Neuropathic pain affects 7-8% of the population and accounts for 20 – 25% of individuals suffering from chronic pain. It can be a personally devastating and costly condition. The burning, aching, or shooting pain is often associated with sensory changes and can be particularly severe and disabling. The pain may also be accompanied by weakness and skin breakdown.

Because neuropathic pain is frequently harder to treat than other types of pain, it often results in a poor quality of life for patients, when in fact novel therapies may be helpful.  Many customary, commercially available drugs used to treat neuropathic pain have limited effectiveness and produce relatively frequent side effects.  Topical therapies, analgesic combinations, and gene-related therapies have shown promise over some existing treatments. Neuropathic pain is often resistant to opioids, so other medication classes, such as tricyclic antidepressants, anticonvulsants, and local anesthetics, are frequently used for treatment. Preparations are often prescribed to contain multiple medications such as ketoprofen, gabapentin, lidocaine, clonidine, and amitriptyline that work in different ways to relieve pain. Each patient is unique; that is why customized compounded medications can help.

Topical analgesics have many advantages over systemically administered (oral or injectable) analgesics, including the ability to provide effective pain relief with reduced systemic drug levels, which is particularly beneficial to the elderly or people with other medical problems. Topical medications have been shown to produce fewer side effects. Coupled with convenient and painless administration, topical therapy results in improved patient acceptance and compliance, and ease of use may reduce overall treatment costs. Because topical medications are applied directly to the target site, the drugs can reach therapeutic levels in the tissues under the area of application, with minimal blood levels and therefore fewer side effects. Lower systemic drug levels may potentially reduce the risk of organ toxicity. In addition, first-pass hepatic metabolism and other variables associated with the gastrointestinal tract are avoided. When oral dosing is not feasible because the patient is nauseated or unconscious, topical therapy is often a viable solution that eliminates the need for injections.

The benefits of topical preparations are highly dependent on the quality of chemicals and the type of base used as a vehicle, as well as compounding technique and equipment. At Peachtree Pharmacy, we only use the finest grade of chemicals and our professional staff has received extensive training in advanced compounding techniques. Ask us for more information.

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Pain Manag. 2017 Nov;7(6):537-558.

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