Podiatry : Diabetic Neuropathy
Neuropathy Foot Cream
The following testimonial appeared in the December 1999 issue of Neuropathy
News, a patient newsletter.
"My local [compounding pharmacist] has created a cream to help alleviate
the pain of foot neuropathy. It reduces the burning and sharp, needle-like
pain. All you need is a very thin coat. The directions call for using it four
times a day, but I find it particularly helpful at night. [The formulation
contains] 2% amitriptyline and 2% baclofen in a transdermal gel."
"Compounding pharmacists have the unique training and ability to create
medications that address the individual needs of patients. One of the most
helpful products they use are transdermal gels that allow for the passage of
medication directly through the tissue into the area of pain. Many of the medications
typically prescribed for neuropathy patients such as amitriptyline, lidocaine,
mexilitene, ketamine and [gabapentin] can cause significant side effects when
taken orally. Transdermal gel minimizes systemic side effects and maximizes
local pain relief. Compounding pharmacists have many resources that offer relief
from neuropathic pain."
In Diabetes Interviews, January 2000, Neil A. Burrell, DPM, CDE, of Beaumont,
Texas, writes "We have a very high success rate using amitriptyline and
baclofen mixed in a gel component. This compound is applied to the feet three
times per day, and offers immediate relief... [For] recalcitrant neuropathic
pain, many times we use a combination of tramadol, gabapentin and amitriptyline."
At our compounding pharmacy, we work together with physicians and patients
to prepare formulations containing the medications and doses that are most
appropriate to meet each patient's specific needs. Let us know how we can be
Diabetes Care, January 2004; 27(1):284-5
Improvement of Temperature and Flow in Feet of Subjects with Diabetes
With Use of a Transdermal Preparation of L-Arginine - A pilot study
Eric T. Fossel, PHD
Strategic Science and Technologies, Wellesley, Massachusetts
PubMed PMID: 14694013 No abstract available.
Topical doxepin could be an alternative and relatively safe treatment in alleviating
neuropathic pain in the diabetic patient, especially when the use of systemic
treatment is contraindicated. In the following case study, the soles of the
patient’s feet were treated with topical doxepin 5% twice daily for four
weeks. The patient responded dramatically with loss of the severe burning sensation
and no side effects reported.
Wounds 15(8):272-276, 2003. © 2003 Health Management Publications,
Burning Feet Due to Diabetic Neuropathy
Amna Al-Muhairi, MD, Tania J. Phillips, MD, FRCPC
The print version of this article was originally certified for CME credit.
For accreditation details, contact the publisher. Tanya J. Phillips, MD,
FRCPC, Boston University School of Medicine, Department of Dermatology, 609
Albany Street, J-106, Boston, MA 02118; Phone: 617/638-5540, Fax: 617/638-5552