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Gabapentin 10%/Ketamine HCL 11.5%/Ketoprofen 5%/Lidocaine HCL 4% Transdermal Gel

Need relief from neuropathic pain, CRPS, or diabetic neuropathy? Bayview Pharmacy compounds a custom transdermal gel with gabapentin, ketamine, ketoprofen, and lidocaine.
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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
Ketamine Hydrochloride
Ketoprofen
Lidocaine Hydrochloride
Topical Gel
65ad73f858564c736bb95a27

Formula Information

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Our compounded transdermal gel formulation combines Gabapentin, Ketamine HCl, Ketoprofen, and Lidocaine HCl in a unique blend designed to address various pain-related conditions. Ketamine HCl, present at 11.5%, is an NMDA receptor antagonist that can provide analgesia and has been used in the management of chronic pain, including neuropathic pain. Ketoprofen, a nonsteroidal anti-inflammatory drug (NSAID), is included at 5% and offers anti-inflammatory and analgesic effects, which can be beneficial in conditions such as arthritis or musculoskeletal pain. Lastly, Lidocaine HCl at 4% serves as a local anesthetic, numbing the applied area and providing immediate relief from pain by blocking nerve signals.

This semisolid formulation is dispensed through a pump mechanism, which allows for easy and precise dosing. The gel is designed to be applied topically, directly over the area of pain, allowing for targeted treatment and potentially reducing systemic side effects. The transdermal delivery system facilitates the absorption of active ingredients through the skin, providing localized relief. This can be particularly advantageous for patients who may have difficulties with oral administration or those who require a localized effect to manage their pain.

The combination of these four active ingredients in a transdermal gel form can be used to treat a variety of disease states, including neuropathic pain, fibromyalgia, complex regional pain syndrome (CRPS), and various inflammatory conditions. The multimodal approach of this formulation aims to address pain through different mechanisms. It is important for prescribers to consider the patient's medical history, current medications, and potential drug interactions when prescribing this compounded medication.

Patients should be instructed on the proper application of the gel, including the amount to be applied and the frequency of use as directed by their healthcare provider. They should also be made aware of potential side effects, such as local skin irritation or systemic effects, although the latter may be less common with topical administration. It is crucial for patients to communicate any adverse reactions or lack of efficacy with their prescriber to adjust the treatment plan accordingly.

For more detailed information or if you have any questions regarding this compounded formulation, please 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 to ensure the safe and appropriate use of this medication.

Drug Interactions

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The transdermal gel formulation containing Gabapentin, Ketamine HCL, Ketoprofen, and Lidocaine HCL is designed for topical application and may offer localized relief from pain. However, it is important to consider potential drug interactions when using this compound, 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 CNS depression when used concurrently with gabapentin.

Ketamine, an NMDA receptor antagonist, can also cause CNS depression. When used with other CNS depressants, there is a risk of additive sedative effects. Patients should be monitored for signs of excessive sedation and respiratory depression. Furthermore, since ketamine is metabolized by the liver, caution should be exercised when used with other medications that affect hepatic enzymes, as this could alter ketamine levels.

Ketoprofen, a nonsteroidal anti-inflammatory drug (NSAID), may interact with anticoagulants such as warfarin, increasing the risk of bleeding. It can also affect renal function and should be used with caution in patients taking diuretics or ACE inhibitors. Concurrent use with other NSAIDs or corticosteroids may increase the risk of gastrointestinal side effects. It is important to monitor for signs of gastrointestinal bleeding or renal impairment.

Lidocaine, a local anesthetic, may interact with other local anesthetics or medications that are structurally related, such as antiarrhythmic drugs like mexiletine. Caution is advised when used with other drugs that can increase methemoglobin levels, such as nitrates or certain antibiotics. Additionally, lidocaine's metabolism may be affected by medications that inhibit hepatic enzymes, potentially leading to increased plasma concentrations and toxicity.

When using this transdermal gel, it is crucial to consider the total systemic exposure to these medications, as systemic absorption can occur, albeit at lower levels than with oral administration. Patients should be advised to inform their healthcare providers of all medications they are taking, including over-the-counter drugs and supplements, to assess for potential interactions. If you have any questions or require further information regarding this formulation and its use in treating disease states, please reach out to us at Bayview Pharmacy.

How Does it Work

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The Gabapentin 10%/Ketamine HCL 11.5%/Ketoprofen 5%/Lidocaine HCL 4% Transdermal Gel is a compounded medication designed to deliver its active ingredients 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 absorption through the skin.

Gabapentin is an anticonvulsant medication that is also used to treat neuropathic pain. In this transdermal formulation, gabapentin works by modulating the activity of certain neurotransmitters in the skin that are involved in the transmission of pain signals to the brain. By altering these signals, gabapentin can help reduce the sensation of pain in the affected area.

Ketamine HCL is an NMDA receptor antagonist that has been found to have analgesic properties, particularly in the management of chronic pain. When applied topically, ketamine can help to block the pain signals at the peripheral level before they reach the central nervous system, providing relief from pain without the psychoactive effects associated with its systemic use.

Ketoprofen is a nonsteroidal anti-inflammatory drug (NSAID) that works by inhibiting the production of prostaglandins, which are substances in the body that mediate inflammation and pain. By reducing the inflammatory response, ketoprofen can help to alleviate both pain and swelling in the tissues surrounding the application site.

Lidocaine HCL is a local anesthetic that provides immediate pain relief by blocking the sodium channels in the nerve endings. This action prevents the initiation and transmission of pain signals, offering a numbing effect to the area where the gel is applied.

This combination of medications in a transdermal gel form is particularly useful for treating localized neuropathic pain, chronic pain conditions such as complex regional pain syndrome, and inflammatory conditions that affect the skin and underlying tissues. The transdermal delivery system allows for the active ingredients to be absorbed directly into the affected area, providing targeted relief with potentially fewer systemic side effects compared to oral medications.

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 specific concentration of each ingredient has been chosen to maximize pain relief while minimizing side effects. If you have any questions about this formulation or its appropriateness for your condition, please reach out to us at Bayview Pharmacy for more information.

Other Uses

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Aside from being commonly used to manage chronic pain conditions, the Gabapentin 10%/Ketamine HCL 11.5%/Ketoprofen 5%/Lidocaine HCL 4% Transdermal Gel formulation may offer therapeutic benefits for various other medical conditions. For instance, due to the neuropathic pain-modulating properties of gabapentin and the local anesthetic effects of lidocaine, this compound could potentially be used in the management of neuropathies, such as diabetic peripheral neuropathy and postherpetic neuralgia, with the goal of reducing pain severity and improving quality of life for patients. Moreover, ketoprofen's anti-inflammatory effects might extend the use of this formulation to inflammatory conditions that also have a pain component, such as certain arthritic disorders. The inclusion of ketamine, known for its N-methyl-D-aspartate (NMDA) receptor antagonist action, may confer benefits in treating refractory pain conditions, where conventional therapies fail to provide adequate relief.

Furthermore, due to its transdermal delivery system, this formulation could be advantageous for patients who cannot tolerate oral medications due to issues like gastrointestinal upset or for those with swallowing difficulties. It is also pertinent for patients seeking localized pain relief without systemic side effects associated with oral medications. The gel's consistency allows for controlled application which could be favorable for patients requiring titration of dosages based on pain levels or for those having sensitive skin conditions where a non-invasive administration is preferred.

However, it is critical to note that any off-label use should be considered on a case-by-case basis and under the supervision of a healthcare provider to ensure safety and efficacy.

Given the individual components' pharmacologic profiles, prescribers may also contemplate the use of this compounding formulation in cases where multimodal pain management approaches are indicated, thereby potentially reducing the need for systemic opioid analgesics and their associated risks. It is imperative for patients and prescribers to engage in a thorough evaluation of the benefit-risk profile of using this compound for alternative indications, and to always consult a compounding pharmacist with the expertise to provide guidance on the appropriate use of this medication.

If you have any questions or require additional information about the potential other uses of this transdermal gel formulation, we encourage you to reach out to us here at Bayview Pharmacy. Our team of compounding pharmacists is committed to assisting healthcare professionals and patients to make informed decisions regarding their treatment options.

Frequently Asked Questions

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What is the purpose of this compounded transdermal gel?

This compounded transdermal gel is designed to deliver a combination of Gabapentin, Ketamine HCL, Ketoprofen, and Lidocaine HCL to the site of application for targeted pain relief and management. Each ingredient plays a unique role in helping to alleviate different dimensions of pain and discomfort.

How do I use the compounded transdermal gel?

To use this transdermal gel, apply the prescribed amount topically to the affected area. The pump mechanism ensures that you get an accurate dosage with each application. Gently spread the gel over the skin, and allow it to absorb fully. Do not cover with a bandage unless instructed by your healthcare provider.

What are the advantages of using a transdermal gel?

Transdermal gels allow for the medication to be absorbed directly through the skin, targeting the area of pain without going through the digestive system. This can result in fewer systemic side effects and may provide more localized relief from discomfort.

Can I apply this gel to broken or irritated skin?

Do not apply this gel to broken, irritated, or inflamed skin. Application should be limited to intact skin surfaces to avoid potential irritation and to ensure proper absorption of the medication.

How often can I apply this compounded transdermal gel?

The frequency of application will be determined by your healthcare provider based on your specific condition and needs. It is important to follow the prescribed regimen and not exceed the recommended dosage.

What should I do if I miss a dose?

If you miss a dose, apply the gel as soon as you remember. However, 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.

Are there any potential side effects of using this compounded gel?

Possible side effects may include local skin reactions such as redness, itching, or irritation at the application site. Systemic side effects are less common with transdermal application but can include drowsiness, dizziness, or gastrointestinal upset. Consult your healthcare provider if you experience any unusual symptoms.

How should I store the compounded transdermal gel?

Store the compounded transdermal gel at room temperature, away from light and heat. Keep the container tightly closed when not in use and out of reach of children and pets. Do not freeze the gel, as this may affect its efficacy and consistency.

Can I use other medications or topical treatments with this compounded gel?

Before using other medications or topical treatments, consult with your healthcare provider, as there may be potential interactions. It's imperative to avoid combining therapies unless advised by a professional, to prevent any adverse interactions or effects.

Is this compounded transdermal gel right for everyone?

This compounded transdermal gel may not be suitable for everyone. It is important to discuss your medical history and any current medications with your healthcare provider to determine if this formulation is safe and appropriate for you.

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.

Gabapentin 10%/Ketamine HCL 11.5%/Ketoprofen 5%/Lidocaine HCL 4% Transdermal Gel
Topical Gel
60 g
controlled

Apply topically to affected area(s)