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Gabapentin 10%/Ketamine 10%/Ketoprofen 10%/Lidocaine 5% Transdermal Gel

The Gabapentin 10%/Ketamine 10%/Ketoprofen 10%/Lidocaine 5% Transdermal Gel is a specialized medication compounded to manage pain associated with various disease states. This semisolid formulation is designed for transdermal delivery, allowing the active ingredients to be absorbed directly through the skin to the affected area. The gel is dispensed through a pump mechanism, which ensures easy and precise dosing.

Gabapentin is an anticonvulsant that is commonly used to treat neuropathic pain, while ketamine, an NMDA receptor antagonist, provides analgesic effects, particularly for chronic pain syndromes. Ketoprofen is a nonsteroidal anti-inflammatory drug (NSAID) that offers anti-inflammatory and analgesic properties. Lidocaine, a local anesthetic, helps to reduce immediate pain sensations. The combination of these four active ingredients in a transdermal gel form is particularly useful for patients suffering from neuropathic pain, complex regional pain syndrome (CRPS), and various musculoskeletal pains.

This compounded medication provides a multimodal approach to pain management, targeting different pain pathways and offering a synergistic effect for relief of symptoms. The transdermal application allows for localized treatment, which can reduce systemic side effects commonly associated with oral medications. The gel formulation is also beneficial for patients who may have difficulties with oral administration or those who require a non-invasive and targeted method of drug delivery.

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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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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.
Gabapentin
Ketoprofen
Ketamine Hydrochloride
Lidocaine Hydrochloride
Topical Gel
65ad63c237d32a214228ad5b

Formula Information

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The Gabapentin 10%/Ketamine 10%/Ketoprofen 10%/Lidocaine 5% Transdermal Gel is a compounded medication designed to deliver a combination of active ingredients through the skin for localized relief. Gabapentin, an anticonvulsant, is used off-label in this formulation for its potential to alleviate neuropathic pain by modulating the nervous system's response to pain. Ketamine, a NMDA receptor antagonist, is included for its analgesic properties, particularly in neuropathic pain syndromes where conventional therapies may not be effective. Ketoprofen, a nonsteroidal anti-inflammatory drug (NSAID), provides anti-inflammatory and analgesic effects, making it useful in the treatment of musculoskeletal pain and inflammation. Lidocaine, a local anesthetic, offers immediate topical analgesia by blocking sodium channels and numbing the area of application.

This multi-mechanistic approach targets various pathways involved in pain and inflammation, making the gel particularly suitable for complex pain conditions such as neuropathic pain, fibromyalgia, and certain inflammatory disorders. The semisolid formulation is designed for transdermal delivery, allowing for direct application to the affected area, which may result in fewer systemic side effects compared to oral medications. The pump mechanism ensures consistent dosing and ease of use for patients, enhancing adherence to the treatment regimen.

Patients and prescribers should be aware that this is a customized medication prepared in a compounding pharmacy, and its use should be based on a thorough evaluation of the patient's medical history and condition. The efficacy and safety profile of this combination gel have not been evaluated by the FDA, as it is a compounded medication. Therefore, it should be prescribed with consideration of the individual patient's needs and potential risks. Monitoring for adverse effects and effectiveness is recommended to ensure optimal therapeutic outcomes.

For further information or questions regarding this compounded formulation, please do not hesitate to reach out to us at Bayview Pharmacy. Our team of knowledgeable compounding pharmacists is committed to providing support and guidance to both patients and healthcare providers in the use of specialized compounded medications.

Drug Interactions

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The transdermal gel formulation containing Gabapentin, Ketamine, Ketoprofen, and Lidocaine is designed for topical application and may offer localized relief from pain without the systemic side effects associated with oral administration. However, it is important to consider potential drug interactions, especially if the patient is taking other medications or has underlying health conditions.

Gabapentin, an anticonvulsant, may interact with antacids containing aluminum or magnesium, as they can reduce the absorption of gabapentin and decrease its effectiveness. It is advisable to administer antacids at least two hours after applying the gel. Additionally, central nervous system (CNS) depressants, including opioids, benzodiazepines, and alcohol, may enhance the CNS depressant effects of gabapentin, leading to increased drowsiness or dizziness.

Ketamine, an NMDA receptor antagonist, can also cause CNS depression. When used concomitantly with other CNS depressants, there is a potential for additive sedative effects. Patients should be monitored for signs of excessive sedation and respiratory depression. Furthermore, chronic use of ketamine may induce liver enzyme CYP3A4, potentially altering the metabolism of drugs metabolized by this enzyme.

Ketoprofen, a nonsteroidal anti-inflammatory drug (NSAID), may interact with anticoagulants such as warfarin, increasing the risk of bleeding. Patients on anticoagulant therapy should be closely monitored for changes in coagulation parameters when initiating or changing the dose of the transdermal gel. Concomitant use of other NSAIDs, corticosteroids, or selective serotonin reuptake inhibitors (SSRIs) may also increase the risk of gastrointestinal bleeding. Additionally, ketoprofen can affect renal function and should be used with caution in patients taking angiotensin-converting enzyme (ACE) inhibitors, angiotensin receptor blockers (ARBs), or diuretics.

Lidocaine, a local anesthetic, may interact with antiarrhythmic drugs such as mexiletine, leading to an additive effect on cardiac conduction. While systemic absorption of lidocaine from topical application is generally low, caution is advised in patients with pre-existing cardiac conditions. Lidocaine is metabolized by CYP1A2 and CYP3A4 enzymes, and drugs that inhibit or induce these enzymes may affect the metabolism of lidocaine.

It is crucial for patients and prescribers to be aware of these potential interactions and to manage them appropriately. Patients should inform their healthcare provider of all medications they are taking, including over-the-counter drugs and supplements. This transdermal gel is used to treat localized neuropathic pain, chronic pain conditions, and inflammatory pain states. The combination of active ingredients targets different pain pathways and provides a multimodal approach to pain management. If you have any questions or require further information regarding drug interactions or the use of this formulation, please reach out to us at Bayview Pharmacy.

How Does it Work

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The Gabapentin 10%/Ketamine 10%/Ketoprofen 10%/Lidocaine 5% Transdermal Gel is a compounded medication designed to deliver a combination of active pharmaceutical ingredients (APIs) directly through the skin to the site of pain or discomfort. This semisolid formulation is dispensed through a pump mechanism, which allows for easy and precise application. The gel-like consistency ensures that the medication stays in place and facilitates the absorption of the APIs into the skin.

Gabapentin is an anticonvulsant and analgesic drug that is commonly used to treat neuropathic pain. In this transdermal formulation, gabapentin works by modulating the activity of certain neurotransmitters in the nervous system, which helps to reduce the sensation of pain. Ketamine, an NMDA receptor antagonist, provides analgesic effects, particularly in the central nervous system, and is used for its ability to reduce central sensitization, which is often associated with chronic pain conditions.

Ketoprofen is a nonsteroidal anti-inflammatory drug (NSAID) that provides analgesic and anti-inflammatory effects. It works by inhibiting the cyclooxygenase (COX) enzymes, which are involved in the production of prostaglandins, substances that contribute to inflammation, pain, and fever. By reducing the levels of prostaglandins, ketoprofen can help to alleviate pain and swelling. Lidocaine, a local anesthetic, works by blocking sodium channels in the neuronal cell membrane, which prevents the initiation and conduction of nerve impulses, thereby providing a numbing effect and further contributing to pain relief.

This combination of APIs in the transdermal gel is particularly useful for treating localized neuropathic pain, chronic pain conditions, and inflammatory disorders. The transdermal route of administration allows for the medication to be absorbed directly into the affected area, providing targeted relief while minimizing systemic exposure and potential side effects. This can be beneficial for patients who may not tolerate oral medications well or for those who require localized pain management.

It is important for both patients and prescribers to understand that this is a specially compounded medication and should be used under the guidance of a healthcare professional. The formulation is customized to meet the specific needs of the patient and the precise condition being treated. If you have any questions about this transdermal gel or its use in treating specific disease states, please reach out to us at Bayview Pharmacy. Our team of knowledgeable compounding pharmacists is here to provide guidance and support.

Other Uses

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The compounding formulation consisting of Gabapentin 10%, Ketamine 10%, Ketoprofen 10%, and Lidocaine 5% transdermal gel has been primarily used to manage various types of chronic pain, such as neuropathic pain, complex regional pain syndrome, and refractory pain from a range of conditions. This unique combination takes advantage of the analgesic properties of each component, which may work synergistically when compounded together. This transdermal gel is typically used in cases where oral therapies have failed, are not tolerated, or where systemic side effects are of concern.

Other uses for this transdermal compound may include localized symptomatic relief for patients with musculoskeletal pain, fibromyalgia, or diabetic neuropathy. Patients with skin conditions that cause pain, such as post-herpetic neuralgia, may also find benefit from this formulation due to its localized effect and reduced systemic exposure.

Furthermore, this gel can be utilized in an off-label manner for managing pain in oncology patients, particularly when pain is not sufficiently controlled by standard therapy. This transdermal approach can offer a form of palliative care to enhance the patient's quality of life. Additionally, it can sometimes be used in veterinary medicine, tailored to the individual needs and tolerances of animals suffering from chronic pain, under the strict direction of a veterinary professional.

Patient-specific factors should be considered when prescribing this formulation, as individual responses can vary based on skin type, severity of the condition, and any potential interactions with other medications. Patients should be counseled on the proper application of the gel, including site selection—usually an area with minimal hair and intact skin—and the importance of adhering to the prescribed dosing regimen to avoid toxicity and ensure optimal efficacy.

It is important for patients and prescribers to note that while there may be ancillary uses for this transdermal formulation, its primary indications are for pain management under careful medical guidance. Prescribers should evaluate the benefit-risk profile for each patient, and consider any relevant contraindications or potential side effects, including local skin reactions or systemic effects from absorption. As with any compounded medication, this formulation should be used when commercially available products do not meet the specific needs of a patient.

If there are any questions regarding the application, potential uses, or suitability of this transdermal gel for a specific patient, we encourage you to reach out to us at Bayview Pharmacy. Our team of knowledgeable compounding pharmacists is dedicated to providing tailored pharmaceutical care and is ready to assist with professional advice and support to ensure appropriate treatment.

Frequently Asked Questions

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What is the purpose of this transdermal gel?

This compounded transdermal gel is used to provide targeted relief from certain types of pain. The active ingredients—Gabapentin, Ketamine, Ketoprofen, and Lidocaine—are combined to help manage neuropathic pain, inflammatory pain, and other specific conditions as prescribed by a healthcare professional.

How do I use this transdermal gel?

Apply the gel as prescribed by your physician. Typically, a small amount is pumped out of the container using the pump mechanism and applied to the affected area of the skin. Spread the gel gently and evenly. Wash your hands after application unless the hands are the treated site.

How often should I use the transdermal gel?

Follow your healthcare provider’s instructions on how often to use the gel. The frequency of application can vary based on your individual treatment plan and condition.

Can I cover the area after applying the gel?

Unless directed by your healthcare provider, it is generally recommended to allow the area to breathe and not to cover it immediately with bandages or dressings. Consult your prescriber for specific instructions.

Are there any side effects with this transdermal gel?

As with any medication, side effects are possible. Common side effects include local skin irritation, redness, or itching. If you experience any severe side effects or signs of an allergic reaction, contact your healthcare provider immediately.

Should I use the gel if I am pregnant or breastfeeding?

Consult your healthcare provider before using this medication if you are pregnant or breastfeeding. The safety of this gel in pregnancy or while breastfeeding has not been fully established.

What should I do if I miss a dose?

If you miss a dose of the gel, apply it as soon as you remember. However, if it is nearly time for your next dose, skip the missed dose and resume your regular dosing schedule. Do not double up on doses to make up for a missed one.

How should this medication be stored?

Keep the gel at room temperature, away from heat and direct light. Do not freeze. Make sure the cap on the pump is securely fastened to prevent the medication from drying out. Keep out of reach of children and pets.

Can I apply the gel to open wounds or damaged skin?

No, this gel should not be applied to open wounds, cuts, or broken skin. It is meant for application on intact skin only. If you are uncertain, consult with your healthcare provider for guidance.

Is this transdermal gel right for everyone?

No, this medication is not suitable for everyone. Patients with certain medical conditions or those taking certain other medications may not be candidates for this treatment. Always discuss your full medical history with your healthcare provider before starting any new medication.

What should I avoid while using this transdermal gel?

Avoid exposure to heat sources, such as heating pads, or prolonged exposure to sunlight on the treated area, as this may affect the absorption of the active ingredients. Additionally, avoid using other topical products on the treated area without first consulting with your healthcare provider.

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.

Gabapentin 10%/Ketamine 10%/Ketoprofen 10%/Lidocaine 5% Transdermal Gel
Topical Gel
60 g
controlled

Apply topically to affected area(s)