Clinical Information
Use as directed by your healthcare provider. Apply a thin layer to the affected area and rub in gently. Wash your hands after use unless you are treating them. If you miss a dose, apply it when you remember unless it is almost time for your next dose. Do not apply extra cream to make up for a missed dose.
Each ingredient targets a different pain pathway. Ketamine blocks NMDA receptors, which reduces nerve pain signals. Ketoprofen stops COX enzymes that create pain-causing chemicals, lowering inflammation. Gabapentin calms over-active calcium channels in nerves, cutting down burning or shooting pain. Clonidine activates alpha-2 receptors that slow pain messages and can lessen redness and swelling. Lidocaine blocks sodium channels, numbing the skin to give quick relief. You may start to feel numbness within 30–60 minutes, with peak relief in about 2–4 hours. Regular use can build steady comfort over several days.
Do not use if you are allergic to ketamine, ketoprofen, gabapentin, clonidine, lidocaine, NSAIDs like aspirin or ibuprofen, or any other ingredient in this cream (may cause severe rash or swelling). Do not apply to open wounds, broken skin, eyes, mouth, or genital areas. Do not use if you are pregnant, trying to become pregnant, or breastfeeding unless your provider decides the benefit outweighs the risk. Not for children under 12 without medical advice. Avoid if you have severe liver disease, severe kidney disease, uncontrolled heart rhythm problems, or very low blood pressure.
Because the cream stays mostly where applied, interactions are less common, but some can still happen. Talk to your provider before using other products that contain lidocaine or NSAIDs (like diclofenac gel) on the same area to avoid overdose. Tell your provider if you take blood thinners (warfarin), blood pressure medicines (especially beta-blockers or other alpha-2 agonists like guanfacine), strong pain medicines (opioids), or sedatives; using them with this cream could increase dizziness or drowsiness. Limit alcohol because it can add to tiredness or slow reflexes. Do not cover the treated area with heating pads or tight bandages, as this can speed drug absorption and raise side effect risk.
Very common (may affect more than 1 in 10 people): mild skin redness, warmth, or tingling where applied; temporary numbness. Common (1–10 in 100 people): dry skin, itching, mild burning, dizziness, or drowsiness that usually passes within an hour. Uncommon (1–10 in 1000 people): swelling at the site, headache, metallic taste, low blood pressure leading to light-headedness. Rare but serious: severe rash, blistering, trouble breathing, fast or irregular heartbeat, or severe dizziness—stop using and seek medical help right away. Most local skin effects improve within minutes to hours after removing the cream.
Store at room temperature (68–77°F, 20–25°C) in the original jar with the lid tightly closed. Keep away from heat, freezing, and direct sunlight. Do not store in the bathroom because moisture can break down the ingredients. Keep out of reach of children and pets. Discard unused or expired cream through a pharmacy take-back program or mix it with coffee grounds in a sealed bag before putting it in the trash. Shelf life is 180 days from the compounding date when stored correctly.
Frequently Asked Questions
Q:How often should I apply the cream?
A:Follow the schedule your provider gave you, usually 2 to 4 times a day. Using more often will not speed relief and may raise side effect risk.
Q:When will I feel pain relief?
A:You may notice numbness within an hour of application. Deeper nerve and muscle pain often improves after several days of regular use.
Q:Can I use a heating pad after applying the cream?
A:No. Heat can cause the drugs to absorb too quickly and increase side effects. Wait at least 6 hours before applying heat to the treated area.
Q:Is it safe to drive after using this cream?
A:Most people can drive safely, but some may feel dizzy or drowsy, especially during the first few uses. If you feel light-headed, do not drive or operate machinery.
Q:What should I do if the cream gets on areas it shouldn't?
A:Rinse the area right away with lukewarm water. If it gets in your eyes, rinse for 15 minutes and call your provider if irritation continues.
Q:Can I use other pain medicines with this cream?
A:Often yes, but you should let your provider know about all medications, including over-the-counter pain relievers, patches, or gels, so they can check for overlaps or interactions.
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