pharmacy. Our team of compounding pharmacists is here to provide you with the information and support you need to ensure appropriate treatment for your patients.
This is a compounded medication that combines Diphenhydramine, Haloperidol, and Lorazepam in a transdermal gel form. The medication is formulated to deliver a specified dose of each medication through the skin, allowing for targeted treatment.
Apply the prescribed amount of gel to a clean, dry area of skin, usually on the upper arm, wrist, or chest, as directed by your healthcare provider. Be sure to avoid areas with cuts, bruises, or irritations.
Transdermal gels offer the advantage of direct application to the skin, which can result in consistent blood levels of the medication without the peaks and troughs often associated with oral administration. They can also be beneficial for patients who have difficulties swallowing pills or maintaining medication schedules.
Store the medication at room temperature, away from heat and moisture. Keep the container tightly closed when not in use, and keep out of reach of children and pets.
The correct dosage of the medication will be determined by your healthcare provider based on your specific condition and response to treatment. It's essential to use the medication exactly as prescribed and not to adjust the dose on your own.
Like all medications, this transdermal gel can cause side effects. Common side effects may include drowsiness, dry mouth, or skin irritation at the application site. If you experience any severe side effects or signs of an allergic reaction, seek medical attention immediately.
Always inform your healthcare provider of all the medications you are taking, including over-the-counter drugs and supplements. Some drugs may interact with the components of this gel, potentially causing harmful effects.
You should notice a decrease in the symptoms the medication is prescribed for. If your symptoms do not improve or worsen, contact your healthcare provider for advice.
If you miss a dose, apply it as soon as you remember. If it is almost time for your next dose, skip the missed dose and continue with your regular dosing schedule. Do not apply extra gel to make up for a missed dose.
The pump mechanism is designed to dispense a measured dose of the gel with each pump. Prime the pump as directed by the instructions, then press down on the pump the required number of times to dispense your dose. Apply the dispensed gel directly to your skin.
After applying the gel, you should allow sufficient time for the medication to be absorbed before showering or swimming. Consult your healthcare provider for specific recommendations, but typically waiting at least an hour is advised.
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.
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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.
Quantity and directions are starting points for this dose form, not treatment recommendations. Dosing remains the prescriber's responsibility.
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.
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.
Apply topically to affected area(s)
