Neuropathy

Main Compounded Neuropathy Treatments:

Topical Multi-Ingredient Combinations: A compounding pharmacy can combine multiple ingredients into one gel to treat the different types of pain. Gabapentin is one of the most commonly used medications for treating neuropathic pain topically. 

Common Topical Formulations: Pain creams compounded for neuropathic pain (ketamine, gabapentin, clonidine, and lidocaine) Lidocaine (topical application route) - Mayo Clinic

Popular Triple Combination: The formulation combining Gabapentin 10%, Ketoprofen 20%, and Lidocaine HCl 5% in a topical cream format serves primarily to provide relief from neuropathic pain, inflammation, and local anesthetic effects 

Key Ingredients Available:

Nerve Pain Medications (Topical):

• Gabapentin - Most commonly used for neuropathic pain
• Pregabalin - Alternative gabapentinoid
• Ketamine - NMDA receptor antagonist
• Clonidine - Alpha-2 agonist

Tricyclic Antidepressants: Our custom-compounded medications can include a variety of active ingredients, such as ketoprofen, amitriptyline, lidocaine, and gabapentin, which have been shown to be effective in managing neuropathic pain 

Local Anesthetics:

• Lidocaine - Various strengths
• Prilocaine - Often combined with lidocaine

Anti-inflammatories:

• Ketoprofen - Topical NSAID

Oral Compounded Options:

Medications like Gabapentinoids (pregabalin and gabapentin), Tricyclic antidepressants (amitriptyline, nortriptyline), Serotonin & Noradrenaline Reuptake inhibitors (duloxetine) Carbamazepine, Sodium Valproate, and Low-dose Naltrexone are used to treat neuropathic pain. 

Evidence-Based Combinations:

For people with diabetic neuropathy, research found combinations of pregabalin, amitriptyline, and duloxetine provided relief from pain. 

Important Notes:

• Most effective neuropathy compounds require a prescription
• Topical formulations reduce systemic side effects
• Combination treatment was well tolerated and led to improved pain relief in patients with suboptimal pain control with a monotherapy. Benzocaine - StatPearls - NCBI Bookshelf
• Custom strengths and combinations not available commercially

The advantage of compounding is creating personalized multi-ingredient formulations that target different pain mechanisms simultaneously.