NSAID Therapy

A compounder can also put a drug in a form that doesn't have to be taken orally, thus avoiding dangerous side effects. For example, one of the ugly side effects of a widely used group of pain relievers, nonsteroidal anti-inflammatory drugs (NSAIDs), is that they can irritate the stomach and often lead to inflammation of the stomach lining (gastritis), ulcers, bleeding, or perforation of the lining. In fact, it's estimated that twenty thousand deaths a year are caused by the serious side effects of NSAIDs. Imagine, people taking a drug that's supposed to make them feel better but ends up killing them!

A compounding pharmacist can make up NSAIDs that can be administered sublingually (absorbed under the tongue) or transdermally (absorbed through the skin when applied as a cream). Either of these delivery methods avoid the gastrointestinal tract altogether and, consequently, avoid damage to the stomach.

MIGRAINE / CLUSTER HEADACHES

Migraines afflict about 30 million people in the United States. They may develop at any age, but usually begin between the ages of 10 and 40 and diminish after age of 50. A migraine headache is a throbbing or pulsating headache that is often unilateral and associated with nausea; vomiting; sensitivity to light, sound, and smells; sleep disruption; and depression.

Traditional drugs of choice for treating migraine have been many. However, many of those medications have limitations, which offset their usefulness. These limitations include high costs, multiple side effects and may require a significant amount of time before providing relief.

Our pharmacy specializes in the preparation of several compounded alternatives to traditional medications and which effectively with targets migraine headache.

1. Ergotamine Tartate Suppositories - this formula is used to abort or prevent vascular headaches such as migraine or cluster headaches that may be complicated by tension and GI disturbance.
2. Piroxicam sublingual troches - can be prepared for symptomatic treatment of migraine headaches.
3. Ketoprofen/Riboflavin/Caffeine capsules - can be used to treat and prevent recurrences of acute migraine headaches.

PLO Gel - what is it?

Most of our topical products are compounded in a pluronic lecithin organogel base referred to as PLO gel. PLO is an emulsion that has the appearance and feel of a gel. The PLO base allows a drug to penetrate the skin without damaging it, so that the active drugs can easily enter into the systemic circulation. One unique characteristic of this base is that it is thermo reversible. It should be stored at room temperature to keep the emulsion solid; if refrigerated it quickly turns to liquid

Transdermal PLO Gels are specially made to target local tissues and achieve local therapeutic drug-levels while minimizing blood-level related toxicities.

PLO gels have already gained acceptance as the intradermal vehicle of choice for a variety of drugs including Diclofenac, ibuprofen, Ketoprofen, and progesterone. The benefits of Transdermal PLO Gels:

1. High Penetrating-Power - Achieve high, therapeutic tissue-levels while reducing blood-level related side effects
2. Ready-to-Use
3. Improved Stability - Remain uniform and appealing for longer periods
4. Easy to self-administer

Cosmetically-Pleasing - a non-greasy, non-tacky, soothing skin moisturizer

Neuropathic pain

Neuropathic pain is a complex, chronic state that usually is accompanied by tissue injury. With neuropathic pain, the nerve fibers themselves may be damaged, dysfunctional or injured. These damaged nerve fibers send incorrect signals to other pain centers. The impact of nerve fiber injury includes a change in nerve function both at the site of injury and areas around the injury.

The use of Ketamine, a dissociative anesthetic agent, is expanding beyond traditional uses. Its mechanism of action - antagonism of the N-methyl-D-aspartate (NMDA) receptor - contributes to the management of pain.

Available topical treatment:

• Neuropathic K+ (with inflammation)
       (Ketoprofen 20%/Gabapentin 5%/Lidocaine 5%/Ketamine 2%)
• Neuropathic K+ (without inflammation)
       (Ketamine 2%/Gabapentin 5%/Amitriptyline 2%/Clonidine 0.6%/Lido 5%)
• Ketamine 2%/Lidocaine 5% PLO Gel
• Ketamine 10%/Gabapentin 6%/Clonidine 0.3% in PLO gel

Examples of available compounds

• KBCYL
       (Ketoprofen 20%/Baclofen 2%/Cyclobenz 2%/Lidocaine 5% PLO gel)
• Neuropathic K+ (with inflammation)
       (Ketoprofen 20%/Gabapentin 5%/Lidocaine 5%/Ketamine 2%)
• Neuropathic K+ (without inflammation)
       (Ketamine 2%/Gabapentin 5%/Amitriptyline 2%/Clonidine 0.6%/Lido 5%)
• Nero Gel
       (Ketoprofen 5%/Amitriptyline 2%/Gabapentin 2%/Lido 5%/Tetracaine 2%)
• NSAID
       (Ketoprofen 20%/Lido 10%)
• Ketamine 2%/Lidocaine 5% PLO Gel
• Ibuprofen 10% gel
• Ketamine 10%/Gabapentin 6%/Clonidine 0.3% in PLO gel
• Lidocaine 10%/Baclofen 2%
• Ketoprofen PLO 10% gel
• Topical Promethazine 50mg/ml # syringes

**Our pharmacists are available to discuss any formulations at 888-226-6779.