Pain is one of the main reasons people seek help from their pharmacist and doctor. Headaches, muscle aches, trauma, arthritis, sprains, strains, neuropathies to name a few. A perhaps surprising number of these can be treated using topically applied medication in the form of ointments, creams, transdermal gels, and sprays. One advantage of topically applied treatments is that the medication is not taken by mouth and therefore bypasses the stomach and is not metabolized immediately by the liver in what is called the “first pass effect”. Another advantage is that the total dose of medication is usually applied directly to the site of the pain and can be administered in much less concentrated form. It is usually slowly absorbed into the systemic circulation and therefore hits the liver in small concentrations to be metabolized. This can decrease liver toxicity. One disadvantage to topical treatment is that the medication may not penetrate the tissues enough to get to the site of the pain. Photosensitivity can also be a problem although this can also be an issue with oral medication.
Topicals work best when the pain or the enervation of the pain is relatively near the surface of the body in an area of relatively non-fatty tissue. The medication used are usually muscle relaxants, anti-inflammatories, anesthetics, and nerve pain blockers.
We have found these creams and gels to be effective in many areas of treatment and to be very safe. If you are having side effects from oral pain medication and are concerned about oral toxicity, or are just not satisfied with the relief you are getting from your current medications, contact one of our pharmacists to see if there might be a compounded topical medication to try for your pain. All of our compounds require a prescription from your physician but we can give you the information you need or we can directly contact your physician for you. We have found most physicians are very open to trying this mode of treatment when they understand how it works and its safety profile.
You can call and talk with one of our pharmacists or you can send an email from our website with your question.