success with compounded topicals?

[oreosandsake]

seems like a plethora of companies out there with giant check lists of things they can put into a topical form

wondering what success people have been having and with what ingredients?

i.e. DPN - ketamine, gabapentin, morphine, lidocaine 2% QID


thanks

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[101N]

Expensive placebo.

 

[nvrsumr]

Expensive placebo.

1+ I mean the lidocaine jelly based works... haha

 

[clubdeac]

Honestly haven't seen anything miraculous with these. A lot of expensive hype. They will be gone in a year

 

[lobelsteve]

I have seen patients come in with tears in their eyes. One lady danced at her kids wedding as the CRPS was better controlled with this than anything. It's magic in Georgia.

We use Brown's Compounding in Colorado (Don6) as well as InforMD (Darce9).


Ketamine, Cyclobenzaprine, tetracaine, gabapentin, ketoprofen, lidocaine

 

[101N]

Expensive folie a deux.

 

[Aether2000]

We also use Brown's and have actually had a surprising number of patients that ask for this and continue using it. The #5, #6, and #7 are the preferred formulations we have found effective, possibly due to the high DMSO content in these compounds driving the medication deep. Of course, the DMSO itself could be causing some reduction in pain. In any case, Brown's has a max out of pocket cost of $35, a very reasonable price.
I honestly did not expect to see the number of successes I have had with this cream, both for joint and neuropathic pain. It appears the formulation may be different than creams past from the mega-expensive companies....

 

[jj337]

Rarely use for CRPS/PHN when nothing else works. Makes some people feel better. I use a Ketamine/Ketoprofen/Gabapentin compound. Probably wrote 4-5 prescriptions all of last year. Definately a last ditch effort in my practice. Overly expensive.

 

[lobelsteve]

Expensive folie a deux.

Not as good as a cheap menage a trois

 

[bedrock]

not as good as a cheap menage a trois

lol!

 

[sweetalkr]

i have had great results with joint problems. if it has ketamine in it, it is a plus. make sure you know if the issue is more myofascial, neuropathic, or inflammatory. choose the correct ingredients corresponding with the disease, and make sure ketamine is in it.

I have had great success with the right patients

 

[dismorfik]

Add menthol 0.05% to any compound for a wonderful soothing effect! Plus it smells wonderful!

 

[normalforce]

I have seen patients come in with tears in their eyes. One lady danced at her kids wedding as the CRPS was better controlled with this than anything. It's magic in Georgia.

We use Brown's Compounding in Colorado (Don6) as well as InforMD (Darce9).


Ketamine, Cyclobenzaprine, tetracaine, gabapentin, ketoprofen, lidocaine

I too have seen a strong Clinical benefit. I have written it for over 200 patients. About 70% report good relief. Best for hand and knee OA, cervical disease, myofascial pain syndromes, DPN....I use focused pain relief based out of victor, ny.

 

[Ligament]

I have seen patients come in with tears in their eyes. One lady danced at her kids wedding as the CRPS was better controlled with this than anything. It's magic in Georgia.

We use Brown's Compounding in Colorado (Don6) as well as InforMD (Darce9).


Ketamine, Cyclobenzaprine, tetracaine, gabapentin, ketoprofen, lidocaine

Steve I called Brown's today to set up an account. Which formulas are your faves? Algos likes #s 5, 6, 7.

 

[lobelsteve]

I only use 6.

 

[drf]

Where are you seeing the numbered compounding creams on the website?

 

[normalforce]

Where are you seeing the numbered compounding creams on the website?

Seriously, give focused pain relief a try. Unbelievable customer service from that company. My patients have been super happy.

 

[Aether2000]

No one is happy if they get a bill for hundreds or thousands of dollars for a topical not covered by insurance. Regardless of how good any topical compounder is, we have a fiduciary duty to our patients to not sink them financially by ordering absurdly expensive medications that provide transient relief when there are other compounders that have very reasonable prices for the same product. Bottom line: ask the compounder what their pricing scheme is and what the maximum out of pocket cost will be for the patient.

 

[pastafan]

No one is happy if they get a bill for hundreds or thousands of dollars for a topical not covered by insurance. Regardless of how good any topical compounder is, we have a fiduciary duty to our patients to not sink them financially by ordering absurdly expensive medications that provide transient relief when there are other compounders that have very reasonable prices for the same product. Bottom line: ask the compounder what their pricing scheme is and what the maximum out of pocket cost will be for the patient.

+1
I have been using alpha direct. They charge self pay patients $50 for 120 gm. and they claim 65-70% insured pay $25 co pay for 360 gm.

 

[Ducttape]

No one is happy if they get a bill for hundreds or thousands of dollars for a topical not covered by insurance. Regardless of how good any topical compounder is, we have a fiduciary duty to our patients to not sink them financially by ordering absurdly expensive medications that provide transient relief when there are other compounders that have very reasonable prices for the same product. Bottom line: ask the compounder what their pricing scheme is and what the maximum out of pocket cost will be for the patient.

the main company i use will get auth through insurance first, then contact the patient with the cost of the medication to the patient based on what is covered. There are special Medicare/Medicaid products with cost.

i tell each and every patient that it will most likely not be covered, and they have the right to refuse when contacted. they are told that this medication cream helps some people, and if they want to try, it might benefit. they are also told they might ask for a much cheaper sample to try (like a $5 sample).

 

[drf]

Wrote 2 scrips for Brown #6 on Friday. Excited to see how it goes. They promised 25-35 or so copay for insurance and 15-60 bucks for self pay through patient assistance program.

Pharmacist was very helpful on the phone as well.

 

[ihaveaquestion]

Wrote 2 scrips for Brown #6 on Friday. Excited to see how it goes. They promised 25-35 or so copay for insurance and 15-60 bucks for self pay through patient assistance program.

Pharmacist was very helpful on the phone as well.

DRF,

What is in #6? I can't find this on the website. I have used compounded topicals a few times but have never been that impressed. I have never included ketamine though so maybe that'll help.

 

[lobelsteve]

DRF,

What is in #6? I can't find this on the website. I have used compounded topicals a few times but have never been that impressed. I have never included ketamine though so maybe that'll help.

Call browns abd aak for Don #6. If any confusion mention my name. Don was my ANS rep. I get nothing from the rx other than happy patients.

 

[drf]

Fr

DRF,

What is in #6? I can't find this on the website. I have used compounded topicals a few times but have never been that impressed. I have never included ketamine though so maybe that'll help.

Me too. This will be my first compounded topical in a couple of years. I'll see how it goes.

Ketamine, baclofen, cyclobenzaprine, diclofenac, tetracaine, gabapentin.

10, 2, 2, 3, 2, 6 % respectively I think.

 

[lobelsteve]

Fr


Me too. This will be my first compounded topical in a couple of years. I'll see how it goes.

Ketamine, baclofen, cyclobenzaprine, diclofenac, tetracaine, gabapentin.

10, 2, 2, 3, 2, 6 % respectively I think.

You've got it.

Browns fax is 855-534-1047.

I check unit dose on Rx form.

Other name is KBCDGT10.

 

[ihaveaquestion]

Thanks everyone! Will give it a shot.

 

[Ligament]

Steve and Algos, I've written about 10 Rxs for Browns #6 since you guys endorsed it. I'll keep you updated. Thanks for the recommendation. I had previously been using a local compounding pharmacy with similar formulas but nowhere near the outstanding results you guys are seeing.