Compounded Prescription Pain Medications: Topical Creams & LDN

Compounded Prescription Pain Medications: Topical Creams & LDN 1024 536 Community Clinical Pharmacy

Customized Medications for Pain Management

Pain management is a common challenge in many healthcare settings. From pediatrics to geriatric medicine, and even veterinary medicine, addressing pain with medications is important and must be done in the safest, most appropriate manner. Pain can exist in many places, with differing severity.

Compounded pain medications have grown in popularity due to the fact that pain can be targeted more uniquely based on each patient’s symptoms, sensitivities, body mass, and other factors that may contribute to better results.

Pain Points in Managing Pain

The ongoing Opioid Epidemic in the United States is prompting a revolution in addressing pain with alternative medication, as almost 50,000 Americans died from opioid-related overdoses in 2019 alone, according to the US Department of Health and Human Services (HHS). The addictive nature of prescription pain pills on the market has caused concern for the future of addressing pain conditions.

Even over-the-counter pain medications such as ibuprofen and naproxen have been linked to increased risk of blood clots, stroke, and ulcers. Also, it’s well-known that long-term use of acetaminophen is associated with liver toxicity.

What alternatives for pain management are available from a compounding pharmacy?

Topical (Transdermal) Medicated Creams for Pain

There are many possible benefits of utilizing topical pain creams, including (but not limited to):

Ability to deliver a higher concentration of the main pain relieving active ingredient in the medication to target the pain directly.

It avoids metabolism through other systems, which may lead to undesirable side effects.

  • The first pass effect is a phenomenon in which a drug gets metabolized at a specific location in the body that results in a reduced concentration of the active drug upon reaching its site of action or the systemic circulation. Source: Clin Pharmacokinet

Potential benefits of topical administration using a permeation-enhancing base may include convenience and ease of administration, improved patient compliance, and allowing for less frequent dosing.

“There is a need and a place for the delivery of drugs through the skin due to the side-effect profile of many oral medications, a tendency for abuse of and addiction to opioid medications, administration challenges, prescriber challenges, and lack of efficacy of traditional therapies.”

Source: Professional Compounding Centers of America (PCCA

Community Clinical Pharmacy is a specialty compounding pharmacy in Mesa, Arizona serving surrounding areas in the East Valley such as Chandler, Tempe, and Gilbert. Shipping available.

Many prescribers are shifting to compounded topical pain creams for certain patient cases. For example: doctors, nurse practitioners, physician assistants in many fields, such as:

  • pain clinics & centers
  • oncology
  • surgical procedures
  • dental
  • hospice
  • orthopedic
  • athletics 
  • animal (vet)
  • more

Experts at Community Clinical Pharmacy work closely with patients and their medical providers to develop the most advanced topical pain creams, using only the best active ingredients and top-of-the-line cream bases.

A base that may work wonders when applied to the arm might not always be the ideal choice for a cream that is supposed to be applied vaginally. We have to take into consideration the application site and make sure that the base we use will be gentle, sturdy, and elegant enough for wherever it’s going.

Learn about the importance of utilizing the right base in your medicated creams.

Low Dose Naltrexone (LDN) for Pain

Naltrexone is an opiate receptor antagonist, which means that it blocks the body’s opioid/narcotic receptors — the same receptors endorphins use.

Naltrexone thus causes the body to produce more endorphins, which in turn boosts the body’s immune function and may produce pain relief. While the typical 50-mg dose of naltrexone blocks the opioid receptors for an extended period of time, low dose naltrexone only blocks the receptors for a few hours, still causing the desired effect of increased endorphins, but dissipating quickly enough for the body to reap the benefits.

Where can I get LDN?
Because naltrexone is only commercially available as a 50-mg tablet, prescriptions for low dose naltrexone must be taken to a compounding pharmacy and specially prepared.

What are the side effects of LDN?
One of the reasons LDN is so exciting is its seeming lack of major side effects. The most common reported side effect is vivid dreams (reported in 37% of patients), though those dreams do not necessarily cause sleep disruption and decrease over time. In rare cases, headaches are also reported as a possible side effect; tapering up to the desired dose may alleviate this.

Know Your Options When It Comes to Pain

Medication is not one-size-fits-all. Commercially available pain medications like addictive opioids and other mass produced drugs are not your only choices. Ask your doctor about compounded alternatives like topical (transdermal) pain creams and low dose naltrexone (LDN). The right option depends on your specific situation.

Are you a prescriber interested in alternatives for your patients’ chronic and acute pain? Connect with our expert pharmacists to learn more about compounded pain medications.

When in doubt, contact one of our knowledgeable pharmacists at Community Clinical Pharmacy. We are here to offer you solutions and assist you in making informed decisions about your health. Contact us with comments, questions, or pharmacy related topics you’d like to know more about. And, as always, stay healthy!


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