From the FDA Drug Label
The FDA drug label does not answer the question.
From the Research
The optimal ketoprofen/gabapentin dose for a topical compound cream for leg pain is not supported by strong evidence, but a common starting formulation could be 5% ketoprofen and 6% gabapentin in a transdermal base, applied to the affected area 3-4 times daily, based on the available literature and clinical practice guidelines 1, 2, 3, 4, 5.
Key Considerations
- The use of compounded topical pain creams, including those with ketoprofen and gabapentin, has increased, but their effectiveness has not been well evaluated in high-quality studies 2.
- Gabapentin has been shown to be effective in treating neuropathic pain, with doses of 1200 mg or more daily providing significant pain relief in conditions like postherpetic neuralgia and painful diabetic neuropathy 1.
- Ketoprofen, a non-steroidal anti-inflammatory drug, has demonstrated efficacy in treating various forms of pain, including chronic pain in osteoarthritis, rheumatoid arthritis, and postoperative pain 3.
- The combination of ketoprofen and gabapentin in a topical cream may provide both anti-inflammatory and neuropathic pain relief, but individual responses may vary, and dosing adjustments may be necessary based on clinical response.
Application and Precautions
- Patients should apply a thin layer of the cream to clean, dry skin and avoid covering with occlusive dressings unless directed.
- Treatment should be reassessed after 2-4 weeks to determine efficacy.
- Those with known allergies to NSAIDs, open wounds, or severe renal impairment should use caution or avoid this combination.
Additional Agents
- Some compounding pharmacists may add additional agents like lidocaine (2-5%) for enhanced pain relief or menthol (1-3%) for cooling sensation, but the evidence for these additions is limited 5.
- The efficacy and clinical value of commonly used ingredients in pain management compounds, including lidocaine, tetracaine, ketoprofen, ketamine, and gabapentin, require further study to identify their exact benefits and side effects 5.