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This transdermal gel formulation combines Diphenhydramine HCL 25 mg, Haloperidol 0.5 mg, and Metoclopramide 10 mg per gram to provide a multipurpose medication intended for the management of various conditions. Diphenhydramine, an antihistamine, is commonly used to relieve symptoms of allergies and to promote sleep. Haloperidol, an antipsychotic, may be used to reduce acute agitation and delirium. The semisolid gel is designed for transdermal delivery, allowing for systemic absorption of the active ingredients through the skin. The pump mechanism ensures consistent dosing and ease of application for the patient. This unique combination of medications in a transdermal gel form is particularly useful in palliative care settings, where it can be used to address a range of symptoms including allergic reactions, nausea, vomiting, agitation, and insomnia.
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.
This transdermal gel formulation combines three active pharmaceutical ingredients: Diphenhydramine HCl, Haloperidol, and Metoclopramide, each serving distinct therapeutic roles. Diphenhydramine HCl, an antihistamine, is commonly used for its anticholinergic and sedative effects, which can help alleviate symptoms of allergies, nausea, and insomnia. It is also beneficial in treating nausea and vomiting, particularly when these symptoms are refractory to other treatments. Metoclopramide, a prokinetic and antiemetic agent, works by enhancing gastrointestinal motility and accelerating gastric emptying, which can be particularly useful in treating gastroparesis and refractory GERD (gastroesophageal reflux disease).
The combination of these three medications in a 25 mg/0.5 mg/10 mg per gram transdermal gel allows for a multimodal approach to managing symptoms such as severe nausea, vomiting, and agitation, which may be associated with various medical conditions, including but not limited to chemotherapy-induced nausea and vomiting, gastroparesis, and palliative care settings. The transdermal route offers the advantage of bypassing the gastrointestinal system, which can be beneficial for patients with vomiting or those who have difficulty swallowing oral medications.
The semisolid gel formulation is designed to be dispensed through a pump mechanism, which ensures consistent dosing and ease of application. The gel is applied to the skin, where it can be absorbed systemically or act locally, depending on the intended effect. This route of administration can be particularly advantageous for patients who require long-term medication management with minimal systemic side effects.
It is important for both patients and prescribers to understand that this compounded medication should be used under the guidance of a healthcare professional, and it is tailored to meet the specific needs of the patient. The prescriber should consider the patient's overall medication profile to avoid potential drug interactions, and the patient should be monitored for efficacy and any adverse effects. 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 committed to providing comprehensive support and guidance to ensure the safe and appropriate use of this medication.
The combination of diphenhydramine HCL, haloperidol, and metoclopramide in a transdermal gel formulation presents a unique profile of potential drug interactions that must be carefully considered by both patients and prescribers. Diphenhydramine is an antihistamine that can cause sedation and has anticholinergic effects. When used concurrently with other central nervous system (CNS) depressants such as opioids, benzodiazepines, or alcohol, there may be an additive effect leading to increased sedation and respiratory depression. Additionally, the anticholinergic properties of diphenhydramine can be potentiated when used with other anticholinergic drugs, increasing the risk of anticholinergic side effects such as dry mouth, urinary retention, constipation, and confusion, particularly in the elderly.
Haloperidol is an antipsychotic medication that can affect the QT interval on the electrocardiogram. It should be used with caution in combination with other medications known to prolong the QT interval, such as certain antiarrhythmic drugs, some antibiotics (e.g., macrolides), and some antidepressants (e.g., tricyclic antidepressants). The risk of QT prolongation and subsequent serious arrhythmia, such as Torsades de Pointes, is increased when these drugs are used together. Haloperidol also has the potential to interact with drugs that induce or inhibit hepatic enzymes, particularly CYP3A4 and CYP2D6, which can alter haloperidol plasma levels and its therapeutic effects.
Metoclopramide is a prokinetic agent that increases gastrointestinal motility and is also used to treat nausea and vomiting. It should be used with caution when co-administered with other serotonergic drugs, such as SSRIs, due to the risk of serotonin syndrome, a potentially life-threatening condition. Additionally, since metoclopramide is a dopamine antagonist, it can potentially interact with Parkinson's disease medications, which are dopamine agonists, and may diminish their effects. Metoclopramide can also interact with anticholinergic medications, leading to reduced efficacy due to opposing effects on gastrointestinal motility.
It is important to note that the transdermal route of administration may alter the interaction profile compared to oral administration, but systemic absorption of these medications can still lead to interactions. Patients should be advised to inform their healthcare providers of all medications they are taking, including over-the-counter drugs and herbal supplements. Prescribers should carefully evaluate the patient's medication profile for potential interactions before prescribing this transdermal gel. Monitoring for side effects and therapeutic efficacy is recommended, and dose adjustments may be necessary based on the patient's clinical response and any concurrent medications.
If you have any questions or require further information regarding potential drug interactions with this transdermal gel formulation, please do not hesitate to reach out to us at Bayview Pharmacy. Our team of compounding pharmacists is committed to ensuring the safe and appropriate use of our formulations.
The transdermal gel formulation containing Diphenhydramine HCL 25 mg, Haloperidol 0.5 mg, and Metoclopramide 10 mg per gram 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, reducing the risk of under or overdosing, and allows for easy application to the skin.
Diphenhydramine HCL is an antihistamine that works by blocking the action of histamine, a substance in the body that causes allergic symptoms. It is commonly used for the relief of allergic reactions, and in this transdermal form, it can provide systemic relief from these symptoms. Additionally, diphenhydramine has sedative properties, which can be beneficial in conditions where a calming effect is desired.
Haloperidol is an antipsychotic medication that works by affecting the actions of chemicals in the brain. It is used to treat a range of psychiatric disorders, including schizophrenia and acute psychosis. In a transdermal formulation, haloperidol can provide a more consistent blood level of the medication, which may help in managing symptoms more effectively and with potentially fewer side effects compared to oral administration.
Metoclopramide is a medication that works as a prokinetic agent, enhancing the motility of the upper gastrointestinal tract. It is often used to treat gastroparesis and reflux. By increasing the movement of the stomach and intestines, metoclopramide helps with the passage of food and reduces symptoms of nausea and vomiting. When administered transdermally, it can provide a continuous therapeutic effect without the peaks and troughs often associated with oral administration.
This combination of medications in a transdermal gel can be particularly useful for patients with gastrointestinal disorders, where nausea and vomiting may prevent oral medications from being effective. It may also be beneficial for patients with psychiatric conditions who experience nausea as a side effect of their medications or who have difficulty with oral administration. The transdermal route bypasses the gastrointestinal system, potentially reducing gastrointestinal side effects and improving medication adherence.
It is important for both patients and prescribers to understand the pharmacokinetics and dynamics of each medication in this formulation, as well as the potential interactions and side effects. The transdermal delivery system provides a unique method of administration that can offer advantages over traditional oral medications, including improved compliance, steady medication levels, and reduced systemic side effects. 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 assist you with your medication needs.
This compounded transdermal gel is designed for targeted treatment and provides the therapeutic effects of its active ingredients through the skin. Diphenhydramine is an antihistamine that can help with allergic reactions or insomnia; Haloperidol is an antipsychotic for managing mental/mood disorders; Metoclopramide helps with gastrointestinal issues by facilitating the movement of the stomach and intestines.
Clean and dry the area of skin where you'll apply the gel. Press the pump to dispense the prescribed amount of gel, and gently rub it onto the skin until it's fully absorbed. Always follow the specific application instructions provided by your healthcare provider.
It's important to apply the gel as directed by your healthcare provider. Typically, it's applied to areas with thin skin, such as the wrists or inner arms, to facilitate absorption, but your provider will give you specific instructions based on your condition and treatment plan.
Side effects can include drowsiness, dry mouth, constipation, changes in appetite, and dizziness. Serious side effects may include muscle stiffness, changes in mood, or difficulty breathing. If you experience any of these, seek medical attention immediately.
The frequency of application should be as prescribed by your healthcare provider. Do not alter the dosing schedule without consulting them, even if you feel better.
It is possible. This gel contains active ingredients that could interact with other medications. Always inform your healthcare provider of all the medications you're taking before starting any new treatment.
Store the gel at room temperature, away from heat and direct light. Do not freeze. Keep the container tightly closed when not in use. It is also important to keep this medication out of reach of children and pets.
Consult with your healthcare provider before using this medication if you are pregnant, planning to become pregnant, or are breastfeeding. They will advise you whether it is safe for you and your baby.
If you miss a dose, apply it as soon as you remember. However, if it's nearly time for your next dose, skip the missed dose and continue with your regular dosing schedule. Do not double the dose to catch up.
No, using the gel after its expiration date can be unsafe. The efficacy of the ingredients may be compromised, and you might not get the intended therapeutic effects. Dispose of expired medication as per instructions from your healthcare provider or local disposal regulations.
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.
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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)
