Instituut voor Neuropathische Pijn

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Analgesic creams from the institute of neuropathic pain

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Topical treatment of neuropathic pain

Topical analgesic creams to treat pain and tingling may have many advantages over systemic treatment with analgesics: 

Evidence based analgesia 
Low propensity for (dose-limiting) side effects 
Easy to combine with other analgesics
Low risk for drug-drug interactions
Easy to dose and to adapt dose (increasing amounts of cream or increasing frequency of administration)
Helping to increase awareness for painfull areas (body-sceme, Koerper schema)  

8 analgesic creams and one paste in INP base

In the institute for neuropathic pain we developed various topical analgesic creams for the treatment of neuropathic pains. The development team working on these creams consisted of two pain physicians and one specialized compounding pharmacists. Creams were developed based in literature search and were optimized using superior formulations, leading to creams with optimal physical chemical properties and clear analgesia. 

The principle of these creams have been described in the literature below and have been prescribed to many hunderds of patients, without any bothersome side effect. The institute is constantly working to developed new creams.

The creams we developed are all specifically formulized based on the experience with drug development in our institute in a special Institute for Neuropathic Pain base (INP base) and those creams consist of:

1. Amitriptyline cream 5 % and 10% in INP base

2. Gabapentine cream 10% in INP base

3. Baclofen cream 1%, 2 % and 5% in INP base

3. Ketamine cream 10% in INP base

5. Isosorbide dinitrate  cream 0,4% and lidocaine cream 3% in INP base

6. Toothpaste baclofen 5% for dental neuropathic pains  in INP base

Most patients report a decrease of pain within 15-30 minutes after application. 

All these creams have a special formulation enabling optimal efficacy with minimal side effects. 


We will sent a prescription form to the physician.  

 

Literature list topical analgesic creams institute for neuropathic pain, the Netherlands

  1. Kopsky DJ, Amelink GJ, Keppel Hesselink JM. Intractable neuropathic pain in spinal intramedullary cavernoma treated successfully with a novel combination cream. Pain Medicine 2012, in press.
  2. Keppel Hesselink JM, Kopsky DJ. Intractable neuropathic pain due to ulnar nerve entrapment treated with cannabis and ketamine 10%. J Clin Anesth. 2012 Feb; 24(1):78-9. [1]
  3. Kopsky DJ, Keppel Hesselink JM. High Doses of Topical Amitriptyline in Neuropathic Pain: Two Cases and Literature Review. Pain Pract. 2012 Feb;12(2):148-53. [2]
  4. Kopsky DJ, Keppel Hesselink JM. Multimodal Stepped Care Approach Involving Topical Analgesics for Severe Intractable Neuropathic Pain in CRPS Type 1: A Case Report. Case Report Med. 2011;2011:319750. [3]
  5. Liebregts R, Kopsky DJ, Keppel Hesselink JM. Topical Amitriptyline in Post-Traumatic Neuropathic Pain. J Pain Symptom Management Vol. 41, No. 4, April 2011: e6-e8 [4]
  6. Keppel Hesselink JM, Kopsky DJ. Letter to the editor (Ketamine 10% in CRPS). Curr Ther Res Clin Exp 2010 71(6): 416-417.
  7. Kopsky DJ, Keppel Hesselink JM.A new combination cream for the treatment of severe neuropathic pain. J Pain Symptom Manage. 2010 Feb;39(2):e9-e10. [5] 

March 2012, JMKH/DJK

Referentie

[1] Hesselink JM, Kopsky DJ. | Intractable neuropathic pain due to ulnar nerve entrapment treated with cannabis and ketamine 10%. | J Clin Anesth. | 2012 Feb;24(1):78-9. Epub 2012 Jan 5.

[2] Kopsky DJ, Keppel Hesselink JM. | High Doses of Topical Amitriptyline in Neuropathic Pain: Two Cases and Literature Review. | Pain Pract. | 2011 Jun 16. doi: 10.1111/j.1533-2500.2011.00477.x. [Epub ahead of print]

[3] Kopsky DJ, Keppel Hesselink JM. | Multimodal Stepped Care Approach Involving Topical Analgesics for Severe Intractable Neuropathic Pain in CRPS Type 1: A Case Report. | Case Report Med. | 2011;2011:319750. Epub 2011 Oct 17.

[4] Liebregts R, Kopsky DJ, Hesselink JM. | Topical amitriptyline in post-traumatic neuropathic pain. | J Pain Symptom Manage. | 2011 Apr;41(4):e6-7.

[5] Kopsky DJ, Keppel Hesselink JM. | A new combination cream for the treatment of severe neuropathic pain. | J Pain Symptom Manage. | 2010 Feb;39(2):e9-e10.

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