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Gabapentin 4%/Ketamine 2.5%/Ketoprofen 4%/Lidocaine 4% Transdermal Gel

FDA-approved generic
Dose form
Topical Gel
Active ingredients
Gabapentin
Ketoprofen
Ketamine Hydrochloride
Lidocaine Hydrochloride

The Gabapentin 4%/Ketamine 2.5%/Ketoprofen 4%/Lidocaine 4% Transdermal Gel is a specialized medication compounded to manage neuropathic pain and chronic pain conditions. 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 in the central nervous system. Ketoprofen is a nonsteroidal anti-inflammatory drug (NSAID) that reduces inflammation and pain, and lidocaine is a local anesthetic that provides immediate relief from pain by numbing the area. The combination of these four active ingredients in a transdermal gel form offers a multimodal approach to pain management, targeting various pathways involved in pain perception and inflammation.

This compounded gel is particularly useful for patients suffering from conditions such as diabetic neuropathy, postherpetic neuralgia, complex regional pain syndrome (CRPS), and other neuropathic or chronic pain states. The transdermal application allows for localized treatment, which can minimize systemic side effects often associated with oral medications. The gel's consistency and the pump dispenser facilitate consistent application, making it a convenient option for patients seeking targeted pain relief.

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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, NJ, NH, FL, ME and PA. New York patients are served on a limited basis while nonresident registration is pending.
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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This medication requires a prescription from your doctor

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.

For prescribersSign in for prescription details and order forms.
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
65ad7134c81c142c264732ab

Formula Information

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Our custom-compounded transdermal gel combines Gabapentin, Ketamine, Ketoprofen, and Lidocaine in a unique formulation designed to provide targeted relief from various pain conditions. Ketamine, an NMDA receptor antagonist, provides analgesic effects, particularly in neuropathic pain syndromes, by blocking pain signals at the spinal level. Ketoprofen, a potent nonsteroidal anti-inflammatory drug (NSAID), offers anti-inflammatory and analgesic properties, making it beneficial for inflammatory pain conditions. Lidocaine, a local anesthetic, works by blocking sodium channels, thereby providing immediate relief from pain by numbing the affected area.

The synergistic combination of these four active ingredients in a 4%/2.5%/4%/4% concentration, respectively, allows for a multimodal approach to pain management. This can be particularly useful in treating conditions such as neuropathies, complex regional pain syndrome (CRPS), fibromyalgia, and musculoskeletal pain, where a single-agent therapy may not be sufficient. The transdermal gel formulation is designed to maximize patient compliance and comfort. It is dispensed through a pump mechanism, which ensures easy and precise dosing. The semisolid consistency of the gel allows for it to be applied directly to the skin over the painful area, facilitating absorption of the active ingredients without the gastrointestinal side effects often associated with oral medications.

For prescribers, it is important to note that this formulation can be tailored to meet the specific needs of individual patients, and it should be used as part of a comprehensive pain management plan. Patients should be instructed on the proper application technique to ensure optimal absorption and effectiveness. Regular monitoring for efficacy and any potential side effects is recommended. As with any compounded medication, this formulation is prepared in a controlled environment to ensure the quality and consistency of the product.

Patients should be aware that while this transdermal gel offers the convenience of at-home application and the potential for fewer systemic side effects, it is still a medication that requires careful use as directed by a healthcare professional. It is essential to use the gel as prescribed and report any adverse reactions or lack of improvement to their healthcare provider.

If you have any questions or require further information about this compounded transdermal gel formulation, please do not hesitate to reach out to us at Bayview Pharmacy. Our team of compounding pharmacists is dedicated to providing the highest level of care and support to both patients and prescribers.

Drug Interactions

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The transdermal gel formulation containing Gabapentin 4%, Ketamine 2.5%, Ketoprofen 4%, and Lidocaine 4% 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 when using this compound, especially if the patient is taking other medications or has underlying health conditions.

Gabapentin, an anticonvulsant and neuropathic pain agent, may interact with antacids containing aluminum or magnesium, as they can reduce the absorption of gabapentin and decrease its effectiveness. Caution is advised when this transdermal gel is used in conjunction with central nervous system (CNS) depressants, such as opioids, benzodiazepines, or alcohol, as gabapentin can potentiate the sedative effects of these substances.

Ketamine, an NMDA receptor antagonist used for its anesthetic and analgesic properties, should be used with caution in patients taking other CNS depressants, as it can enhance sedation and respiratory depression. Additionally, chronic use of ketamine may induce liver enzyme CYP3A4, potentially affecting the metabolism of other drugs metabolized by this enzyme.

Ketoprofen, a nonsteroidal anti-inflammatory drug (NSAID), can interact with anticoagulants like warfarin, increasing the risk of bleeding. It may also reduce the effectiveness of antihypertensive drugs and diuretics. Concurrent use with other NSAIDs, including aspirin, should be avoided to reduce the risk of additive side effects, such as gastrointestinal irritation or renal impairment. Caution is also advised when used with selective serotonin reuptake inhibitors (SSRIs), as this can increase the risk of gastrointestinal bleeding.

Lidocaine, a local anesthetic and antiarrhythmic agent, may interact with other local anesthetics or medications that affect cardiac conduction, such as beta-blockers or calcium channel blockers. When applied topically, the risk of systemic interactions is lower, but caution is still advised, especially in patients with pre-existing cardiac conditions.

It is essential to inform the prescriber of all medications, supplements, and over-the-counter products the patient is currently using to avoid potential interactions. This transdermal gel is intended for localized treatment of conditions such as neuropathic pain, chronic pain syndromes, or specific musculoskeletal pain. 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 this formulation and its use, please reach out to us at Bayview Pharmacy for assistance.

How Does it Work

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The Gabapentin 4%/Ketamine 2.5%/Ketoprofen 4%/Lidocaine 4% Transdermal Gel is a compounded medication designed to deliver a combination of 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 nervous system, which helps to reduce the sensation of pain. Ketamine, a medication primarily used for anesthesia, has been found to have analgesic properties at lower doses. It works by blocking NMDA receptors, which are involved in the transmission of pain signals in the nervous system, thus providing relief from chronic pain.

Ketoprofen is a nonsteroidal anti-inflammatory drug (NSAID) that reduces inflammation, pain, and swelling by inhibiting the enzymes involved in the production of inflammatory mediators. Lidocaine, a local anesthetic, provides immediate relief from pain by blocking the sodium channels required for the initiation and conduction of nerve impulses. When applied topically, lidocaine can help to numb the area and reduce pain sensation.

The combination of these four active ingredients in a transdermal gel allows for a multimodal approach to pain management. By targeting different mechanisms of pain and inflammation, this formulation can be particularly useful for patients suffering from conditions such as neuropathic pain, complex regional pain syndrome (CRPS), and certain musculoskeletal disorders. The transdermal route of administration ensures that the medication bypasses the gastrointestinal tract, reducing the potential for systemic side effects and providing targeted relief at the site of application.

It is important for both patients and prescribers to understand the proper use of this medication, including the appropriate dosing and application instructions. As with any medication, there may be potential side effects, and it is essential to monitor the patient's response to therapy. If you have any questions or require further information about this formulation and its use in treating specific disease states, please reach out to us at Bayview Pharmacy. Our team of compounding pharmacists is here to provide support and guidance to ensure the safe and appropriate use of this medication.

Other Uses

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The unique combination of gabapentin, ketamine, ketoprofen, and lidocaine in this transdermal gel formulation, primarily designed for the management of neuropathic pain, may also have other potential therapeutic applications. Due to its compounded nature, this medicated gel serves as a multi-mechanistic approach to pain management, which can be advantageous for conditions where both inflammation and neuropathic pain are present. For instance, patients suffering from complex regional pain syndrome (CRPS), postherpetic neuralgia, and diabetic neuropathy may find relief from this specific mixture of medications.

Aside from these indications, the anti-inflammatory properties of ketoprofen and the analgesic effects of both gabapentin and ketamine could potentially benefit those with osteoarthritis or rheumatoid arthritis experiencing localized pain and inflammation. Moreover, individuals with certain dermatological conditions associated with pain and inflammation might experience symptomatic relief. However, it is essential for each patient to consult with a health care provider prior to use to determine if this formulation is suitable for their specific condition.

Another use of this transdermal gel could be in the setting of localized musculoskeletal or soft tissue injuries, such as sprains, strains, or tendinitis. The combination of analgesic and anti-inflammatory components may contribute to reducing swelling and discomfort at the site of injury, potentially facilitating a more comfortable healing process. Additionally, patients with fibromyalgia who experience localized flares or particular points of intense pain may find the application of this gel beneficial as part of their overall management strategy under medical guidance.

While the aforementioned uses showcase the flexibility of this formulation, it is imperative for patients and prescribers to be aware that this is a potent compound and its efficacy and safety for conditions outside of those initially indicated should be thoroughly evaluated on a case-by-case basis. The transdermal delivery system allows for targeted application and may reduce systemic side effects, yet appropriate assessment, and monitoring remain crucial to ensure patient safety. If there are any questions or considerations regarding off-label use, interaction with other medications, or individual suitability, we encourage reaching out to us at Bayview Pharmacy for a professional consultation. Our knowledgeable team of compounding pharmacists is dedicated to providing guidance and customized care for our patients and their providers.

Frequently Asked Questions

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What is this compounded transdermal gel used for?

This compounded gel is commonly prescribed for managing various types of pain, including neuropathic pain, and may be used for conditions such as peripheral neuropathy, post-herpetic neuralgia, or complex regional pain syndrome. By combining Gabapentin, Ketamine, Ketoprofen, and Lidocaine, it aims to provide relief from pain through multiple mechanisms of action.

How do I apply this transdermal gel?

The gel should be applied topically to the affected area. Wash your hands before and after use. Apply a thin layer of the gel to the skin and gently rub in until it is no longer visible. Do not cover with a bandage unless instructed by your healthcare provider. The dosing frequency will be directed by your physician or pharmacist.

Can this gel be applied to any area of the body?

No, it should only be applied to intact skin surfaces and not on open wounds, mucous membranes, or near the eyes. Use the gel only on the areas of the body as directed by your healthcare provider.

What are the advantages of using a compounded transdermal gel?

Compounded transdermal gels allow for targeted treatment and may reduce the risk of systemic side effects compared to oral medications. The combination of active ingredients can address various pathways of pain transmission. Also, the pump mechanism facilitates easy and precise dosing.

Will this transdermal gel cause side effects?

As with all medications, side effects are possible. Common side effects may include local skin irritation, redness, or itching at the site of application. Systemic side effects are less common with topical administration, but if you experience any unusual symptoms, please contact your healthcare provider.

How should this gel be stored?

The gel should be stored at room temperature, away from heat and direct sunlight. It should also be kept out of reach of children. Do not freeze the medication. Refer to the label for any additional storage instructions provided by the pharmacy.

Can I use this gel in conjunction with other medications?

You should consult your healthcare provider before using this gel with other medications. This includes both topical and systemic drugs, as interactions can occur when combining medications with similar or opposing effects. Always provide your doctor or pharmacist with a complete list of medications you're currently taking.

Is this transdermal gel suitable for children?

The safety and effectiveness of this gel have not been established in children. Use in pediatric patients should be under the direct supervision of a healthcare provider and evaluated on a case-by-case basis.

What should I do if I miss a dose?

If you miss a dose, apply it as soon as you remember. However, if it is nearly time for your next dose, skip the missed dose and return to your regular dosing schedule. Do not double the dose to catch up.

How do I know if the gel is working?

Improvements in pain are a sign that the gel is working. Pain relief might not be immediate and can vary among individuals. Ongoing assessment with your healthcare provider is essential to determine the effectiveness and adjust treatment if necessary.

Can I use the transdermal gel before or after physical activities?

Yes, you may use the gel before or after physical activities, as directed by your healthcare provider. However, you should allow the medication to dry completely before engaging in activities or taking a bath or shower.

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, 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.

Gabapentin 4%/Ketamine 2.5%/Ketoprofen 4%/Lidocaine 4% Transdermal Gel
Topical Gel
60 g
controlled

Apply topically to affected area(s)