All,

I just read on the TEA site about Dr. Mark Davis, Mayo Clinic compounding a topical amitriptyline and ketamine cream; which lead me to a Google search; which lead me to searching here.

Wow! It looks like all sorts of combinations are being tried with some common themes to fight pain, burning/vascular response, etc.

So I am very interested in trying this. My doctor has never recommended this so I am betting she just needs a starting point and recommendation. She seems willing to try things.

Anyway, I am fortunate that both Gralise 1200mg/day (extended Gabapentin) and 5% Lidoderm patches. Would compounding these together be a good place to start? A better question is how much?

Thanks

my post are 98% pain free.dated 03-17-2013 and 03-28-2013

Making a compounded cream is a personal thing. Choice of the many ingredients depend on what you need.

Here is one thread that discusses them:
http://neurotalk.psychcentral.com/sh...ht=compounding

If your doctor is not experienced with this, your options are:

1) have your doctor call a colleague who might know.

2) call a compounding pharmacy near you and pose the question.
Hopefully they will give you ingredients to choose from and percentages to go with the recipe for your doctor to choose from.

You don't need typically all that are possible.

I do think you should investigate the Morton's Epsom lotion yourself from WalMart... it is really really good. Do that first to see if it is enough for you. (It is in the first aid section of the store and only $5.98)

Try the compounds. I have PN or RSD., Use the patches, and the compound with Ketamine in it. It does reduce pain. Taking off the lidoderm patches smarts a bit. I also have tried bio freeze and this helps a bit too. I wish you all the best. ginnie

Thanks for all the quick responses. Unfortunately, Epsom Salts do not work for me. So I would not hold out much hope for cream.

The good news is my doctor just got back to me and said he has heard of people compounding Gabapentin and Lidocaine together for topical use. His thought is that the Lidocaine is really what's working in the combination. He wants my pharmacist's contact info at my local compounding pharmacy so they can confer and he wants to research this a bit.

I am excited my doctor is willing to work with me on this. Sounds like we off to the races.

The absorption of magnesium dissolved and floating around in water (from a soak), is much much lower than the magnesium concentrated in a cream or lotion. The compounding creams especially are called transdermal gels, and that is because they carry most efficiently of all topical forms, whatever is mixed in them, into the deeper tissues of the skin where most of the blood vessels and capillaries are.

The magnesium cream by Kirkman, has a measuring spoon to deliver 100mg/dose in fact via the cream.

Not everyone gets the same benefit from the epsom soaks.. Alot depends on your skin (males have thicker skin than females), and how long you soak, and how much you dissolved in the bath/tub. But the soaks do work for many, and in varying degrees. I never seemed to get lower blood pressure results from soaks, but I sure do get substantial lowering of my high blood pressure to normal range with the concentrated lotion form of magnesium.

If you do get a transdermal compounded product, I'd ask for magnesium to be in it too... average dose of 100mg/gram (or at whatever dose the pharmacy recommends). Magnesium blocks pain receptors called NMDA receptors, and also opens up little blood vessels to facilitate absorption of the rest of the cream.

Forgot to mention I did try the Magnesium Sulfate Cream. I've tried so many things I forget. I still have some at home. Sadly, it did not help. I will see about adding that to what they compound.

Thanks.

If you still have that cream, you can use it alternately with the compounded one. It may facilitate absorption of the other ingredients in the one that comes from the pharmacy.

... just to mention, getting a stiff body brush and brushing your whole body (in the direction of your heart) to remove dead skin before getting the epsom salt bath, feels great (both invigorating and relaxing), stimulates the lymphatic drainage system, is good for your skin, makes your skin feel soft and helps your skin absorb the epsom salts.

Natalie

Dac...
I have atypical Trigeminal neuralgia. Heavy duty pain. I use a compounded cream with lidocaine, Capsaisin and Gabapentin with fairly good results. However, my insurance no longer wishes to cover it's cost and it is crazy expensive.

Does anyone know if Medicare drug benefits cover compounding creams? I must have this medication and can't work due to all the pain.

Also, looking for any other insurance info. Regarding compounded medication.

Thank you.