Plain Language Summary : The Therapeutic Potential of Transdermal Gabapentin in the Symptomatic Management of Chronic Neuropathy

✎Dr. Katherine Gabriel, PharmD, RPh

ORCiD: 0009-0004-0341-9744

Original Article: Scriptum Pharmacologia

Abstract

Standard pharmacotherapeutic options in the management of neuropathic pain are often poorly tolerated due to various contraindications, drug interactions, and troublesome adverse events. The investigation and pharmaceutical development of localized anti-neuropathic options is increasing among researchers and manufacturers, but results have not yet determined the role in therapy of transdermal/locally acting analgesics, anti-neuropathics, and anti-inflammatories. Compounding Pharmacies and FDA 503b Outsourcing Facilities aid in this critical endeavor through endogenous compounding and manufacturing (respectively) of

transdermal analgesic formulations. This review summarizes the currently available clinical data supporting the implementation of transdermal gabapentin preparations in the management of chronic neuropathic symptoms. Transdermally applied analgesic, anti-inflammatory, and anti-neuropathic preparations are crucial in the development of pain management modalities which reduce the risk of numerous well-known complications, including drug-drug interactions, conflicting patient comorbidities, and CNS depressant effects. The adjunctive treatment of neuropathy with a transdermal analgesic/antispasmodic preparation remains under- investigated, and the role of these preparations in the management of chronic neuropathic pain remains unclear.

Plain Language Summary:

This review looks at how topical Gabapentin, along with its oral (pill/capsule) form, can help with the symptoms of chronic neuropathy. First, let’s go over what chronic neuropathy is, what causes it, and the types of symptoms that people experience.

With chronic neuropathy, the nerves in your body are damaged or not working properly. Think of the nerves in your body as messengers that tell your brain what is going on. For example, if you touch a hot stove, the nerves will send a message to the brain that the stove is hot & this results in removing your hand from the hot surface. Overall, your nerves are confused and constantly sending incorrect messages to the brain. People who suffer from chronic neuropathy constantly feel pain in addition to tingling or numbness. The current medications used to treat chronic neuropathy can cause side effects like sleepiness or confusion, especially if taken for a long time or in high doses. This can make it hard for someone to live a normal life because they feel too tired or groggy to function. That can lead to feelings of frustration/depression. Scientists, researchers and individuals in the pharmaceutical industry have put their brilliant minds together to find a solution to the side effects of Gabapentin that make it hard to function throughout the day. Patients can apply Gabapentin cream to the painful area to manage the symptoms of tingling, numbness or “pins and needles”. The medication , which can be made by a local compounding pharmacy or large-scale compounding pharmacy, provides relief of symptoms by delivering medication throughout the skin without the unwanted side effects. Treatment for chronic neuropathy is not a one-size-fits-all approach. Therefore, more research is needed on adding topical Gabapentin cream to current treatments. It shows promise as being not only as effective, but also safer than current oral medications.

Reference

1. LaStella A. The therapeutic potential of transdermal gabapentin in the symptomatic management of chronic neuropathy. J Scrip Pharm. Published online October 01, 2024. doi: 10.70390/LEHL0487