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Reflex Sympathetic Dystrophy (RSD) (CRPS) Message Board

Reflex Sympathetic Dystrophy (RSD) (CRPS) Board Index

Has anyone used a compounded transdermal gel (Ketoprofen, Ketamine, Lidocaine, Amitripyline) for their pain? How well do the transdermal gels work to reduce pain? Are there any side effects? I'm not sure which medicine works best for bone/nerve pain, and my doctor is of no help and offers no advice.

Thanks for any information.
My family Doctor put me on Amitriptyline, it really helps with some of the pain.

I take that and I wear a lidoderm patch... helps me sleep at night. I affaid to take alot of the other meds.
My pain doc ordered a cream for me that contains Amitriptyline, Bupivacaine, Gabapentin, Ketamine, Ketoprofen and Lidocaine

I am very happy with how it works. It seems to take about 45 minutes to an hour to work.

I do not have the "sensitvity" type pain.... so I do not know if it helps with that. What I find it helps me with is pain that feels like a muscle that has been WAY overused. Like how your arm muscles would feel the next morning after unloading two truckfuls of cement blocks by yourself the day before.... when you have not done any exercise in a year. That kind of pain. Also the sharp twinges and the dull throbbing ache.

I had been using 3 lidoderm patches on my shoulder and upper arm. This cream works better, and is much easier to apply.

Hope that helps....
I ocassionally use a compounded gel of Amitriptaline, Neorontin, and Lidocaine for the burning sensation on the skin of my arm/hand. It takes a few minutes to work, but does help to lessen the burning skin sensation. It doesn't do anything for my "deep" bone/muscle pain. The only problem I have with it is that it is mixed in a vaseline-type base. This means that I have to keep my arm away from clothing, furniture, etc until it dries (about an hour) or else it stains everything. That's the hard part - trying to hold my arm away from everything for that long. I've tried wrapping an old towel around my arm after applying it, but it is less effective that way b/c the gel gets absorbed by the towel instead of my skin. I asked my PMD and the pharmacy that makes it if they can mix it in a lotion/cream base (something that absorbs better and faster than petroleum gel), but they said they can't do that.
Mine has the addition of the ketamine, which I would really recommend to you. Perhaps the additional ingredients that mine has that yours does not is what helps me with the muscle pain and deeper ache.

Mine also comes in something called a lipoderm base - the first place I got it at it came really creamy, sort of the consistency of cake icing, but not sticky or oily - it absorbs right in. No trouble with clothing.

It was very expensive there, and my insurance only wanted to cover it if I sent to their 90 mail in. When they made it the first time, they called me because it came out like water - and they wondered if that is what it should be - they ended up ordering in a new base, and re-made it - and now it is like a thinner hand lotion. Still not oily at all, but just a touch sticky till it really gets dry.

You can search online for Bird's Hill Pharmacy and RSD ... my doc called them for suggestions for a cream for me, since he was not sure of the amounts of which drug to use. That's where we ordered the cream first. They have a lot of experience with creams like this. My insurance would only cover it if we sent in to their own 90 day mail order compounder though. So I had to pay for the ones from Bird's Hill myself.
Daylilyfan -

Thanks for the info - I will ask my PMD about contacting a different pharmacy that will use the lipoderm base. That would make a huge difference for me if the base could be a lotion instead of an oily gel.

Thanks Again!

- Lefty
the pharmacist at the 90 day mail in my insurance uses is great working with me on this. He said there are any number of "bases" they can use. He said that most compounders get used to using a certain one and so they stick with it. He said since they are a large place that does larger quantities (90 days at a time) they have multiple bases. If your insurance has a 90 day, you might try calling that compounding pharmacy directly and talking to the pharmacist. Explain what you would want and they will probably try to accomodate. Or put a note directly on the prescription to call you about it. With the skin sensitivity, texture of the cream can make a difference with RSD.
I just found out today my employer is changing insurance carriers. That probably means I'll have to change compounding pharmacies... :-(
Good Luck!

edited for spelling
Daylily -

Ugh! Don't you hate it when they change insurance companies on you?!!! Drives me crazy. The employers are just trying to save a buck and don't seem to give a #[email protected]* about the employee's health. :nono:
What really drives me nuts is all the TV commercials for health insurance carriers - why do they even bother advertising their plans when the vast majority of people don't have any choice what insurance they get? We get what our employers give us (or should I say "[U]sell[/U] us"), and that's that.
Thank God I'll be on Medicare come September.
I hope they give you a decent insurance plan.
I was put on a lotion of Ketamine, Amytryptiline and another ingredient which I forget. Worked like a charm and kept the burning pain away for 4 hours. Trouble is I went on vacation and wanting to be as active as possible, I used it every four hours and became extremely allergic to it. Got terrible rash which mad the burning all the worse. We tried to reduce the dosage but rash came back. So anyone using these type of things should be aware that they cannot use on a regular basis - probably no more than twice a day for fear of getting allergic. It was so good that I cried like a baby when it was taken away from me. Laura.
Thanks for that warning. I have been alternating the cream and lidoderm patches. I had just sent for a 90 day supply of the patches (at 3 a day) when I found out about the cream, so I have quite a few on hand.

Maybe I should try to continue with that practice. The patches work ok under my shirts during the time I am at work, but the cream works much better at night, when the patches would tend to roll up.

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