Compounded Topical Analgesics for Chronic Pain

Cline, Abigail; Turrentine, Jake E.

doi:10.1097/der.0000000000000216

Cited by 22 publications

(9 citation statements)

References 73 publications

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“…Furthermore, while ketamine infusions have been well studied, alternative routes of ketamine administration have been evaluated less extensively. For example, open studies of 2% topical ketamine preparations have suggested a therapeutic effect on chronic pain without adverse effects locally or systemically, though further research is needed to elucidate its efficacy [122]. e S-enantiomer of ketamine also appears to have a two-to threefold more potent analgesic effect than (R)-ketamine [123], and the utility of using (S)-ketamine alone as a treatment for pain warrants additional study.…”

Section: Drawbacksmentioning

confidence: 99%

A Review of Nonanesthetic Uses of Ketamine

Pribish

Wood

Kalava

2020

Anesthesiology Research and Practice

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Ketamine, a nonselective NMDA receptor antagonist, is used widely in medicine as an anesthetic agent. However, ketamine’s mechanisms of action lead to widespread physiological effects, some of which are now coming to the forefront of research for the treatment of diverse medical disorders. This paper aims at reviewing recent data on key nonanesthetic uses of ketamine in the current literature. MEDLINE, CINAHL, and Google Scholar databases were queried to find articles related to ketamine in the treatment of depression, pain syndromes including acute pain, chronic pain, and headache, neurologic applications including neuroprotection and seizures, and alcohol and substance use disorders. It can be concluded that ketamine has a potential role in the treatment of all of these conditions. However, research in this area is still in its early stages, and larger studies are required to evaluate ketamine’s efficacy for nonanesthetic purposes in the general population.

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Section: Drawbacksmentioning

confidence: 99%

A Review of Nonanesthetic Uses of Ketamine

Pribish

Wood

Kalava

2020

Anesthesiology Research and Practice

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“…15 Gabapentin has been primarily used as a systemic therapy for erythromelalgia, 7,16,17 but a topical formulation of gabapentin can also be useful for erythromelalgia. 18,19 While there are no case studies of topical gabapentin used specifically to treat erythromelalgia, studies have found topical gabapentin effective for treating a variety of other neuropathic pain. 15,[20][21][22] Compounded topical amitriptyline-ketamine gel is a formulation developed by the Mayo Clinic as a new treatment option for refractory erythromelalgia.…”

Section: T a B L E 1 Topical Therapies For Erythromelalgiamentioning

confidence: 99%

Topical treatments for erythromelalgia

Raef

Williams

Fedeles

2022

Dermatologic Therapy

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Erythromelalgia is a rare neurovascular disease that causes episodes of pain, redness, and warmth in the extremities, and can be debilitating. Currently, there is no universally effective treatment for erythromelalgia. As the precise etiology of erythromelalgia remains obscure, presently available treatments are aimed at alleviating erythromelalgia's wide-ranging symptoms. In general, topical therapies for erythromelalgia are preferred for their more limited side effects and for those with contraindications to systemic therapies. This review will summarize the current topical therapies available to treat erythromelalgia and discuss emerging therapies based on our growing understanding of erythromelalgia pathophysiology.

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“…29,30 Limited drug-drug interactions, less potential for misuse, ease of application, direct application to the targeted site of pain, patient satisfaction, and success in treating the patient's pain can provide advantages over systemically delivered oral medications. 17,21,31,35 Although adverse GI and renal side effects appear reduced with topical versus oral diclofenac, the US Food and Drug Administration (FDA) mandates that warnings be placed on all NSAID products about the risks of GI and CV adverse effects. This Relieving Pain: Evaluating Patient Quality of Life Improvement -Perceptions, Experience and Feedback After Use of A Topical Pain Relief Patch (RELIEF) study evaluated patients with mild to moderate and acute and chronic pain conditions and their overall perceptions of pain treatment and associated symptoms with the use of a specific topical pain-relieving patch (Salonpas ® Pain Relieving Patch.…”

Section: Introductionmentioning

confidence: 99%

<p>Improvement of Pain and Function After Use of a Topical Pain Relieving Patch: Results of the RELIEF Study</p>

Gudin¹,

Dietze²,

Hurwitz³

2020

JPR

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Purpose: Pain is the most common reason for patients to consult primary care providers. Identification of effective treatments with minimal adverse events is critical to safer opioidsparing and multi-modal approaches to pain treatment. Topical analgesic patches target medication to peripheral sites of pain while potentially avoiding adverse effects associated with systemic medications. Opioids, prescription nonsteroidal anti-inflammatory drugs, and over-the-counter oral medications are associated with systemic toxicities, increasing morbidity and mortality. This study evaluated a topical analgesic pain-relieving patch in reducing pain severity and improving function in patients with mild to moderate arthritic, neurological, or musculoskeletal pain. Patients and Methods: This Institutional Review Board-approved study evaluated the effectiveness of a topical pain-relieving patch in reducing Brief Pain Inventory (BPI) scores in patients. The treatment group (TG) (n=152) received patches for 14 days. A control group (CG) (n=47) did not receive the patch. After day 14, 34 CG patients crossed over to treatment (CROSSG) with the patch. Surveys were administered to patients at baseline and 14 days to assess changes in pain severity and interference. Changes in oral pain medication use, side effects, and satisfaction use were also assessed. Results: Paired data were collected in the CG, TG and CROSSG. At day 14, TG pain severity score and pain interference score decreased (49% and 58.1%, respectively). Pain severity and interference scores decreased less in the CG (12.3% and 14.8%, respectively). In the study, 60.5% of the TG were using concomitant oral pain medications "a lot less", and 90.8% were very/extremely satisfied with the patch. CROSSG patients showed similar reductions in pain severity and interference scores after patch treatment. No side effects of treatment were reported. Conclusion: Results indicate that this topical analgesic pain-relieving patch can reduce BPI pain severity and interference scores in adult patients with mild to moderate arthritic, neurological, and musculoskeletal pain and should be considered as a treatment option.

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Compounded Topical Analgesics for Chronic Pain

Cited by 22 publications

References 73 publications

A Review of Nonanesthetic Uses of Ketamine

A Review of Nonanesthetic Uses of Ketamine

Topical treatments for erythromelalgia

<p>Improvement of Pain and Function After Use of a Topical Pain Relieving Patch: Results of the RELIEF Study</p>

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