You are not alone, many people
suffer needlessly with chronic pain, such as arthritis, fibromyalgia, migraine
headaches, or nerve and muscle pain. Uncontrolled or unrelieved chronic pain
interferes with all aspects of a person’s life, from your ability to concentrate
on a project, while at work, exercising or playing sports, or interfering with
your interpersonal relationships with family and friends. You can’t forget the
pain. The management of pain often presents a major challenge, not only to the
patient, but also the prescriber and the pharmacist. The good news is that
chronic pain can be managed.
The Solution to Chronic Pain
Compounding often affords the best
solution for the effective management of chronic pain. Working closely with you
and your Prescriber, the Pharmacist can develop a compounded medication,
formulated to personally take into account the location and type of pain and
your tolerance for pain, providing you with the best possible strength and
dosage form for maximum pain relief.
Examples Of Chronic Pain Solutions
Compounding pharmacies formulate
solutions that are especially suited to meet the diverse needs of chronic pain
associated with the following:
Migraines Headaches– By formulating pain medication to be administered
through nasal sprays, transdermal pain gels, flavored troches or lozenges, that
provide fast relief, while bypassing the gastrointestinal tract, with optimal
results without stomach irritation.
Arthritis– By formulating pain medications that eliminate the problems of
stomach irritation and other unwanted side effects by combining oral medications
into topical gels, creams, or sprays that can be directly applied to the area of
pain
Nerve and Muscle Pain– By formulating topical anti-inflammatory medications
that are incorporated into a variety of transdermal gels, including pluronic
lecithin organogels (PLO), that allow for the absorption of the drug through the
skin, avoiding gastric side effects.
Fibromyalgia– By formulating the sometimes multiple medications needed to
treat the syndrome, into a single topical gel, ready to be applied directly to
an affected area, or they can be combined into a single capsule, resulting in
better compliance.
Sports Related Injuries– By formulating specialized topical
anti-inflammatory creams and gels that can include anesthetic agents and muscle
relaxants, at the same time avoiding the systemic side effects of oral
medications
Non-Steroidal Anti-inflammatory Drugs (NSAIDs)
The most commonly
prescribed medications for pain are Non-Steroidal Anti-inflammatory Drugs or
(NSAIDs). They are used by prescriber to relieve pain in the majority of
patients. These drugs have side effects, such as stomach upset, gastritis, and
ulcers, with long term oral use. However, Compounding pharmacists have developed
a therapeutic alternative to oral NSAIDs, a variety of NSAID transdermal gels.
These gels require a prescription specifically written for a patient by a
licensed Prescriber. Each product is individually formulated for that patient.
Facts about NSAID transdermal creams:
There is less concern about upset stomach and gastritis with NSAID gels,
since less then 3% of the drug reaches systemic levels in the body, reducing the
potential for any side effects.
The amount of gels needed to treat pain and inflammation is small, usually
about 1/4 teaspoon, or enough to cover the affected area. Application is
generally three time daily to achieve sufficient relief of pain and reduce
inflammation.
Most NSAIDs are available in a transdermal gel. The most commonly prescribed
NSAID creams are Ketoprofen, Naproxen, Ibuprofen, Piroxicam, Indomethacin, and
Diclofenac.
Other drugs can be added to the NSAID gel to solve secondary problems. For
example:
Muscle relaxants for muscle strain
Neuroleptics for nerve pain
Other analgesics for increased pain relief
Local aesthetic agents
NSAID transdermal creams cost on an average less than $1.00 per day.
NSAIDs may be covered by your insurance company. In general, Worker’s
Compensation Insurance will pay the entire cost of the creams.
NSAID transdermal gels are not commercially available from drug
manufacturers because the drugs are what is termed off patent, and there is no
motivation for drug manufacturers to invest millions of dollars to develop a
product without patent and profit protection.
Sports Medicine
Have you ever suffered from a
sports injury like tennis elbow, sprained wrist or ankle, swimmer’s ear, fungal
infections, sore back, swelling , or leg cramps? Have you ever wondered by the
Pros seem to recover faster from the aches and pains than you do? The answer is
that their trainers and physicians are advocates of compounding. Compounding has
solutions for all your sports related injuries. Athletes of every type, whether
professional, amateur, or just an exercise junky, who suffer from acute or
chronic injures that may result from repetitive sports, can benefit from
compounding.
The compounding pharmacist in association with your trainer and prescriber
will formulate a medication designed for your body type and level of activity.
Products that are available commercially are limited in dosage strengths and
forms. This individualized compounded formula with the appropriate dosage
strengths, potency and method of delivery may be just what you need to put you
back into the game.
Compounding Areas for Sports Injuries:
Blisters– Flexible collodion preparations
Fever Blisters– Lip balms with or without sunblock
Fibromyalgia, Fibrositis, or Myofascial Pain syndrome
is defined by the American College of Rheumatology as a chronic pain syndrome in
combination with hyperalgesia. Most health care professionals consider this
syndrome to be a minor rheumatism. This clinical syndrome affects millions of
Americans, mostly middle-aged women usually beginning between the ages of 20 and
30. It comes and goes in cycles and is characterized by generalized
musculoskeletal pain, stiffness, chronic aching, sleep disturbance and fatigue.
Certain tender points are important in it’s diagnosis. These are described as
specific anatomical sites with reproducible tenderness upon touch. The syndrome
is aggravated by such factors as emotional stress, fatigue, unaccustomed
exertion and damp or cold weather. There is no clearly defined cause, some feel
very strongly that it may be caused by an inflammatory reaction. There is also
some evidence that the syndrome is hereditary, passed on from generation to
generation.
Medications, physical therapy, massage and other forms of treatment are used
to provide relief, these are not generally adequate in the long run. One logical
class of drugs, nonsteroidal anti-inflammatory drugs, seems to show more promise
in providing relief, and are being employed in the treatment of fibromyalgia.
Ketoprofen, one of the most studied nonsteroidal anti-inflammatory drugs, has
been shown to be effective in the treatment of fibromyalgia, when administered
topically. This application provides several advantages, it delivers the drug
directly to the pain site, it produces a high local drug concentration, and
without high systemic concentration of the drug. The use of a transdermal
nonsteroidal anti-inflammatory drug, such as ketoprofen, as part of a logical
drug therapy regimen, could lead to reduced inflammation that may ease
stiffness, aching, and fatigue, thereby greatly improving the fibromyalgia
patient’s overall quality of life.
Lifestyle changes that may help the patient with their symptoms:
Stress reduction - Develop a plan to deal with daily stress
Regular Mild Exercise
Adequate Sleep
Education
Medications
Other techniques - Some people obtain relief from massages, hot baths and
relaxation techniques
ICP - Providing quality solutions with maximum benefits for a healthier you.