Topical and transdermal pain formulations are very popular among health care providers and patients, but unfortunately, not all doctors are familiar with how to best prescribe customized medications. Topical and transdermal preparations are often preferred to oral medications due to decreased side effects and the avoidance of initial breakdown of drug by the liver (first pass metabolism). Dosage forms include creams, ointments, and gels; medication sticks; solutions, and sprays.
“Topical” and “transdermal” are not interchangeable terms. Transdermal medications are applied topically but not all topical medications are absorbed through the skin and enter the bloodstream to have effects elsewhere in the body. The extent of absorption is dependent on the base and compounding technique. Transdermal preparations can create a greater systemic effect than topical preparations.
Compounded topical creams can play an outstanding role in meeting the needs of patients with diabetic neuropathy-associated pain. A 2015 study showed good to excellent results in relief of pain associated with diabetic neuropathy and relief of other chronic neuropathic pain with the use of compounded creams. Use of the creams resulted in a reduction in the need for oral analgesics and referrals made by physicians to pain specialists.
We will work together with you and your health care provider to customize medications that meet your unique needs. We typically suggest starting with lower doses and one to two drug combinations and adjusting the dose and choice of medications based on each patient’s response.
“Use of Topical Pain Medications in the Treatment of Various Pain Syndromes” by Sahar Z. Swidan, PharmD and Hagar A. Mohamed, MS. Topics in Pain Management. February, 2016. 31(7): 1-10.
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