I recently asked my PCP for a compound topical cream containing ketamine, lidocaine, gabapentin, etc. He was completely unfamiliar with these so instead I asked for a 5% Lidocaine ointment since my main problem was being unable to get the lidocaine patches on my neck muscles and occipital area which cause me the most pain.

For those looking for some less expensive relief, it may be worth it. Insurance covered it (was only $14 tho) and it helped calmed my neck muscles down incredibly after a deep cervical block.

I know the compound creams can be expensive so I just wanted to share this. Also, I can renew it about every 8 days so the one tube is plenty.

Cheers,
Dawn

I use a compounded cream, and Lidoderm patches. To save $ I tried the lidocaine ointment. I was trying to come up with an inexpensive alternative. I found it to be really greasy, and did not soak in. My pharmacist tried ordering it from 3 different places to see if he could find one that would work. The compounded cream soaks in so well, that it must have me "spoiled."

I have used the cream for 9 years now. My family doc won't prescribe it, I have had to go to a PM doc or a neurologist to get it. Family doc is uncomfortable prescribing anything with ketamine.

I am glad your finding the ointment helpful.

Do you have any tips you could share with me on getting the ointment to soak in so it is not so greasy?

The compounded products use a special base called a transdermal gel.
Compounding pharmacies make this from scratch, and it is used for the pain products like ketamine etc to penetrate to the deeper tissues. RX only.

The other products you can find do not use that type of base because their approved FDA use is for the skin only. So they are not likely to penetrate deeply.

The only gel type thing I have ever found OTC is the base Biofreeze uses. The amount of menthol in it ..3.5%works very well for PN pain...whereas the new Precise cream by makers of Tylenol, had 9.5% which does not work at all the same way...it is a greasy cream base!

Very interesting, I didnt realize it was a different base but for $14 it really seems to help in the areas of my neck where a lidocaine patch won't stick. I did have a horrible flare up during the holidays, got the script for this and within 2 days, it had calmed down. It may just be coincidence but I'm not sure.

For the heck of it, I just sprayed Biofreeze on top of it on my neck to see what would happen. Feel really good so far.

I definitely agree it is incredibly greasy which is a pain since it gets in my hair but well worth some pain relief and reduction in swelling to me if it works.

The neck area has alot of oils in the skin. The Lidoderm patches are an aqueous (water based) adhesive. The oils in the skin repel the water based layer delivering the drug.

So cleaning the neck area with soap and rinsing well, may help the patches stick there. Maybe even a little alcohol before.

Thanks, I'm sure that's a good part of the problem and no doubt my long hair is another. Also, I'm trying to get something around the occipital area as I have so much pain there. I "briefly" see Dr. Shwartzman while under ketamine tomorrow and may ask if he can prescribe a compound that may work better.

I've tried all sorts of crazy thing with the lidocaine patches tho and usually wind up with the all tangled up in my hair by morning!

I like the new Precise cream.....didn't find it greasy at all

I'm still waiting on a compounded cream, long story about insurance coverage.....

I found the Precise cream okay for aching joints, arthritis type symptoms. But it did nothing for me regarding burning pain. Precise also has high dose of methyl salicylate which is an aspirin type compound. This is probably the ingredient most helpful for arthritic type pain. Biofreeze does not have this ingredient at all.

Those of us with burning PN pain, want relief. Precise does not give that response for me with its very high menthol content.
But the lower % Biofreeze GEL...works instantly and lasts all night.

I think this is because of the base carrying the menthol alters the results.