Pain Management Drug Compounding

Highly Effective Topical Anti-Inflammatory and Pain Reliever Without All The Systemic Effects.”

Medications that relieve inflammation and pain and relax muscles can cause undesirable side effects, including cardio-vascular complications, drowsiness, gastric irritation and unwanted systemic side effects.1 Topical administration (e.g., cream, gel and ointment), on the other hand, delivers the drug directly to the disease site and produces high local drug concentration, while reducing unwanted side effects.2

Ketoprofen (Orudis) and/or Piroxicam (Feldene) topical gels have anti-inflammatory and analgesic effects and are used in the local and symptomatic treatment of:

* Acute and chronic rheumatoid arthritis

* Tenosynovitis (e.g., Tendinitis)

* Acute and chronic osteo and peri arthritis

* Bursitis (e.g., Tennis Elbow)

* Gonarthroses (inflammation of the knee joint)

* Carpal Tunnel Syndrome

* Contusions

* Dislocations

* Edema

* Sprains

* Myalgia

* Myositis

* Hematoma

* Superficial Thrombosis

* Acute musculoskeletal disorder

* Phlebitis

* Soft tissue injuries (e.g, ankle sprains, achilles tendinitis, rotator cuff inflammation, etc.

* Ankylosing spondylitis (inflammation of the spine joints)

These gels are often prescribed by Arthritis Specialists, Orthopaedic Surgeons, Sports Medicine Specialists and Rehabilitation Therapists. They are often used in combination with ultrasound for added deep-tissue effectiveness.

For example, in a 1992 study on the treatment of gonarthroses (inflammation of the knee joint), the application of Piroxicam gel (even at a low level of 5mg/gm) resulted in more than 90% improvement of all evaluated criteria, including pain, mobility and required assistance during change of position (sitting, standing up, and climbing stairs). The gel was applied to the joint area 3 times daily for 2 weeks. Tolerance level was 97.5%. The conclusion to this study states that Piroxicam gel is an important asset to local treatment in rheumatology and will be a valuable asset to orthopedic surgery and sports medicine.5

With a prescription from a physician, we at Regency Medical Pharmacy can prepare Ketoprofen with Piroxicam for additional anti-inflammatory effects and Ketoprofen with Lidocaine for anti-inflammatory and numbing effects.

Ketoprofen and Piroxicam are both non-steroidal anti-inflammatory drugs (NSAIDs). Ketoprofen is structurally related to Fenoprofen, Ibuprofen and Naproxen.3 Piroxicam is structurally unrelated to other NSAIDs.4

Gabapentin (Neurontin), Ketamine (Ketalar), Misoprostal (Cytotec). Capsaicin, Amitriptyline (Elavil), Baclofen and many other active drugs could be added to the above for neurological (e.g., Shingles and diabetic neuropathy) and other types of pain relief.

BASE USED
These gels are prepared in a Pluronic Lecithin Organogel (PLO gel) vehicle for enhanced penetration. PLO is an antipyretic gel which becomes more viscous as it warms up by body heat.

DIRECTIONS
Apply the compound to the affected area, in a thin smooth film, 3 to 4 times daily (as needed). If wearing a brace over the gel, make sure to first air out the area for approximately 30 minutes. This gel is easily removed with water.

HOW TO ORDER
These gels can be called in to us by a physician and we, at Regency Medical Pharmacy, can compound them for you.
Prescription details could be as such:
* Ketoprofen 10% or 20%, in PLO gel
30gm or 60gm
Apply TID PRN

* Ketoprofen 15%, Piroxicam 2%, in PLO gel
30gm or 60gm
Apply TID PRN

* Ketoprofen 15%, Lidocaine 5%, in PLO gel
30gm or 60gm
Apply TID PRN

* Ketoprofen 10%, Ketamine HCL 2%, Capsaicin 0.075%, in PLO gel
30gm or 60gm
Apply TID PRN