Topical analgesic formulations are gaining interest for the treatment of peripheral neuropathic pain since the beginning of 2000. Advantages of topical analgesics over oral medication are the absence of systemic side effects and drug-drug interactions, higher concentrations of active compound at the pain area, fast onset on action, improvement of compliance, and no risk of abuse. In many peripheral neuropathic pain states the pain area is small and thus topical analgesics are suitable. Most patients experience pain reducing effect within 30 minutes after application of compounded topical analgesics, such as creams containing amitriptyline, ketamine, baclofen, or clonidine. This helps to quickly identify responders on selected analgesic creams.
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