Compounded Prescription Pain Medications: Topical Creams & LDN

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?

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

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.

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.

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