Project Description

Transdermal Compounding Medication

Transdermal pic 1

 

Description:

Transdermal compounding provides a valuable tool to treat refractive and difficult conditions that cannot be adequately treated or tolerated with commercially available pharmaceuticals. Applications can be made directly at the

point of pain, at the triggerpoints, or at the dorsal horn.

There are a myriad of potential combinations that can be made using the most common agents for inflammatory and neuropathic pain. For inflammatory pain we use ketoprofen and diclofenac as our standard NSAID. Since

the agents can increase other inflammatory cytokines, we frequently incorporate

Transdermal pic 2

other ingredients that can inhibit selective leukotrienes, tissue necrosis factor alpha, etc. Additionally we add agents that decrease oxidative stress and augment absorption. We do

have formulas for inflammation that do not have NSAIDs if the effect on INRs is a concern.

For neuropathic pain, we generally use ketamine as it is the strongest NMDA receptor antagonist. Since there is no first pass effect with transdermal applications, it is very well tolerated with no CNS adverse effects as can occur with oral and parenteral routes of administration. We do have other formulas using other NMDA antagonists if there is a need for a preparation that is not controlled (Schedule III).

There are numerous other classes of medications that have a synergistic effect as a result of varying mechanisms of action on the AMPA/NMDA receptors. A non-inclusive list would include anesthetics, antidepressants, anticonvulsants, antihypertensives, etc.

For the Treatment of:

  • Osteoarthritis
  • Rheumatoid Arthritis
  • Fibromyalgia
  • Neuropathic Pain
  • Reflex Sympathetic dystrophy (RSD)
  • Post Herpetic Neuralgia
  • Diabetic Neuropathy
  • Phantom Limb Pain
  • Musculoskeletal Pain ( knee, hip, back, elbows, etc. )
  • Acute Sports Injuries
  • Intractable Pain

Resources: