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Need to find out about Neurontin Cream

Posted by Pam S. on 4/29/03 at 11:52 (117340)

Dear Friends:
I just got home from a visit with a very impressive ortho foot/ankle dr. who knew alot about TTS. She liked the idea of the Neurontin Cream but did not know a compounding pharmacy. She wrote me a script for the Cream. I know of one pharmacy like this in the Denver area. I will do some research on this. I think it could be helpful. I would take 20%.

She said I also have PF and gave me a night splint. They have huge success with those. We shall see how I can SLEEP in it!! Gotta run.
PS You all know just about all there is to know in the whole wide world about these feet disorders. You should all be proud of yourselves - painful tooties and all. Pam

Re: Here's some info on a compounding pharmacy

Sharon W on 4/29/03 at 12:04 (117342)

Pam,

Here is some info on a compounding pharmacy that produces topical gels for nerve pain and other things. (I posted this about 9 months ago, this is just a search/copy/paste.)

Sharon

Posted by Sharon W on 8/30/02 at 16:07
More info on those (prescription) topical nerve and pain gels I found with my search, if anyone is interested. It comes from the following site:

http://www.drugs-r-us.org/treatments.html

Transdermal Gels for Pain

Pluronic Lecithin Organogels are used for transdermal delivery of various medications. Medications most commonly used are anti-inflammatories, muscle relaxers, nerve blockers, local anesthetics, hormones and anti-emetics.

When using anti-inflammatories, PLO's deliver a high concentration of the drug to the desired site. Studies have shown up to 100 times higher NSAID synovial fluid concentrations when compared to NSAID blood levels. It allows for quick onset of action, three to five minutes, while bypassing the gastrointestinal tract for those patients at risk of the side effects most commonly seen using oral anti-inflammatories.

Usually dispensed in 30gm or 60gm tubes.

PRESCRIPTIONS:

NEURO-GEL

For Neuropathic Pain

Ketoprofen 10% / Carbamazipine (Tegretol)2% / Lidocaine 10%

*Neurontin, Dilantin, or Elavil may be substituted for Tegretol.

Neuro-Gel 2

Ketoprofen 20% / Lidocaine 10% / Amitryptilline 2%

SHINGLES GEL

Ketoprofen 20% / Lidocaine 10% / Deoxy d Glucose 2% / Carbamazapine (Tegretol) 2%

Apply to affected area 3 times a day.

Wash area before each application.

GUANETHEDINE SPRAY

For Reflex Sympathetic Dystrophy

Guanethedine 1% / Lidocaine 4%

Apply to painful area 2 to 3 times daily.

POST HERPETIC NEURALGIA SOLUTION or 'PHN' SOLUTION

Amitriptylline 2% / Capsaicin 0.075% / Lidocaine 5% / Clonidine 0.2%

TRIGGER POINT GEL

Ketoprofen 10% / Guaifenesin 10% / Capsaicin 0.075% / Lidocaine 4%

Apply to trigger point areas 3 to 4 times a day.

Compounds for Neuropathic Pain

Gaba-Clon Gel

Neurontin 6% / Clonidine 0.02%

Apply topically 3 to 4 times a day.

KCL Cream

Ketoprofen 20% / Carbamazepine (Tegretol) 2% / Lidocaine 10%

Ketamine 5% in a PLO

Used for any neuropathic pain, TMJ pain, myofacial pain, fibromyalgia, etc.

Apply topically 3 to 4 times daily.

Orthopedics

Changing the route of administration can eliminate some side effects such as stomach discomfort and ulcers. This service usually involves consulting with the physician.

Transdermal Gels for Pain

Pluronic Lecithin Organogels are used for transdermal delivery of various medications. Medications most commonly used are anti-inflammatories, muscle relaxers, nerve blockers, local anesthetics, hormones and anti-emetics.

When using anti-inflammatories, PLO's deliver a high concentration of the drug to the desired site. Studies have shown up to 100 times higher NSAID synovial fluid concentrations when compared to NSAID blood levels. It allows for quick onset of action, three to five minutes, while bypassing the gastrointestinal tract for those patients at risk of the side effects most commonly seen using oral anti-inflammatories.

Usually dispensed in 30gm or 60gm tubes.

PRESCRIPTION:

Ketoprofen 20% gel - for inflammation in the joints.

Keto-Flex Gel - (Ketoprofen 20%, Cyclobenzaprine 2%)

Keto-Lido Gel - (Ketoprofen 20%, Lidocaine 5%)

Keto-Cam Gel - (Ketoprofen 20%, Piroxicam 1%)

Ketocyclolido Gel - (Ketoprofen 20%, Cyclobenzaprine 2%, Lidocaine 5%)

Or any combination....

Apply 2 to 4 times a day or as needed to the affected area. Rub in well.

http://www.drugs-r-us.org/treatments.html

-----------------------------

I hope this will help someone.

Sharon

Re: Need to find out about Neurontin Cream

Bev on 4/29/03 at 13:09 (117344)

Pam,
If you have a lot of problem walking first thing in the morning, you will find that the night splints will help , they really helped me. My arches were still hurting so much at night still wearing them so I got arch braces to wear with them and that helped too.At first I had big clunky night splints from the ortho and it was hard sleeping,(gave my hubby bruses too ) so then I ordered lighter ones from FootSmart.com and these are great. I am so very happy for you that you have such a great foot and ankle doctor, you are one of the LUCKY ONES :D I also will be interested in the Neurontin cream when you find out about it.
When you said that you had to 'gotta run' was that really that you were goin' to 'run'? Ouch :)) BYE

Re: Here's some info on a compounding pharmacy

Bev on 4/29/03 at 13:17 (117345)

Sharon,
Wow, I saved that site, you sure are a wealth of information, sharon, ask and we shall receive :D Thankyou . Were you able to find anything on those two questions of mine from 4/25/03 # 117052 and # 117140 ? Am I making too much of a pest of myself? Just let me know if I am , okay?

Re: Need to find out about Neurontin Cream

Pam S. on 4/29/03 at 14:28 (117352)

Bev and Sharon:
You make me laugh, Bev. NO I am not running - just busy today with alot of chores etc. and appts. you know how it is. Bev, maybe you can be helped too by one of these creams. The night splint is a good one. It is light. I have used them before. Here I go again.

Sharon,Thank you once again for the info. You are once again amazing. OK ladies we have to work together on this one and maybe this could help us. I did not have the impression this dr. was up on the use of creams or gels. WOW you can get them with Elavil, neurontin etc etc. I do not know which one to select. She just wrote the script for Neurontin Cream because that is what I said. She said Great give it a try. I am sure she would add to it. She was very nice. I liked having a female for some reason. I am not finding time to focus on this right now but I am sort of excited about it so I wanted to get this note out to you. I KNOW I have a phone number of a pharmacy so I will work on that later. We just need to get the right formulation for our symptoms. Should I fax this DR the sheet that Sharon just posted? Sometimes the pharmacist know alot if you get lucky.
I am sorry I have to LEAVE NOT RUN HAAAA (I wish), Fondly, Pam ps I have already tried that CT cream that was discussed on these posts but I did not notice a difference.

PSS What pleases me is I cannot tolerate Vioxx etc and I bet my feet could benefit from the antiimflammatory sp? agents in some of these.

Re: Here's some info on a compounding pharmacy

Sharon W on 4/29/03 at 14:36 (117354)

Bev,

That thread is no longer displayed on the doctors' board, but if you click for the next set of messages (at the bottom of the page) it will show that thread. I did answer you, but forgot to change the subject and say 'For Bev'. I am not the expert, though; you really do need to get one of the doctors to answer those. Sometimes they just miss seeing a post, but if you post on the doctors' page AND say 'Attention: doctors, please answer' or some such, they usually will...

Sharon
.

Re: Need to find out about Neurontin Cream

Sharon W on 4/29/03 at 14:46 (117355)

Pam,

Yes, anti-inflammatory gels or creams don't have those stomach side effects that you get when you swallow something or try to digest it. (I've never heard of using Vioxx cream, but anything is possible!)

I use Voltaren cream sometimes, an anti-inflammatory medication that if taken as a pill can damage your liver, but those side effects are minimized if you apply it as a cream -- and it DOES help when I can feel that my feet are swollen. Since I've been wearing compression hose, though, I don't need the Voltaren cream very often.

If you call that compounding pharmacy and fax them your doctor's prescription, they can probably either make up Neurontin cream for you (as a special order) or contact your doctor and find out if she wants to have you use one of their standard mixtures. Or, as you say, you also could fax your doctor that list of compounded topical gels and ask if she would prefer you to try one of their standard combinations.

Either way, please let us all know how it went! (If it goes well, I might try to talk MY doctor into it...)

Sharon
.

Re: Need to find out about Neurontin Cream

Pam S. on 4/29/03 at 15:21 (117359)

Sharon:
I located the compounding pharmacy outside of Denver. They will make up anything you want them to. It is called Belmar Pharmacy 800-525-9473.
Should I have my dr. do the Neurontin as the base or the Elavil? They can add anything to it we want. We can customize our own cream. Isn't this exciting. I wonder if it will work. Maybe if you had Elavil cream you would not have to take it by mouth and have that dreadful dry mouth. Just a thought.

For some reason I do not feel this Dr is going to know what to order. Surely she will she is a SURGEON. I just know how in the past I have had to be such a self advocate and ask for what I want.

So we know I want a good anti-inflammatory and a good cream for nerve pain. She said they can put Flexerile(muscle relaxer in there) Would that help PF? I will put a call in the this Dr. It will probably take DAYS to get this done.

PS I asked her if she thought I had PN and she replied people in good health usually do not have that. She did seem to want to go into it but you know you only have so much time and I had ALOT of questions. She also said I was on the RIGHT medication for PN anyway. (No mention as to WHY a person would have these symptoms.) I hope you are having a decent day . You too, Bev.

Re: Need to find out about Neurontin Cream

Sharon W on 4/29/03 at 15:31 (117360)

Pam,

It's up to you and your doctor -- but if I could try any combination of drugs in a topical gel or cream, I think first I would want to try the one mentioned on that site I posted, the NEURO-GEL, substituting Neurontin for the Tegretol. It sounds like a great anti-pain combo.

For Neuropathic Pain

Ketoprofen 10% / Gabapentin (Neurontin) 2%/ Lidocaine 10%

Sharon
.

Re: Need to find out about Neurontin Cream

Sharon W on 4/29/03 at 15:50 (117362)

Pam,

I also really like this one:

Compounds for Neuropathic Pain

Gaba-Clon Gel

Neurontin 6% / Clonidine 0.02%

Apply topically 3 to 4 times a day.

I read a study about rubbing on Clonidine to reduce nerve pain, and they concluded it is very effective for neuropathic pain.

Sharon
.

Re: Need to find out about Neurontin Cream

Sharon W on 4/29/03 at 16:09 (117365)

I found that old post of mine about the topical clonidine gel; it has the link for the research study I had come across in my research (and excerpts follow):

Sharon

-------------------

http://www.prnewswire.com/cgi-bin/stories.pl?ACCT=104&STORY=/www/story/03-07-2000/0001158905&EDATE=

BUFFALO GROVE, Ill., March 7 /PRNewswire/ -- Curatek Pharmaceuticals today
announced that it has begun Phase III human clinical trials with topical
clonidine gel, an innovative treatment for peripheral neuropathic pain,
including widespread and frequently debilitating conditions where current
treatments are often ineffective.
'Countless numbers of patients today suffer from intractable neuropathic pain that not only causes severe discomfort, but in many cases even prevents them from performing basic tasks such as walking or using their hands,' said Dr. Robert Borgman, president of Curatek. 'Based on the results of clinical studies to date, we believe this new approach to therapy offers the potential to become an important solution for a currently unmet clinical need.'
The new treatment is an innovative topical gel formulation of clonidine
that has been designed to provide concentrated, site-specific therapy over the complete painful area without blocking motor or sensory nerve function. In initial clinical trials, it was associated with minimal side effects and was found effective where other treatments had failed.

While clonidine has been widely prescribed in oral form or as a
transdermal patch for the treatment of hypertension, it has also been shown to act as a potent local analgesic. Because its effect is
concentration-dependent, however, the compound does not provide analgesia at the site of pain when administered orally.
Moreover, when delivered via transdemal patch, clonidine produces
analgesia in only a narrow band with poor pain relief in areas not covered by the patch. In addition, the systemic concentrations of clonidine produced by the transdermal patch may result in systemic side effects, including dry mouth, drowsiness, fatigue, headache, lethargy and sedation, insomnia, dizziness, impotence, dry throat, constipation, nausea and change in taste.
'The new topical clonidine gel formulation is easily spread to permit the analgesic properties to reach all of the affected painful nerves, while
resulting in minimal blood levels to avoid systemic side effects,' Dr. Borgman said. 'Although its precise mechanism of action is unknown, it is believed that site-specific concentrations of clonidine may decrease the local release of norepinephrine, an agent that stimulates sensitized nerve fibers to cause painful sensations.'

Re: Need to find out about Neurontin Cream

Pam S. on 4/29/03 at 16:13 (117366)

Sharon:
I called my dr. and left a message. I called the pharmacy and they highly recommend the Ketoprofen. They have not done any gels with Neurontin and they were concerned about the cost. I am not sure if my insurance will cover compounding gels but I can find out later. They are going to try a combination of Ketoprofen/flexerile/Neurontin. This will not be a cure he cautioned me but as I said earlier any amt of relief would be nice. So I just called and told the nurse to call this man and he will take care of it.

Just gets exciting to try something new. I know not to expect a miracle.
Thanks for answering so promptly. I will keep everyone posted. Hope it smells ok HAAAAAAA

Re: a little more info-i am out of sequence above

Pam S. on 4/29/03 at 16:27 (117371)

FYI - I called them back about the Clonidine. He said he would feel more comfortable with the formulation of Neurontin/flexerile/Keta. I guess that is where we will start. Was it ok that I put their phone number on this post. They are a small business and could not handle a ton of calls. But there are probably not alot of us reading this... or are there? T hanks Pam

Re: Need to find out about Neurontin Cream

Bev on 4/29/03 at 17:06 (117377)

Pam and Sharon,
Thankyou girls for all the info. I am tooo tired to read it tonight so I printed it out and I will take it with me to the doctors appointment next week. Ever notice how pain makes one extra tired? Bad day today :(