Goodbye to Compounded Analgesic Creams

Localized pain affects many patients who seek alternative remedies without systemic side effects and compounded topical products are often used. Researchers at a military treatment facility evaluated 399 patients with local pain in a randomized, double-blind, placebo-vehicle controlled, intention-to-treat, 3 parallel armed study. Subjects were prescribed one of 3 multi-drug compounded creams or a placebo/vehicle cream and applied to the painful region three times a day. For neuropathic pain, the combination cream contained ketamine, gabapentin, clonidine and lidocaine and for nociceptive pain, a combination of ketoprofen, baclofen, cyclobenzaprine and lidocaine. Subjects with mixed pain received a cream with ketamine, gabapentin, diclofenac, baclofen, cyclobenzaprine and lidocaine. The compounded creams offered no benefit over placebo in pain relief.

Links to: Pallimed (2/2019) and Ann Intern Med (2/2019)