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#1
Old 04-01-2006, 12:56 PM
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Why can't I get ibuprofen in a topical ointment in the U.S.?

Well, a couple of websites offer a horribly overpriced topical ibuprofen creme, but the websites look kind of iffy - magic weight loss potions, nutritional supplements, etc.

When we were in France, we bought a nifty ibuprofen-in-a-gel over the counter, called "Ibutop". This stuff's terrific for sore tendons and muscles. However, we ran out. I'm dealing with a case of tennis elbow and wanted some more ibuprofen ointment, but wasn't going to buy from the above-mentioned dicey websites. I ended up ordering some gel from a British website and crossing my fingers that I'm not breaking any laws.

So why can't I buy it in the U.S.? Is it against the law? Not profitable enough for our corporations to sell?
#2
Old 04-01-2006, 08:14 PM
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Is there a compounding pharmacy in your area? Try calling them and seeing if they have it or can prepare it, and if it requires a prescription. I don't know for sure they could do this, but it's worth a shot.

I had an orthopaedic surgeon give me a prescription for a ketoprofen with lidocaine gel for achilles tendinitis. He gave me the prescription, and told me to go to the compounding pharmacy for it. Ketoprofen is another NSAID that is related to ibuprofen. Here's a description of the stuff I used --- the ketoprofen 15%/lidocaine 5% gel.

While searching, I saw that they sell Orudis in gel form in Australia. I don't know if you could find it here or not.
#3
Old 04-01-2006, 08:25 PM
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Would that really more effective than swallowing a pill? If I rub topical ibuprofin on the skin over a sore muscle, does it really target that muscle more than other areas? Or does some simply enter my blood stream through the skin, and I might as well have rubbed it on my ass as far as the sore muscle is concerned? (Assuming the sore muscle was not, in fact, an ass muscle to begin with).

Perhaps the FDA has judged it to be an ineffective way of administering ibuprofin?
#4
Old 04-01-2006, 08:37 PM
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Recent studies have shown that topical NSAID creams (NSAIDS are medicines like ibuprofen, aspirin, naproxen, and others but NOT tylenol or acetaminophen) perform better than placebo creams for pain relief for about two weeks, but then they perform no better than placebo after that.

In addition, the study found that topical NSAIDS didn't perform nearly as well as oral NSAIDS.

http://news.bbc.co.uk/1/hi/health/3935785.stm
#5
Old 04-01-2006, 10:36 PM
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I can tell you I got ketoprofen patches in Japan for a sprained shoulder ligament and they did precisely jack and shit (respectively). Just go for the tablets, or better yet, a nice fat injection of corticosteroid/anaesthetic mix.
#6
Old 04-01-2006, 10:47 PM
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I had some adventures with plantar fascitis in the U.K. and was told to buy an OTC topical analgesic gel, the name of which escapes me at the moment. It was great, though - really did the trick.

I couldn't figure out why I'd never seen anything like it in the U.S., so I asked the pharmacist when I got home. Actually, we do - and it has a higher percentage of the active ingredients. It's Icy-Hot, but it's usually with the arthritis remedies, so it never crossed my mind to look there for it. There are lots of generic versions, too - the CVS version I have at the moment lists active ingredients of menthol (10%) and methyl salicylate (30%). Good stuff when my foot/ankle act up.
#7
Old 04-01-2006, 11:00 PM
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Quote:
Originally Posted by Revtim
Would that really more effective than swallowing a pill?
Even if it's psychosomatic (assuming it's safe) I'd say, go for it.

BTW FYI Walgreens is a coumpouding pharmacy. They just don't seem to advertise it, and if it's something out of the ordinary, they need overnight to do it.
#8
Old 04-02-2006, 10:14 AM
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Interesting posts, folks. Thanks. If the stuff I ordered doesn't seem to add any value, I'll just stick to oral ibuprofen. I was trying to spare my stomach a little, since the pain is very localized and sharp.

Quote:
Originally Posted by Eva Luna
I had some adventures with plantar fascitis in the U.K. and was told to buy an OTC topical analgesic gel, the name of which escapes me at the moment. It was great, though - really did the trick.
I ordered "Ibuleve" from the U.K. - was this what you used?

Revtim, I have used this stuff in the past, as has my husband, and we both get relief from temporary, sharp muscle or tendon pain. I don't think it was a placebo effect.
#9
Old 04-02-2006, 10:26 AM
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Quote:
Originally Posted by teela brown
I ordered "Ibuleve" from the U.K. - was this what you used?
Now that I've had sleep and caffeine, I remember - it was Intralgin or something like that. Cheap and effective - I think it cost 99p or something. The GP in the small town where my college roomie lives recommended it - she diagnosed the problem in a 5-minute office visit. Pure genius.
#10
Old 04-02-2006, 06:54 PM
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Quote:
Originally Posted by teela brown
Revtim, I have used this stuff in the past, as has my husband, and we both get relief from temporary, sharp muscle or tendon pain. I don't think it was a placebo effect.
My uneducated guess is that it helped not because of the placebo effect, but because some of it got into your bloodstream via skin capillaries, which would have happened on pretty much any skin area you would rubbed it on, whether it was the injured area or not. I think it would have been much more effective to swallow a pill, as the study Qadgop referenced indicates.

If I rub an ointment on my arm, does it actually penetrate to the muscle? That seems pretty unlikely to me.

All uneducated guesses, I admit. Qadgop (or any other doc), did any of what I just typed turn out to be true?
#11
Old 04-02-2006, 06:57 PM
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Quote:
Originally Posted by Joey P
Even if it's psychosomatic (assuming it's safe) I'd say, go for it.
Why use a placebo when there's actual effective drugs to treat the condition? It's my understanding they are tested to be effective greater than placebo, so they're going to work better than any psychosomatic effect.
#12
Old 04-03-2006, 09:36 AM
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Location: Florida, USA
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Quote:
Originally Posted by Revtim
My uneducated guess is that it helped not because of the placebo effect, but because some of it got into your bloodstream via skin capillaries, which would have happened on pretty much any skin area you would rubbed it on, whether it was the injured area or not. I think it would have been much more effective to swallow a pill, as the study Qadgop referenced indicates.

If I rub an ointment on my arm, does it actually penetrate to the muscle? That seems pretty unlikely to me.

All uneducated guesses, I admit. Qadgop (or any other doc), did any of what I just typed turn out to be true?
Any docs out there that can tell if any of my speculation here is true?
#13
Old 04-03-2006, 11:40 AM
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Revtim, drug administration through intact skin is actually a very complex subject. Intact skin (as opposed to mucous membranes such as in the nose/mouth/rectum/vagina, etc) is a very good waterproof barrier to the passage of most water-soluble chemicals. It has had to evolve that way to keep our insides wet in a dry external environment.

Getting thereapeutic levels of drugs into the body via transdermal methods is an ongoing area of research, with potentially very lucrative outcomes - imagine replacing all of your daily medications with weekly patches, for instance. There are many technical issues, including the relative fat/water solubility of the drugs, thickness of skin, body mass, etc. There are some transdermal preparations that result in appreciable blood levels of drug (see estrogen patch) and others that have a predominantly local effect (see EMLA cream). There are technological methods to drive agents through the skin (see iontophoresis).

Most things that come in cream or ointment form for self-application by the patient have strictly local or surface effects. Transdermal systemic drugs come in more dose-controlled forms like prescription patches. It's less likely for someone to overdose on transdermal nicotine if they have to apply extra patches despite the package warnings than if they could just squeeze out an extra couple of inches of paste from the tube.

At any rate, the short answer is that it's difficult to get something to both penetrate the skin AND stay fairly localized.
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