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Suffering pain? Is a compounded pain cream right for you?

A few weeks back I went to a very interesting seminar in Vancouver for compounding pharmacies. The topic was pain and compounding pain relief creams.

It was a special event for Pharmasave stores that are partners with PCCA (the leader in quality compounding pharmacy supplies, products and education).

 

A whole day of talking about pain control may not seem like an interesting topic to you, but considering about 30% or more of the patients I see every day in the pharmacy are there because of pain, it’s a very interesting topic for me.

A lot of the available pain relief pills have serious risks.

• The anti-inflammatories like Ibuprofen, Naproxen and Diclofenac are associated with stomach ulcers, kidney damage and increased risk of heart attacks.
• The opioid medications like codeine, morphine, oxycodone and fentanyl have risks of dependence and addiction , and as you’ve probably heard on the news risk of death due to stopping breathing (called respiratory depression).
• Oral medications for nerve pain can be associated with daytime grogginess, drowsiness, and impaired thinking.

So you can see there is a lot of room for improvement when it comes to treating pain, and oral medications are not without risks.

The majority of the talk revolved around innovative pain creams. Pain creams you can’t get at just any regular pharmacy.

Oral Pills vs Topical Pain Creams

You see applying a cream to your skin has different effects than taking a pill by mouth. When you swallow a pill it goes into the digestive tract, it’s absorbed out of there and first goes into the liver. The liver is our main metabolizing organ: meaning the liver attempts to change drugs into a form that makes it easier to get out of the body.

Then from the liver the drug (and now its metabolites) enter into the general blood stream and is carried to other parts of the body.

So if you have a painful knee ligament and you take a pain pill it doesn’t just seek out the knee and head straight there after you swallow it. No, it has to go from digestive tract, to the liver, then to rest of your body including the knee. It’s the long way there. And potentially a dangerous way there because on the journey that drug could affect your liver, your kidneys, your brain, etc…

But when you apply a pain-relieving cream directly to the painful knee ligament it gets to the source of the pain. We call this a localized effect.

Applying a pain relief cream isn’t without potential risks as well – I’m not trying to say that – but when you apply a medication in a cream directly to the painful site you usually need lower amounts of the drug.

A car analogy that “drives” this point home is a pain cream is an express route directly to the pain, and not the long, meandering route there. So you need less gas…I mean less drug.

Trying to Target Several Pain Receptors with one Cream

An interesting point was brought up during the seminar: there can be many receptors involved with transmitting the pain signal.

The pain signal that is sensed in the affected area, relayed to the spinal cord and then up to the brain where your brain processes that signal and says, “ouch that’s painful.”

What’s neat is that a doctor can prescribe a pain-relieving cream that has different medicines in it with each ingredient targeting a different type of pain receptor or source of pain.

For instance:

You could have an anti-inflammatory like ketoprofen or diclofenac in it that targets the COX enzymes

You could have a muscle relaxant in it like Magnesium, Methocarbamol, Baclofen or Cyclobenzaprine to help relax those tight, knotted muscles

You could have a local anesthetic, like lidocaine or prilocaine, to help numb the area

You could have medications intended for nerve pain, like Gabapentin or Amitriptyline, in much lower doses than you`d need to take in a pill

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I have intended this information for educational purposes only, and please speak to your doctor about these possibilities.

Start thinking “Outside the bottle.”

Please speak to one of our compounding pharmacist to discuss options that may work for you.

Give us a call at 250-494-7088