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Active Ingredients
Important Disclaimer
These statements have not been evaluated by the Food and Drug Administration (FDA). Compounded products are not FDA-approved and are not intended to diagnose, treat, cure, or prevent any disease. Individual results may vary. The information provided is for educational purposes only and should not be considered medical advice. Always consult with your healthcare provider before starting any new treatment.
Clinical Information
Evidence-based details for healthcare providers
A valid prescription from a DEA-registered prescriber is required.
Limited to 5 refills within 6 months of the original prescription date.
Subject to state and federal controlled substance regulations.
Use as directed by your healthcare provider. Apply a thin layer to the affected skin 3 to 4 times daily. Gently massage for several minutes until absorbed. Wash hands after use unless treating them. If you miss a dose, apply it when you remember unless it is almost time for your next application. Do not apply two doses at once.
Gabapentin calms over-active nerve signals that cause shooting pain. Ketoprofen blocks substances called prostaglandins that create swelling and soreness. Amitriptyline raises certain nerve messengers that reduce pain signals in the skin. Lidocaine briefly stops sodium channels in nerves, creating a numbing effect within 15–30 minutes that can last 2–3 hours. Acyclovir stops the shingles virus from making new copies in skin cells, helping the rash heal. Most people feel less burning within a few days, while full pain relief may take 1–2 weeks of regular use. The antiviral benefit is strongest when used early in an outbreak.
Do not use if you are allergic to gabapentin, ketoprofen, amitriptyline, lidocaine, acyclovir, other NSAIDs, tricyclic antidepressants, local anesthetics, or any cream ingredients (such as the base). Do not apply to open wounds, broken skin, or mucous membranes. Avoid if you have a history of severe asthma triggered by NSAIDs, active skin infection needing oral treatment, or methemoglobinemia. Not for use in children under 12 unless specifically directed by a pediatric specialist. Pregnant or breastfeeding individuals should consult their healthcare provider before use because safety data are limited.
Because the cream works mainly on the skin, most interactions are unlikely, but small amounts can enter the bloodstream. Using other topical NSAIDs or oral NSAIDs (like ibuprofen, naproxen) may raise risk of skin irritation or systemic side effects such as stomach upset. Taking strong depression medicines (such as MAOIs) with amitriptyline may heighten drowsiness. Large use of other products containing lidocaine (patches, gels) can increase numbness or heart rhythm effects. Tell your provider about prescription drugs, over-the-counter medicines, herbal supplements (especially St. John’s wort or kava), and alcohol use. Avoid covering the treated area with tight dressings or heating pads, which can boost absorption.
Very common (more than 1 in 10 people): mild redness, temporary burning or tingling at the application site; usually improves within 30 minutes. Common (1–10 in 100 people): itching, dry skin, slight numbness that lasts longer than expected, mild drowsiness. Uncommon (1–10 in 1,000 people): skin rash away from treated area, swelling, headache, stomach upset. Rare but serious: severe allergic reaction with hives or breathing trouble, bluish skin or lips (sign of methemoglobinemia), unusual bleeding or bruising. Most local reactions get better when the cream is stopped. Seek medical help right away for severe or persistent side effects.
Store tightly closed at room temperature 68–77°F (20–25°C). Keep away from heat, high humidity, and direct sunlight. Do not freeze. Keep out of reach of children and pets. Do not use after the labeled expiration date. Dispose of leftover or expired cream through a pharmacy take-back program or mix with coffee grounds in a sealed bag before throwing it in the household trash.
Frequently Asked Questions
How quickly will this cream help my shingles pain?
Many people feel a mild numbing effect within 30 minutes because of lidocaine. Deeper nerve pain relief often builds over several days of regular use, with best results after 1–2 weeks.
Can I use this cream along with my oral shingles medicine?
Yes, the cream is often used together with oral antivirals or pain pills. Tell your healthcare provider everything you are taking so they can watch for overlapping side effects.
Is it safe to put a bandage over the area after applying the cream?
Leave the skin open to air unless your provider tells you to cover it. Tight dressings, heating pads, or plastic wrap can make too much medicine absorb, which may increase side effects.
What should I do if the cream stings or burns?
A brief, mild sting is common and usually fades quickly. If burning lasts longer than 30 minutes, becomes severe, or the skin looks worse, wash the area with mild soap and water and call your healthcare provider.
Can I drive after using this cream?
The cream itself does not affect driving, but a small amount of amitriptyline can sometimes cause drowsiness. If you feel sleepy or light-headed, wait until you feel alert before driving.
How should I store the large 240 g size once opened?
Keep the tube tightly closed when not in use and store it in a cool, dry place away from bathrooms and kitchens. Do not transfer it to another container; use it directly from the original tube.
Related Products
Gabapentin | Amitriptyline | Lidocaine Cream
Gabapentin, amitriptyline, and lidocaine transdermal cream is a compounded topical medication used for certain types of nerve-related pain on the skin. It is applied to a specific painful area to help reduce burning, tingling, and sensitivity. Because this is a compounded medication, it is made for an individual patient based on a prescriber’s order and is not FDA-approved as a combined product.
Diltiazem Ointment
Diltiazem topical ointment is a compounded prescription medicine used to help relieve pain and promote healing of anal fissures (small tears near the anus). It may also help reduce anal muscle spasm that can worsen pain during and after bowel movements. This product is made by a compounding pharmacy based on a prescriber’s instructions and is not FDA-approved as a finished, commercially manufactured drug product.
Ketamine Rapid Dissolve Tablets
Compounded rapid-dissolve tablets that contain ketamine hydrochloride. The tablets melt under the tongue for quick absorption. Your healthcare provider may prescribe them to manage certain conditions when other treatments have not worked. Use only under close medical supervision because ketamine is a controlled substance with important safety rules.
Hydrocortisone | Lidocaine | Nifedipine Rectal Rocket
This compounded suppository (often called a "rectal rocket") combines hydrocortisone 3%, lidocaine 2%, and nifedipine 0.3% to help ease pain, swelling, and itching caused by hemorrhoids or anal fissures. The special shape lets part of the suppository stay outside the anus while the rest sits inside, giving medicine to both internal and external areas at the same time. Your healthcare provider may choose this product when creams or over-the-counter treatments are not enough.