Topical compounded pain medications

We need a safe way to scale compounding so that customized treatments like those discussed here can be a realistic and affordable alternative to standard opioid pain management…

Many patients have chronic pain in their muscles, joints, or skin. For these patients, topical pain medication can be an effective alternative to oral medications.

Oral Pain Medications

Oral medications must first pass through all organs including the stomach, liver, brain, heart, & kidneys. In the end, only a small amount of the medication makes it to the painful region. On the way there, the oral medications can cause side effects in all of the end organs, leading to drowsiness, addiction, heart disease, stomach ulcer, liver toxicity, and kidney failure.

Topical Pain Medications

On the other hand, topical medications go straight to the target and can minimize side effects.


Painful skin, muscle, & bones can be directly targeted.

Instead of exposing the entire body to the medication, topical formulations can avoid systemic side effects to the stomach, liver, brain, heart, and kidneys. Very potent mixtures of medications, like ketamine with muscle relaxants and anti-inflammatories, can therefore be used safely.

Rubbing the medication is therapeutic in itself, and helps with central sensitization (heightened sensitivity across the sense) via desensitization .


Some patients with sensitive skin develop a rash or skin irritation. More often than not the reaction can be avoided by compounding with a different base.

Compounded medications are made by hand by pharmacists in certain pharmacies but most US insurances do not cover these medications up-front. The prices vary widely. Work with your Pain Physician to find a pharmacy that works best for you.

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