Topical treatment of neuropathic pain

Topical analgesic creams for treatment of neuropathic pain and tingling, may have many advantages over systemic treatment with analgesics.

flickr-marco-verch-43558626792_da63452e95-INP topical treament neuropathic painIn our Institute for Neuropathic Pain (INP) in the Netherlands, 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 hundreds of patients with neuropathic pain. Without any bothersome side effect. Our Institute is constantly working to developed new creams.

The creams we developed

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%
  2. Gabapentine cream 10%
  3. Baclofen cream 1%, 2 % and 5%
  4. Ketamine cream 10%
  5. Isosorbide dinitrate cream 0,4%
  6. Lidocaine cream 3%
  7. Phenytoin cream 5% and 10%, which seems to have the fastest action of onset, and the longest duration.

Since 2016 we also have developed a 10% phenytoin cream, quite effective in small fibre neuropathic pain. For most creams, 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. 

March 2012, Prof. dr. J.M. Keppel Hesselink, Drs. D.J. Kopsky, arts
‘Topical treatment of neuropathic pain’

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Literature list topical analgesic creams INP

  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]

Referentielijst

[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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