topical preparations

[howe928]

1) some says we should treat salicylate as NSAIDs (because it gives aspirin its pain-relieving quality and aspirin is a NSAIDs) some says it is not classified under NSAIDs...what do you think?

2) how about oil of wintergreen (methy salicylate)? this is classed under rubefacient, so it is safe if you are on NSAIDS, any objection?

3) are you happy to sell topical preparations containing this to customers taking NSAIDS e.g. aspirin or diclofenac or ibuprofen

4) again, are you okay to sell topical preparations containing this to customers taking coumarins e.g. warfarin

5) do you feel comfortable to sell topical preparations containing anaesthetics to patient with heart problems?

[Sir_Dispensalot]

wintergreen has a significant interaction with warfarin or so i've been told...

and ibuprofen gel 10% applied tds is supposed to be bioequivalent to 400mg orally tds only with significantly less gastric effects - obviously all other interactions with drugs and particular pathologies should be paid attention to...

i would assume diclofenac gel absorbs systemically too... in other words if patient is already on an nsaid then they shouldn't be on a topical prep too...

not sure how methyl salicylate interacts with nsaids but i would err on the side of caution...

[Jeff]

1) some says we should treat salicylate as NSAIDs (because it gives aspirin its pain-relieving quality and aspirin is a NSAIDs) some says it is not classified under NSAIDs...what do you think?

Depends on the mood I'm in - and my instinct at the time.

2) how about oil of wintergreen (methy salicylate)? this is classed under rubefacient, so it is safe if you are on NSAIDS, any objection?

No objection

3) are you happy to sell topical preparations containing this to customers taking NSAIDS e.g. aspirin or diclofenac or ibuprofen

Yes - but I'll try to steer them to the same topical NSAID as the one that they are already taking.

4) again, are you okay to sell topical preparations containing this to customers taking coumarins e.g. warfarin

Yes - but with a verbal warning.

5) do you feel comfortable to sell topical preparations containing anaesthetics to patient with heart problems?

I'd don't feel comfortable selling topical anaesthetics full stop.

Jeff