title: Compounded Topical Analgesics for Chronic Pain.
abstract: Analgesic medications compounded for topical use are gaining popularity for the management of chronic pain. The advantages of topical pain medications include reduction of systemic adverse effects, improved patient acceptance, few drug interactions, ease of dose determination, avoidance of first-pass metabolism, and direct access to the target site. Compounded topical medications typically use a mixture of 3 or more single medications to achieve multiple complementary effects at lower doses of each individual medication. Herein, we review the mechanisms, adverse effects, and evidence for some of the most commonly used medications in topical compounds for pain management. Because more topical medications are used for chronic pain, dermatologists can expect an increase in irritant and allergic contact dermatitis related to these medications.
authors.affiliation: From the *Medical College of Georgia, and †Division of Dermatology, Department of Medicine, Medical College of Georgia, Augusta University, Augusta, GA.
authors.forename: Abigail E
authors.initials: AE
authors.lastname: Cline
authors.forename: Jake E
authors.initials: JE
authors.lastname: Turrentine
mesh_terms: D000279:Administration, Cutaneous; D000588:Amines / Q000008:administration & dosage; D000639:Amitriptyline / Q000008:administration & dosage / Q000031:analogs & derivatives; D000700:Analgesics / Q000008:administration & dosage*; D000779:Anesthetics, Local / Q000008:administration & dosage; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage; D001418:Baclofen / Q000008:administration & dosage; D002211:Capsaicin / Q000008:administration & dosage; D059350:Chronic Pain / Q000188:drug therapy*; D003000:Clonidine / Q000008:administration & dosage; D003509:Cyclohexanecarboxylic Acids / Q000008:administration & dosage; D004338:Drug Combinations; D004339:Drug Compounding; D000077206:Gabapentin; D006801:Humans; D007649:Ketamine / Q000008:administration & dosage; D008012:Lidocaine / Q000008:administration & dosage; D009125:Muscle Relaxants, Central / Q000008:administration & dosage; D005680:gamma-Aminobutyric Acid / Q000008:administration & dosage
chemical_list: D000588:Amines; D000700:Analgesics; D000779:Anesthetics, Local; D000894:Anti-Inflammatory Agents, Non-Steroidal; D003509:Cyclohexanecarboxylic Acids; D004338:Drug Combinations; D009125:Muscle Relaxants, Central; D000639:Amitriptyline; D005680:gamma-Aminobutyric Acid; D007649:Ketamine; C004704:cyclobenzaprine; D000077206:Gabapentin; D008012:Lidocaine; D001418:Baclofen; D003000:Clonidine; D002211:Capsaicin