The primary care physician often has to help diabetic patients suffering from localized neuropathic pain. Most of the current anti-epileptics and anti-depressants however, especially when prescribed to the elderly patients, have troublesome drawbacks: drug-interactions, side effects and tolerability issues. Topical compounded creams might be a good alternative, especially since it is easy to test in the general practice to discover responders to these creams. At our Institute for Neuropathic Pain we see many patients suffering from peripheral neuropathic pain. We have developed a number of compounded creams based on amongst others amitriptyline 10%, ketamine 10%, clonidine 0.2%, baclofen 5%, and phenytoin 10%. Many patients profit from such topical formulations and we will describe how a primary care physician can fast decide whether as specific compounded cream is useful for a patient. Patients suffering from peripheral neuropathic pain, as in diabetic neuropathy, chronic idiopathic axonal polyneuropathy (CIAP) and chemotherapy induced polyneuropathy (CIPN) as well as from complex regional pain syndrome (CRPS), seem often to be responsive to such topical approach. If you are on a personal connection, like at home, you can run an anti-virus scan on your device to make sure it is not infected with malware. If you are at an office or shared network, you can ask the network administrator to run a scan across the network looking for misconfigured or infected devices.
The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Subjects were randomly assigned in a 1:1 ratio to receive 1 of 2 treatments applied topically TID to both feet for 85 days: Clonidine Gel (3.9 mg of clonidine HCl total daily dose), or Placebo Gel (vehicle without clonidine). Listing a study does not mean it has been evaluated by the U. Approximately 140 adult subjects with symmetrical distal PDN were expected to be randomized into the study. Study CLO 290 was a multicenter, randomized, double blind, placebo controlled, 2 arm parallel group study of Clonidine Gel in the treatment of pain associated with PDN. However, a pre-planned fully blinded interim analysis was performed when 70 subjects had completed the study for the purpose of re estimating sample size. Following the recommendation of the independent, third party statistician who conducted the interim analysis, the sample size was adjusted to allow approximately 260 subjects to be randomized into the study. The study included 5 phases: Screening Phase (up to 21 days duration), Baseline Phase (Day 14 to Day 8), Placebo Lead in Phase (Day -7 to Day 1), Double blind Treatment Phase (85 days), and a Post-treatment Follow up Phase (7 days, only for subjects not enrolling in the open label long term safety study, CLO 311). -adrenergic agonist, is an extremely potent analgesic agent.1 However, adverse effects, such as sedation and hypotension, limit its clinical use.2 Given these undesirable centrally mediated side effects, it may be advantageous to apply clonidine topically, to the site of pain origin. With topical treatment, one may achieve analgesic efficacy due to high drug concentration at the site of pain origin while avoiding high blood drug concentration and thus centrally mediated side effects.3,4 Because αadrenoceptors are located not only in the central nervous system but also on dorsal root ganglion (DRG) cells,5,6 topical clonidine may produce antinociception and/or antihypersensitivity. Several previous studies have shown the antinociception/antihypersensitivity from peripherally administrated clonidine, including topical clonidine given tail immersion in an animal model of nociceptive pain,3 intraarticular clonidine in an animal inflammatory pain model,7 perineural clonidine in an animal neuropathic pain model, 8,9 intraarticular clonidine in humans undergoing knee arthroscopy,10 and topical clonidine delivered a patch in patients with sympathetically maintained pain.11 To date, however, the antinociceptive and/or antihypersensitivity effects of clonidine topically given in cream has not been studied in animals or humans, except one pilot study in patients with oral neuropathic pain or neuralgia.12 -adrenoceptor agonists may be effective in relieving hypersensitivity states associated with neuropathic pain, postoperative pain, and inflammatory pain. Currently, however, no systematic data are available regarding the antihypersensitivity effects of clonidine cream in these hypersensitivity states. In addition, to our knowledge, no study has been conducted to compare the antihypersensitivity effects of topical clonidine among these pathophysiologic pain conditions. The current comparative study was designed to determine whether clonidine cream can reduce hypersensitivity in the rat models of neuropathic pain, postoperative pain, and inflammatory pain. After approval from the Institutional Animal Care and Use Committee, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan, male Sprague-Dawley rats weighing 250–300 g were studied.
The evidence for topical clonidine was found to be inconclusive. 5% medicated plaster, gel and cream and an 8% spray in studies of differing designs, each. A000058199 停用 meweily granules "tolin" 東菱藥品工業有限公司; a001358100 停用 aminophylline tablets.