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03/02/2012 02:51 PM

Pain relief awesomeness


Been having horrible all-over joint, muscle, nerve pain. Can't even describe it.

New pain management doc prescribed a topical cream made by a compounding pharmacy. It is amazing. Really helps, right away. No waiting. Much fewer side effects than systemic meds. Doesn't suppress immune system like systemic meds either.

Pain cream ingredients


• Ketamine –analgesic, anaesthetic for nerve pain

• Baclofen – muscle relaxant – agonist for GABA receptors

• Cyclobenzaprine – muscle relaxant, also related to tricyclics

• Diclofenac (NSAID)

• Gabapentin – for use for neuropathic and migraine pain. GABA analogue

• Tetracaine – local anesthetic

article that he co-wrote is here: 4637.2010.00809.x/abstract

Topical NSAID Therapy for Musculoskeletal Pain

Simon Haroutiunian MSc1,2,*, Daniel A Drennan MD3, Arthur G. Lipman PharmD1,3

Article first published online: 4 MAR 2010

DOI: 10.1111/j.1526-4637.2010.00809.x

Wiley Periodicals, Inc.


Pain Medicine

Volume 11, Issue 4, pages 535–549, April 2010

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Author Information

Publication History

Haroutiunian, S., Drennan, D. A. and Lipman, A. G. (2010), Topical NSAID Therapy for Musculoskeletal Pain. Pain Medicine, 11: 535–549. doi: 10.1111/j.1526-4637.2010.00809.x

Author Information

1Department of Pharmacotherapy, College of Pharmacy, University of Utah

2Department of Pharmaceutics, School of Pharmacy, The Hebrew University of Jerusalem, Israel

3Department of Anesthesiology, School of Medicine; and Pain Management Center, University Health Care, Salt Lake City, Utah, USA

*Simon Haroutiunian, MSc, Department of Pharmaceutics, School of Pharmacy, The Hebrew University of Jerusalem, Jerusalem, 91120, Israel. Tel: +972-26757667; Fax: +972-26757246; E-mail:

Publication History

Issue published online: 31 MAR 2010

Article first published online: 4 MAR 2010


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View Full Article (HTML) Get PDF (214K)Keywords:NSAID;Nonsteroidal;Topical;Pharmacokinetics; Pain;Musculoskeletal



Systematic reviews previously reported in the literature document that topical nonsteroidal anti-inflammatory drugs (NSAIDs) are effective in relieving pain in acute and chronic painful musculoskeletal disorders including osteoarthritis, tendonitis, and muscle strains.

Because several topical NSAIDs are available, with important differences among the formulations, there is a need to address and summarize the evidence of their effectiveness and safety.


We searched Medline and Cochrane CENTRAL databases for clinical trials and systematic reviews of topical NSAIDs in musculoskeletal pain, using the following keywords:

“NSAID,”“nonsteroidal,”“anti- inflammatory,”“topical,”“cream,”“gel,” “solution,”“lotion,”“patch,” plaster,”“musculoskeletal,”“tendonitis,”“s train,”“sprain,”“trauma,” and word roots “pain” and “arthritis.”


Topical NSAIDs may vary significantly in their absorption kinetics and pharmacodynamic effects, based on NSAID molecule and the formulation chosen.

Some topical NSAID formulations have been shown to be more effective than placebo in multiple studies, or to have comparable efficacy and a better safety profile than oral NSAIDs for single joint osteoarthritis and acute muscle injuries.

In acute and chronic low back pain, widespread musculoskeletal pain, and in peripheral neuropathic pain syndromes, the current evidence does not support the use of topical NSAIDs.

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Daniel A Drennan

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bettyg, leader added the article above.

Post edited by: Bettyg, at: 04/19/2012 02:03 AM


03/02/2012 03:17 PM
doglickPosts: 682

How does it work? Do you take a bath in the stuff or what?

03/02/2012 05:18 PM
Posts: 139

I wouldn't mind trying some of that creme. Please keep us updated on how effective it is for long term use. Thanks for sharing.

Do you know the name of the creme? I'd like to ask my LLMD about having it compounded for me.

Thanks so much for sharing.

03/02/2012 09:28 PM
Posts: 3076
Group Leader

Hmmm does using the Gabapentin (Neurontin) in cream form take away the weight gain side effect? I loved my neurontin but it caused serious weight gain Sad

Let us know how the cream contines to work... might have to talk to my dr about it.

My doc prescribed me a nausea cream - Promeethazine compounded into a cream - that works wonders.

03/04/2012 08:51 AM

How it works: you just rub it on where it hurts. For nerve pain, you rub it in near the nearest large nerve. It doesn't smell bad, and it isn't greasy.

So far, it works great Smile Lasts for about 6 hours, but I'm finding that it seems to interrupt the pain cycle, so I don't have to use it every day, except on my knees.

It doesn't have a name - the compounding pharmacy just combines the list of ingredients I posted. Apparently your doc can customize the formulation to your needs. (for instance leaving out the stuff for nerve pain if you don't need it)

I don't know about how it works relative to neurontin. I haven't been on neurontin before. So I apologize that I can't answer the question regarding weight gain.

I think the best thing to do if you think it might work for you is to print out the list of ingredients and the article that I linked, and take them to your LLMD, neurologist, or pain management doctor.

Another idea is to call your nearest compounding pharmacy and see if they already make this or a similar cream, and find out what info you need to give your doctor to get them to prescribe it.

Different insurances may or may not cover compounded Rxs. It cost me a $50 copay for two bottles, 180 gms each.

emphasized, bettyg, leader

Post edited by: Bettyg, at: 04/19/2012 02:08 AM

04/18/2012 10:15 AM

Just wanted to bump this up for folks who may be having pain issues.

Update on long term use - I actually use this less than I used to, because it really seems to interrupt the pain cycle. So I have a lower degree of pain for a while after I use it.

Not as effective on headaches as I had hoped, but really helps with joint and nerve pain.

Has anyone else tried similar? What were your experiences?

04/18/2012 10:22 AM
Posts: 2353
Group Leader

I have also used that compounded mix...mine was a gel....

when I had facial's pretty amazing

04/18/2012 10:24 AM
Posts: 126

gosh, i wish I had some right now, very painful day today! hope it continues to help u

04/18/2012 07:32 PM
Posts: 29
New Member

I've used something very similar every night for almost a year and its worked really well. Mine's also compounded and has:

ketamine, gabapentin, clonidine, ketoprofen, lidocaine, amitriptyline, and doxepin

My doc said it was something that a dr teitelbaum (not sure if that's spelled right Smile) if someone's doctor wants to look it up. She also said that medicines often work better in combination than alone, which seems to make sense.

I've tried every other type of pain control you could imagine and other than narcotics, this is one of the few things that has worked. I much prefer using topical things rather than pills because the side effects, drug interactions, and risks are much less.

So the person that asked about weight gain, while I don't know about that specifically, I'd be willing to bet that it would be gone or much less if used topically.

I haven't noticed it making the pain better long term, but for me having something I can fall back on when the pain is bad to keep it under control is such a relief and makes everything way more tolerable.

04/18/2012 08:45 PM
Posts: 826

Bring it on! Smile

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