Pain Management

Compounded Pain Management

Topical Pain Relievers

Dexamethasone/ Diclofenac 2%
Dexamethasone/ Piroxicam 2%
Dexamethasone 2%
Dexamethasone/ Ketoprofen 10%
Ketoprofen 10% or 20%
Phenylbutazone/ Cyclobenzaprine/ Lidocaine 10% / 2% / 5%
Ketamine 50 mg/mL
Ketamine/Ketoprofen 50 mg/mL / 10%
Flo Gel : Cyclobenzaprine/ Lidocaine/ Ketoprofen 2% / 5% / 10%
Naproxen 5%, 10%, or 15%
Guaifenesin Speed Gel 10%
Guaifenesin Speed Gel with Ketoprofen (20%) & Lidocaine (5%)
Guaifenesin Speed Gel with Cyclobenzaprine (2%) & Diclofenac (2%)
Amitriptyline 5%
Amitriptyline 5% / Capsaicin 0.04%
Amitriptyline 5% / Lidocaine 5%
Baclofen 2%
Baclofen 2% / Cyclobenzaprine 2%
Carbamazepine 2%
Carbamazepine 2% / Cyclobenzaprine 2%
Cyclobenzaprine 5%
Gabapentin 2% / Carbamazepine 2%
Gabapentin 2% / Clonidine 0.3%
Shingles Formula
Shingles Formula with Dexamethasone

Analgesic Capsules

Morphine SO4 E.R. with Dextromethorphan: 15, 30, 60, 90, 100, 160, or 200 mg
Oxycodone E.R. with Dextromethorphan: 20, 40, 60, or 80 mg
Hydrocodone E.R. with Dextromethorphan: 5, 7.5, 10, 15, 30, 40 mg
Dextromethorphan E.R.: 30 or 100 mg
Cyclobenzaprine 10 mg/ Guaifenesin 30 mg/ Dextromethorphan 30 mg

Liquid Analgesics

Morphine SO4 60 mg/mL
Oxycodone/ APAP 5 mg/ 325 mg/ 5 mL

Details Below..
Topical Pain Relievers

When applied topically, these everyday agents enable medical practitioners to lower the dose of more potent narcotics. Also, because of the dosage form, one is able to decrease the number of potential, harmful side-effects associated with most pain relieving medications.
Dexamethasone/ Diclofenac 2% : Dexamethasone is a corticosteroid that can be used as an anti-inflammatory and anti-pruritic. Diclofenac is a non-steroidal anti-inflammatory drug (NSAID).

Dexamethasone/ Piroxicam 2% : Dexamethasone is a coritcosteroid that can be used as an anti-inflammatroy and anti-pruritic. Piroxicam, a member of the oxicam family, is able to inhibit edema, erythema, tissue proliferation, fever and pain.

Dexamethasone 2% : Dexamethasone is a corticosteroid that can be used as an anti-inflammatory and anti-pruritic medication.

Dexamethasone/ Ketoprofen 10% : Dexamethasone is a coritcosteroid that can be used as an anti-inflammatory and anti-pruritic. Ketoprofen is an anti-inflammatory agent whose use is best indicated for pain involving torn muscles and like injuries.

Ketoprofen 10% or 20% : Ketoprofen is a non-steroidal anti-inflammatory agent (NSAID) whose use is best indicated for pain involving torn muscles and like injuries.

Phenylbutazone/ Cyclobenzaprine/ Lidocaine 10% / 2% / 5% : Phenylbutazone is a pyrazolone derivative that exibits anti-inflammatory, anti-pyretic, analgesic, and uricosuric properties. It is primarily used for the treatment of all types of arthritis, including gout and osteoarthritis, and is also indicated for the treatment of painful shoulder and superficial thrombophlebitis. Cyclobenzaprine is a muscle relaxant and anti-spastic agent that works without affecting muscle function. Lidocaine is a local anesthetic, which, applied topically, is able to numb the area.

Ketamine 50 mg/mL : Ketamine, typically used for reflex sympathetic dystrophy, is for nerve pain that may not be responsive to other medications. This topical application allows practitioners to reduce the dose of more potent narcotic painkillers.

Ketamine/Ketoprofen 50 mg/mL / 10% : Ketamine has been shown to be very effective in treating nerve pain. Ketoprofen is a non-steroidal anti-inflammatory drug (NSAID) with analgesic and antipyretic properties.> Flo Gel

(Cyclobenzaprine/ Lidocaine/ Ketoprofen 2% / 5% / 10%) : Cyclobenzaprine is a muscle relaxant and anti-spastic agent that works without affecting muscle function. Lidocaine is a local anesthetic that, used topically, is able to numb the area. Ketoprofen is a non-steroidal anti-inflammatory drug (NSAID) with analgesic and anti-pyretic properties.

Naproxen 5%, 10%, or 15% : Naproxen is a non-steroidal anti-inflammatory drug (NSAID) with anti-pyretic and analgesic properties.

Guaifenesin Speed Gel 10% : Guaifenesin has been shown in several veterinary studies to be an effective muscle relaxant. Its mechanism of action is unclear.

Guaifenesin Speed Gel with Ketoprofen (20%) & Lidocaine (5%) : Guaifenesin is a muscle relaxant. Ketoprofen is an non-steroidal anti-inflammatory agent (NSAID). Lidocaine is applied topically to numb the area.

Guaifenesin Speed Gel with Cyclobenzaprine (2%) & Diclofenac (2%) : Both the Guaifenesin and the Cyclobenzaprine in this formulation act as muscle relaxants. Diclofenac is a non-steroidal anti-inflammatory drug (NSAID).

Amitriptyline 5% : Amitriptyline has been shown to reduce nerve pain when used topically. Its mechanism of action is unknown.

Amitriptyline 5% / Capsaicin 0.04% : Amitriptylline is for nerve pain. Capsaicin is effective for relieving neurologic, neuropathic, and arthritic pain.

Amitriptyline 5% / Lidocaine 5% : Amitriptyline is a good treatment for neurological pain. Lidocaine, used topically, is able to numb the area in question.

Baclofen 2% : Baclofen is a very effective muscle relaxant and anti-spastic agent. It possibly works by decreasing excitatory neurotransmitter release.

Baclofen 2% / Cyclobenzaprine 2% : Baclofen is used for muscle relaxation and to decrease muscle spasms. Cyclobenzaprine is also an effective muscle relaxant and anti-spastic that works without affecting muscle function.

Carbamazepine 2% : Carbamazepine is effective for treating trigeminal neuralgia. It decreases polysynaptic responses and blocks post-tetanic potentiation. This topical formulation is good for relieving nerve pain.

Carbamazepine 2% / Cyclobenzaprine 2% : Carbamazepine is an effective treatment for nerve pain. Cyclobenzaprine is an ant-spastic and muscle relaxant that works without affecting muscle functon.

Cyclobenzaprine 5% : Cyclobenzaprine influences both gamma and alpha motor systems and reduces tonic somatic motor activity. It is a muscle relaxant and anti-spasmic that is able effectively do its job without affecting muscle function.

Gabapentin 2% / Carbamazepine 2% : Gabapentin has been shown to be effective in relieving nerve pain. Gabapentin acts by mimicing GABA, an inhibitory neurotransmitter. Carbamazepine is also a good treatment for nerve pain.

Gabapentin 2% / Clonidine 0.3% : Both Gabapentin and Clonidine are effective treatments for nerve pain. Gabapentin acts by mimicing GABA, an inhibitory neurotransmitter. Clonidine stimulates alpha-adrenoreceptors in the brain, resulting in reduced sympathetic outflow from the central nervous system.

Shingles Formula : This product combines the anti-inflammatory effects of Ketoprofen and the pain-relieving properties of Lidocaine with the anti-viral medication Deoxy-D-Glucose. It is a great formulation for both the treatment of shingles and post-herpetic pain.

Shingles Formula with Dexamethasone : Combining Ketoprofen, Lidocaine, and Deoxy-D-Glucose (the ingredients in Shingles Formula) together with the glucocorticoid activity of Dexamethasone, this formulation is excellent for the treatment of shingles, herpes, and related dermatoses.

Analgesic Capsules

Morphine SO4 E.R. with Dextromethorphan: 15, 30, 60, 90, 100, 160, or 200 mg : Morphine is, of course, the primary drug in the area of pain management. As an analgesic preparation it is virtually irreplaceable. Unfortunately, when given chronically, tolerance always ensues. This is why we have incorporated Dextromethorphan into the formulation. Recently, it has been shown that Dextromethorphan can slow the development of morphine tolerance. It does this by binding to and blocking the NMDA receptor. This is the receptor that is needed for morphine tolerance to develop. The E.R. stands for extended release.

Oxycodone E.R. with Dextromethorphan: 20, 40, 60, or 80 mg : Oxycodone, a morphine relative, is also a very good analgesic. It too has been combined with Dextromethorphan in order to slow the development of tolerance. And we have made this product extended release as well.

Hydrocodone E.R. with Dextromethorphan: 5, 7.5, 10, 15, 30, 40 mg : Hydrocodone extended release is another morphine related medication used to decrease pain. Once again, the Dextromethorphan has been added to slow the development of tolerance.

Dextromethorphan E.R.: 30 or 100 mg : Dextromethorphan extended release capsules are available so that the patient can continue his or her regular morphine related products and take this to slow the development of tolerance. The mechanism of action is listed above under Morphine E.R. with Dextromethorphan.

Cyclobenzaprine 10 mg/ Guaifenesin 30 mg/ Dextromethorphan 30 mg : Cyclobenzaprine is a muscle relaxant that works without affecting muscle function. Guaifenesin, in higher doses, also acts as a muscle relaxant. Dextromethorphan is incorporated into the product so that if used with a morphine related pain medication, it will act by slowing the development of tolerance.

Liquid Analgesics
As liquids, these analgesic products are used successfully in treating pain in children and the elderly, who may not be able to swallow capsules or tablets.
Morphine SO4 60 mg/mL : Morphine is a classic drug in the area of pain management. It is primarily used for its analgesic properties. For information on how to slow the development of tolerance to morphine, see Morphine E.R. with Dextromethorphan Capsules, listed above.

Oxycodone/ APAP 5 mg/ 325 mg/ 5 mL : Oxycodone is a semi-synthetic, morphine-related medication used for the management of severe pain. APAP stands for Acetyl-p-aminophenol, in short, Acetaminophen. It is used widely as an analgesic and antipyretic. It is effectively used in treating many types of pain including arthritis and menorrhea.

For more information concerning dosage, potential side effects, mechanism of action, etc., in dealing with these or other compounded products, feel free to e-mail, telephone, or come down and visit us at Noble Pharmacy in Noble, Oklahoma.