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Diseases & Conditions

Pain Management and Discomfort Control

The physician and the pharmacist dedicate their efforts not only to curing illness, but also to minimizing the pain and discomfort of the chronically ill. The compounding pharmacist works closely with the physician to achieve this with respect to the following pain and discomforts suffered as a result of chronic sickness or terminal illness:

  • Specially compounded medications to control nausea and vomiting which may be delivered transdermally, or in unique dosage formats including suppositories, patches, imitation sweets, and the like.
  • Promethazine is commonly used in a gel dosage format.
  • Suppositories using a combination of Lorazepam, diphenhydramine, haloperidol, and metoclopramide are have been used in suppositories controlling vomiting in 70% of experimental subjects.

Treatments for Pain

Easing acute (post trauma, post operative) pain is an essential form of promoting patient well being. The management of chronic pain is also of great importance. In cases of acute pain in which the patient’s disease has been stabilized, absence of effective pain management can impede productive labor, good family relations, and the enjoyment of free time and recreation. Chronic pain may be produced by a wide variety of causes and may become an ongoing problem due to factors that exacerbate the basic problem such as allergic reaction, fatigue, psychogenic factors, and the like. Chronic pain management, therefore, is a complex matter and may require the collective effort of pharmacist, physician, psychological counselors, and others so that a multi-disciplinary approach and individualized treatment methods for the needs of individual patients is required.

The most effective treatment for particular cases may combine medications that relieve pain with those that reduce anxiety and the physical effects of the same. Such medications would include anti-depressants, anti-arrhythmics, as well as anesthetics, anti-viral medication, NMDA antagonists, including dextromethorpan and ketamine. Such medications combined in appropriate dosages can reduce nocioceptor response and thus reduce the need for the use of opioids. Appropriate combinations of medications using different mechanisms that produce the sensation of pain can reduce the concentration of component medications.

The compounding pharmacist often employs gels, ointments, and creams that penetrate the skin. This is done to avoid the negative effects sometimes associated with oral medication. Transdermal medications bypass the gastrointestinal system to deliver the necessary medication to the pain inflicted area. Because the human digestive process is bypassed in this way, greater concentrations of the effective medication can be used for optimum effect.

Medications to Manage Pain

Over-the-Counter Medications:

  • Vicodin
  • Norco
  • Lortab
  • Naprosyn
  • Celebrex
  • Tylenol
  • Duragesic
  • Oxycontin
  • MS Contin
  • Dilaudid
  • Neurontin
  • Lyrica
  • Soma

Compounded Medications:
We can make topical gels, creams, lotions, oral suspensions, capsules or lollipops of the following:

  • Ketamine
  • Diclofenac
  • Ibuprofen
  • Ketoprofen
  • Hydrocodone
  • Gabapentin
  • Lidocaine
  • Bupivacaine
  • Morphine
  • Oxycodone
  • Fentanyl
  • Cyclobenzaprine
  • Baclofen
  • Ketorolac
  • Magnesium chloride
  • Loperamide
  • Piroxicam
  • "It is rare to find health professionals who are so willing to educate the patient on what they need to know."

    Clair C. | West Hollywood, CA