Taking Pain Medication through the Skin Instead of Orally

As a medical practitioner, I constantly treat patients with common complaints of pain. Every so often, I encounter patients that complain of certain medications causing side effects, especially nausea or vomiting. Recently, I had the pleasure of meeting with several pharmacists and discussing alternative treatment plans for these individuals, who are unable to tolerate the most common pain relievers out there, which are the non-steroidal anti inflammatories such as Ibuprofen due to systemic side effects.

During our conversation I was enlightened to learn more about certain medications that can be administered transdermally or through the skin instead of being taken orally. These medications are called compounded medications, also known as a PLO gel, - which stands for Pluronic Lecithin Organogel. This is the mode of how the medication is made to make it transdermal.

The PLO itself disrupts the outermost layer of the skin without damaging the skin itself. This then allows the medication to be diffused through the outer layer of the skin into the dermis and epidermis of the skin which is deeper into the skin. This is then considered a type of medication that is used to administer medication only through the skin and it will be dispersed into the blood flow in that particular area.

These types of medications can and are used to only penetrate the site of pain without having any systemic side effects that other medications may have when taken orally such as nausea, vomiting or any sedating effects. These medications are absorbed through the skin for almost immediate relief to the site of pain.

There are many types of medications that can be formulated by the pharmacist with the PLO base to create an ointment or cream to be applied to the site of pain. Most physicians will prescribe a combination of medications to be used in making the ointment or cream to obtain optimal effects. These medications can include a non-steroidal inflammatory, muscle relaxant and/or an anesthetic.

Examples of certain types of pain that these medications can be used for include neuropathic pain, bursitis, arthritis, tendonitis, muscle pain or muscle spasms.

In my particular practice of occupational medicine where I handle most work related injuries with overuse of the shoulder, elbow, hands and knees I have seen success with these types of compounded medications. I have had great feedback from patients who are using these ointments and they also report no systemic effect which is of great relief for both the patient and me.

I strongly suggest that anyone concerned about taking certain pain medications orally discuss this with his or her health care provider as to see if there is an alternative such as a compounded transdermal medication. And as always do not use any medication without seeking the expert opinion of their medical provider as these or any medication may not be for everyone and may have an adverse effect.

Resources:

http://en.wikipedia.org/wiki/Stratum_corneum