Neural Burning Treatment Options

Hello Group,

I just got off the phone with the head pharmacist at Community Drug
Compounding Pharmacy. Her name is Susan Marrenthin. I detailed
some of the latest research on topical treatments for neural pain,
neural burning, sensory burning and discussed rosacea with her in
depth.

Basically, there are three well known prescription-based topicals
that have been shown in clinical studies to relieve neural burning
and pain sensations, each based on a different mechanism.

1. 6% Gabapentin in an emollient cream base for sensitive skin (not
PLO base)
2. 2% Amitryptilline in an emollient cream base for sensitive skin
(not PLO base)
3. 2% Clonidine in an emollient cream base for sensitive skin (not
PLO base)

Community drug makes all three of these creams and places them in 30
1ml syringes (30 grams per month) so the patient can dispense it
directly into the hand via syringe with the exact amount needed
without overdoing it. The syringes also keep the medication fresh
and keep them from oxidizing (most compounding pharmacies just place
the cream into large jars that are open to the air and you scoop out
the cream with your hand). The base is very rosacea friendly
without alcohols or major penetration enhancers.

We spoke in-depth about rosacea neural pain and her specialty is in
the treatment of different forms of neuropathic pain. There are
many ways that she can make this up for rosacea sufferers.

1. Each one individually as detailed above.
2. An elegant mixture of all three (6% Gabapentin, 2%
Amitryptilline and 2% clonidine in one emollient cream)
3. A combination of all three with a patented form of alpha lipoic
acid compounded into the cream.


The cost for a one month supply would run $50 to $80 (for 30
grams). This is a very reasonable price and may be covered by some
insurance companies. You should apply the cream one to two times
daily and if they are going to have a positive effect one should
start noticing improvement within 45 to 60 days.

If you have neural rosacea pain, then these may be worth a try. You
can get a script made out from your doctor and send it in to
community drug.com. But the only problem is that the Pennsylvania
regulations state that they cannot fill scripts outside the USA.
So, I spoke to her about this problem. She knows an online medical
physician who dispenses scripts to all over the world. The
physician works at medicalwellnesscenter.com. A patient outside the
US would be charged a one time consultation fee and the script would
be sent directly to community drug and then shipped out to you. I
have no idea how much shipping is though or the online consultation
for 6 refills..

This is not set up yet. Community drug is going to get in touch
with the physician this week and set up the above mentioned script
options so the physician can basically just OK the script and send
it to community drug after a brief medical history online.

I will contact the group once this system is set up. You can start
out conservatively by trying only one of the compounds or try the
three compound cream with or without alpha lipoic acid. The
interesting thing about the three pronged combination is that they
each have a different mechanism of action and therefore has a much
better potential for relieving neural burning because peripheral
sensory burning involves several pathways.

Let me stress something. I am in no way affiliated with the online
drugstore or online physician. I don't make a single penny off of
anything, nor do I get recognition or anything out of this. I just
wanted to make these treatments available to everyone in a user
friendly fashion (e.g. everything online) without any boundaries
outside the US. I also wanted to remove the inevitable frustrating
debates with physicians who don't know much about rosacea and are
not willing to prescribe anything other than metrogel.

You will need to monitor your heart rate and blood pressure as
clonidine may lower the blood pressure slightly in a small (less
than 5% chance) group.

I will keep everyone updated. I hope this ends up helping some.

Onwards and Forwards,

Geoffrey
______________________________

Dr. Geoffrey Nase
Ph.D. Microvascular Physiologist
http://www.drnase.com
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