Name: Amitriptyline 3% / Clonidine 0.2316% / Lidocaine 5% Compounded Pain Cream
Availability: InStock

Amitriptyline 3% / Clonidine 0.2316% / Lidocaine 5% Compounded Pain Cream

This compounded pain cream combines three different actives — amitriptyline 3%, clonidine 0.2316%, and lidocaine 5% — in a single topical formulation. So it works through three different pain pathways at the same time. Because it’s a compounded “special”, the cream is made specifically for the prescription rather than mass-produced. After all, it’s reserved for neuropathic pain that hasn’t settled with standard treatments. Important: this is a UK Prescription-Only Medicine (POM), so supply only happens after a UK-qualified prescriber reviews your situation.

At Courier Pharmacy, we believe in treatment that fits the person.

This page covers what this triple-action cream is, when it’s the right choice, how it differs from licensed treatments, and the safety points that genuinely matter.

Five key takeaways

This is a compounded UK Prescription-Only Medicine (POM). So it’s compounded by a specialist pharmacy after your prescriber issues a prescription. Each tube is made for one patient
The cream contains three actives: amitriptyline (a tricyclic with multiple pain-modulating effects), clonidine (an alpha-2 adrenergic agonist), and lidocaine (a sodium channel blocker). Together, they target neuropathic pain through three different routes
Reserved for neuropathic pain that hasn’t responded to standard treatments. In particular, it’s used in peripheral neuropathy, post-herpetic neuralgia, localised neuropathic pain, complex regional pain syndrome, and some chronic pain conditions
Topical delivery reduces (but doesn’t eliminate) systemic side effects. However, all three actives can be absorbed through skin, so the cream must be used as prescribed and never applied to large areas or broken skin without specific advice
Honest framing: the evidence for compounded combination creams is suggestive rather than conclusive. After all, individual actives have RCT evidence in their own right, but the specific combination has limited head-to-head data. It’s a clinical option, not a first-line treatment

Why choose Courier Pharmacy for this compounded cream

At Courier Pharmacy, our approach starts with a simple idea: treatment should fit the person, not force the person to fit the system.

Dr Ada Jex-Cori

Our service is shaped by the philosophy of Dr Ada Jex-Cori, our brand pharmacist.

Dr Ada represents the spirit of the pharmacy: evidence-led, community-rooted, and willing to challenge the one-size-fits-all approach to medicine. She is named in honour of three pioneering women in science: Ada Lovelace, the mathematician and visionary; Sophia Jex-Blake, the first female doctor in the UK who fought the medical establishment; and Gerty Cori, the biochemist and Nobel Prize winner.

In our fictional world of Ethrewell, Dr Ada fights against pharma’s standardised approach to medicine. In the real world, she represents what we stand for. Her view is straightforward: you are not broken. The system is. And we are here to change that.

Dr Ada Jex Cori at courierpharmacy.co.uk holding a coupon

Compounded specials — when one-size-fits-all doesn’t fit

Compounded creams are the embodiment of personalised medicine. After all, each tube is made for one patient, based on what their prescriber thinks they need:

Different patients respond to different pain mechanisms
Standard licensed products don’t cover every clinical situation
Combining actives in one cream can simplify the routine
Topical delivery can reduce side effects compared to oral medicines

So compounded creams are a clinical option when standard treatments don’t fit. However, they’re not a quick fix — they need the same thoughtful prescribing and review as any medicine.

Honest framing about evidence

Many providers oversell compounded pain creams. Courier Pharmacy is different:

Individual actives (amitriptyline, clonidine, lidocaine) have RCT evidence for neuropathic pain
Specific combinations have less robust evidence than individual actives
Some patients get genuine relief; others don’t
Compounded creams are a clinical option, not a guaranteed solution
If we don’t think this cream is right for you, we’ll say so

Pain and the bigger picture

Chronic pain often connects to wider health patterns. So our pharmacist can discuss:

Sleep and pain — poor sleep worsens pain sensitivity
Mood and pain — depression and anxiety can amplify pain perception
Mast cell activation syndrome (MCAS) and chronic widespread pain
Fibromyalgia and central sensitisation
Diabetes management as it affects peripheral neuropathy
Vitamin B12, vitamin D, and other nutritional contributors
Physical therapy, pacing, and self-management strategies

Sometimes the pain is the visible part of a wider story — and that’s worth talking through.

Pharmacist support before and after purchase

Our pharmacist is here to discuss:

Whether this compounded cream is the right choice for your situation
How to use it safely and effectively
Watching for systemic absorption and side effects
How to combine with other treatments
When to ask for prescriber review or referral
Other compounded combinations if this one doesn’t suit

This is free and on hand before and after purchase.

Trust earned, not claimed

We are GPhC-regulated, and our content is grounded in NICE guidance, the BNF, peer-reviewed pain medicine research, and the real experience of patients using compounded pain treatments.

If this cream isn’t the right answer for your situation, we’ll tell you honestly. After all, prescribing the right treatment matters more than fulfilling a request.

How to buy this compounded cream from Courier Pharmacy

This cream is a UK Prescription-Only Medicine (POM). So supply needs a prescription, which our prescriber issues after reviewing your consultation.

How our service works

Add the cream to your basket and complete the online consultation. The consultation covers your pain history, prior treatments tried, current medicines, allergies, and other relevant medical history
Our UK-qualified prescriber reviews your answers to confirm whether this compounded cream is suitable. So if extra information is needed, or if a different treatment would suit better, we’ll get in touch
Once approved, your prescription goes to a UK specials pharmacy, which compounds the cream specifically for you. This typically adds a few days to delivery time
Your dispensed cream is sent out in plain, discreet packaging
Free pharmacist and prescriber support is on hand before and after your purchase

When other options might suit better

If this compounded cream isn’t right, we’ll explain why. Other options may include:

Versatis 5% lidocaine patches: licensed specifically for post-herpetic neuralgia
Capsaicin cream (Zacin 0.025% or Qutenza 8% patch): for specific neuropathic conditions
Voltarol Emulgel or ibuprofen gel: for inflammatory rather than neuropathic pain
Different compounded combinations: amitriptyline + ketamine, AKL, or other formulations
Oral medicines: amitriptyline tablets, duloxetine, gabapentin, pregabalin
Pain specialist referral: for complex or persistent neuropathic pain
Lifestyle and self-management approaches alongside medical treatment
Investigation of underlying causes if not already done

Our community service

Our free fortnightly drop-in clinics at Insomnia, Derby run every other week from 10am to 12pm.

Healthcare shouldn’t only happen when you’re paying for it. So we show up, even when it’s free.

We cover chronic pain, neuropathy, fibromyalgia, MCAS, CFS, dermatology, eczema, psoriasis, allergies, asthma, hair loss, men’s and women’s health, digestive health, weight management, and whatever else people bring through the door. No appointment needed, no charge, no pressure.

Dr Ada Jex Cori at courierpharmacy.co.uk holding a coffee 2

Active ingredients

Each application of this compounded cream delivers three actives:

Amitriptyline hydrochloride 3%: a tricyclic compound that blocks sodium channels and modulates pain signalling at the nerve ending
Clonidine hydrochloride 0.2316%: an alpha-2 adrenergic agonist that reduces pain signal transmission
Lidocaine 5%: a local anaesthetic that blocks sodium channels in nerve fibres

Why the triple combination

This is the key thinking behind compounded pain creams. So instead of relying on one mechanism, this formulation hits three different parts of the pain pathway:

Amitriptyline: works centrally on sodium channels, NMDA receptors, and monoamine systems — even when applied to skin
Clonidine: reduces the firing of pain-sensing nerves through alpha-2 adrenergic receptors
Lidocaine: blocks the sodium channels that nerve fibres need to transmit pain signals
Together, the three actives may produce more pain relief than any single one alone
In addition, lower individual doses can sometimes be used when combining actives, which may reduce systemic side effects

After all, neuropathic pain involves multiple mechanisms. So a multi-pathway approach can make sense when single-target treatments haven't worked. However, the evidence for specific compounded combinations is less robust than for individual actives, and our prescriber will discuss this with you.

Why this specific concentration

The amitriptyline 3% and lidocaine 5% concentrations sit within ranges studied in clinical research. So the 3% amitriptyline is high enough for meaningful local effect, while staying below concentrations linked to more systemic absorption. The 0.2316% clonidine looks unusual — it's a calculated concentration designed to deliver a specific topical dose, not a standard pharmacy strength.

The base cream

The cream uses a specialist base designed to help the three actives penetrate skin and reach nerve endings. So this base typically contains penetration enhancers, emollients, and stabilisers. The specials pharmacy that compounds your cream will list the full base on the label.

What is a "compounded medicine"?

This matters for understanding what you're buying. So compounded specials are unlicensed medicines compounded for individual patients in the UK from compounding pharmacies. Key points:

Made by a GPhC registered compounding pharmacy
Prepared after your prescription is received
Not mass-produced — each tube is individually made
Doesn't have a standard SmPC (Summary of Product Characteristics)
Allowed when no licensed alternative meets the patient's clinical need

What is this cream for?

This compounded cream is for neuropathic pain — that is, pain caused by damaged or dysfunctional nerves rather than by tissue injury or inflammation. So typical use includes diabetic peripheral neuropathy, post-herpetic neuralgia, complex regional pain syndrome (CRPS), chemotherapy-induced peripheral neuropathy, and some localised chronic pain conditions where standard treatments haven't worked.

Who is it for?

This cream is for adults with localised neuropathic pain that hasn't settled with standard treatments. So that typically means people who've tried oral medicines (amitriptyline, gabapentin, pregabalin, duloxetine) without adequate relief, or who experienced unacceptable side effects from oral options. Our prescriber decides whether this triple-action approach is the right next step for your situation.

What does it claim to do?

Each of the three actives works on a different aspect of pain signalling. Amitriptyline blocks sodium channels and modulates serotonin and noradrenaline pathways at the nerve ending. Clonidine acts on alpha-2 adrenergic receptors to reduce pain signal transmission. Lidocaine blocks sodium channels in nerve fibres. Together, they aim to dampen pain at the nerve level without requiring oral medication.

What it doesn't do

This cream doesn't treat the underlying cause of nerve damage — it manages the pain. So if your neuropathic pain is caused by treatable factors (diabetes, vitamin B12 deficiency, alcohol use, medication side effects), addressing those causes still matters. The cream also isn't designed for inflammatory pain (use Voltarol Emulgel or oral anti-inflammatories), muscle pain, or general aches.

How this cream works

Each of the three actives works on a different part of pain signalling. So this multi-pathway approach is the clinical thinking behind the combination.

Amitriptyline — multiple mechanisms

Amitriptyline is best known as an oral antidepressant. However, when applied topically, it works through several mechanisms relevant to neuropathic pain:

Blocks sodium channels in nerve fibres — similar to how local anaesthetics work
Antagonises NMDA receptors involved in pain transmission
Affects adenosine and opioid receptors locally
Modulates serotonin and noradrenaline pathways at the nerve ending
Reduces nerve firing in damaged or hypersensitive nerves

Importantly, topical amitriptyline can have some systemic effects too. So the dose must be controlled, and signs of systemic absorption (drowsiness, dry mouth) are worth watching for.

Clonidine — alpha-2 adrenergic action

Clonidine is best known as a blood pressure medicine. Topically, it works differently:

Stimulates alpha-2 adrenergic receptors on pain-sensing nerves
Reduces the release of pain-signalling neurotransmitters
Dampens the firing of damaged or sensitised nerves
May reduce inflammation around the nerve ending
Particularly useful in diabetic peripheral neuropathy based on existing research

Lidocaine — sodium channel blockade

Lidocaine is the most well-established topical pain treatment in this combination:

Blocks voltage-gated sodium channels in nerve fibres
Prevents nerve fibres from generating pain signals
Works quickly when applied to intact skin
Already licensed in the UK as Versatis 5% patches for post-herpetic neuralgia
Provides immediate-acting relief, while amitriptyline and clonidine work over longer time-frames

Why three together

The clinical rationale is that neuropathic pain involves multiple pathways. So:

Blocking only sodium channels may not be enough
Hitting three different targets may give more complete pain relief
Lower individual doses are sometimes possible when combining actives
Different patients respond to different mechanisms — covering several increases the chance of benefit
However, the evidence for specific combinations is less robust than for individual actives

In short, this combination is a clinical attempt to match multiple pain mechanisms with multiple treatments. After all, neuropathic pain rarely has just one cause.

How to use this cream

This summary is for reference only. The definitive guide is the patient information sheet supplied with your dispensed cream and your prescriber's specific instructions. If anything isn't clear, contact our pharmacist or prescriber.

Standard application

How to use the cream:

Wash your hands thoroughly with soap and water before applying
Make sure the application area is clean and dry
Apply a small amount to the painful area only — about a pea-sized amount per palm-sized area
Gently massage in until absorbed
Apply 2-3 times daily, or as your prescriber has instructed
Wash your hands thoroughly after applying
Don't apply more than the prescribed amount, even if pain isn't fully controlled
Don't apply to broken, weeping, or severely inflamed skin without specific advice

How much to use

Less than you'd expect. Specifically:

A pea-sized amount covers about a palm-sized area
More cream doesn't mean more pain relief — it means more systemic absorption
Stick to the prescribed amount per application and per day
Maximum daily dose is set by your prescriber based on the area being treated
Don't apply over large body areas without specific advice

When you should see improvement

Different actives work over different time-frames:

Lidocaine: rapid onset within 30-60 minutes
Clonidine: builds up effect over days to weeks of regular use
Amitriptyline: takes 2-4 weeks of regular use for full benefit
Overall, expect to give the cream at least 4 weeks before judging effectiveness
If no improvement by 6-8 weeks, contact your prescriber for review

Where you can apply it

Generally:

Areas of localised neuropathic pain (hands, feet, forearms, lower legs, areas of post-herpetic neuralgia)
Specific painful nerve distributions
Localised CRPS areas

Avoid:

The face, especially near eyes, mouth, or mucous membranes
Genital or anal areas without specific advice
Broken, weeping, infected, or severely inflamed skin
Areas of normal skin near where you've already applied (cover only the painful area)
Large body areas (more than a hand-sized area without specific advice)

Hand washing matters

Always wash hands thoroughly after applying. So:

Use soap and water for at least 30 seconds
Wash under fingernails carefully
Don't touch your face, eyes, or mouth until you've washed
Don't handle children or pets directly with cream on your hands
Wear disposable gloves if applying for someone else
Wipe down surfaces you may have touched before washing

Food, drink, and lifestyle

The cream doesn't interact significantly with food or drink directly. However, some lifestyle factors matter:

Avoid heavy alcohol use while using this cream, since amitriptyline systemic absorption can add to sedation
Tell other healthcare professionals you're using this cream before surgery or dental procedures
Be aware of driving and machinery effects (see below)
Don't use heat packs or occlusive dressings over the cream without specific advice, since these increase absorption

Storage

Store as instructed on the label (typically room temperature, away from direct sunlight)
Replace the cap securely after use
Use within the period stated on the label (specials often have shorter expiry than licensed medicines)
Keep out of sight and reach of children and pets
Don't share the tube between household members
Return any unused cream to a pharmacy for safe disposal

Warnings and precautions

Don't use this cream if you

Don't use this cream if you:

Have a known allergy to amitriptyline, clonidine, lidocaine, or any base ingredient
Have severe heart problems, including arrhythmias, heart block, or recent heart attack
Take MAOI antidepressants (monoamine oxidase inhibitors)
Have severely impaired liver function
Are pregnant or breastfeeding, unless specifically advised by a specialist

Use with care if you

Talk to our prescriber before using if you:

Take other tricyclic antidepressants, SSRIs, SNRIs, or other antidepressants orally
Take blood pressure medicines, particularly other clonidine, beta-blockers, or alpha-blockers
Have heart problems, including any history of irregular heartbeat or heart failure
Have low blood pressure or a tendency to faint
Have epilepsy or any history of seizures
Have glaucoma or narrow angles in the eye
Have an enlarged prostate or urinary retention
Have liver or kidney problems
Are over 65, since you may be more sensitive to systemic effects

The systemic absorption issue

This matters because even topical creams can be absorbed. Specifically:

All three actives can be absorbed through skin, especially if applied to large areas or broken skin
Systemic side effects (drowsiness, dry mouth, dizziness, low blood pressure) suggest excessive absorption
Stop the cream and contact our prescriber if you notice these effects
Don't apply more cream or to larger areas than prescribed
Heat (warm showers, heat packs, hot weather) can increase absorption
Occlusive dressings, tight clothing, or covering with cling film all increase absorption

Sudden stopping

Be aware that:

Clonidine, even topically, can cause rebound high blood pressure if stopped suddenly after long use
If you've been using the cream regularly for several weeks, talk to our prescriber before stopping
Gradual reduction is sometimes recommended
This is more relevant after several weeks of consistent use than for occasional applications

Use in older adults

Older adults can use this cream, but with extra caution:

More sensitive to systemic effects of all three actives
Greater risk of dizziness, drowsiness, or low blood pressure
Polypharmacy (multiple medicines) is more common — interaction risk is higher
Reduced kidney and liver function affects how the body handles absorbed medicine
Start with smaller amounts and build up under prescriber guidance
Watch for cognitive effects (confusion, drowsiness, slowed thinking)

Use in children

This cream isn't designed for children. So if a child has neuropathic pain, specialist paediatric pain assessment is essential — different treatments and doses apply.

Use in pregnancy and breastfeeding

Generally avoid:

All three actives can cross the placenta to varying degrees
Safety data for this specific combination in pregnancy is limited
Discuss with your prescriber and GP before use
Breastfeeding: actives can pass into breast milk; talk to GP and prescriber
Alternative options should usually be tried first in pregnancy and breastfeeding

Driving and machinery

Be cautious. So:

Amitriptyline (even topically absorbed) can cause drowsiness
Clonidine can cause sedation and low blood pressure
Don't drive or operate machinery until you know how this cream affects you personally
If you notice drowsiness or dizziness, avoid driving until effects settle
This is more relevant in the first 1-2 weeks of use, while your body adjusts

Side effects

Topical delivery reduces, but doesn't eliminate, the side effects associated with each active. So watch for both local and systemic effects.

Common local side effects

Skin irritation, redness, or itching at the application area
Burning or stinging when first applied (usually settles within minutes)
Dry skin in the treated area with regular use
Mild numbness at the application area (lidocaine effect — usually expected)

Less common but possible side effects

Contact dermatitis (allergic skin reaction)
Photosensitivity in the treated area
Dry mouth (from systemic amitriptyline or clonidine absorption)
Drowsiness or mild sedation
Mild dizziness, particularly on standing
Constipation
Mild low blood pressure

Rare but serious side effects

Severe allergic reaction (swelling of face, lips, tongue, throat; breathing difficulty) — medical emergency
Cardiac arrhythmia or significant heart rhythm changes
Significant low blood pressure with fainting
Seizures (rare, more likely with excessive absorption)
Significant cognitive effects (confusion, marked drowsiness, difficulty concentrating)
Lidocaine systemic toxicity (metallic taste, tinnitus, tongue numbness, seizures) — rare unless over-applied

Stop and seek urgent medical help if

You develop signs of severe allergic reaction
You experience chest pain, irregular heartbeat, or marked palpitations
You feel faint, dizzy, or experience marked blood pressure drops
You notice tinnitus, metallic taste, or unusual sensations around the mouth
You develop seizures or significant confusion
You experience marked drowsiness, especially affecting safety

Yellow Card reporting

You can report suspected adverse drug reactions to the MHRA via the Yellow Card scheme at yellowcard.mhra.gov.uk. Reporting helps build the safety picture for everyone.

Drug interactions

Even though this is a topical cream, interactions still matter because of partial systemic absorption.

Important interactions

Talk to our prescriber before using this cream if you take:

Other antidepressants (tricyclics, SSRIs, SNRIs, MAOIs) — risk of serotonin syndrome and additive effects
Other clonidine-containing products
Blood pressure medicines (beta-blockers, alpha-blockers, calcium channel blockers) — additive low blood pressure
Other antiarrhythmic medicines
Sedatives, hypnotics, or strong painkillers — additive drowsiness
Alcohol regularly — additive sedation
Anticholinergic medicines (some bladder medicines, some Parkinson's medicines)
Strong CYP2D6 inhibitors (some heart and depression medicines) — affects amitriptyline metabolism

Not relevant interactions

Generally fine:

Most oral antibiotics
Most over-the-counter cold and flu treatments
Standard cosmetics applied to untreated areas

Frequently asked questions

Is this cream a licensed medicine?

No — it's a compounded medicine, which means it's an unlicensed medicine made specifically for individual patients in the UK.

Why use a compounded cream rather than licensed medicines?

Generally because licensed options haven't worked or weren't tolerated. So:

Oral medicines for neuropathic pain can cause significant side effects
Topical delivery reduces (but doesn't eliminate) systemic side effects
Multiple actives in one cream can address several pain mechanisms
Some patients respond to specific compounded combinations after standard treatments have failed

How quickly does it work?

Different actives have different time-frames:

Lidocaine effect: within 30-60 minutes
Clonidine effect: builds up over days to weeks
Amitriptyline effect: takes 2-4 weeks for full benefit
Overall, give the cream at least 4-6 weeks before judging effectiveness

Is the evidence strong for this combination?

Honestly, mixed. So individual components (amitriptyline, clonidine, lidocaine) have RCT evidence for neuropathic pain. However, the specific triple combination has less robust head-to-head data than each active alone. After all, compounded specials are clinical tools used when standard treatments haven't worked — they're not first-line and not guaranteed to help everyone.

Why the unusual clonidine concentration (0.2316%)?

That specific concentration is calculated to deliver a particular topical dose. So compounded creams sometimes use unusual concentrations because they're worked back from a target amount delivered per application. The strength has been chosen for clinical reasons rather than convenience — and the specials pharmacy compounds to that precise specification.

Can it cause systemic side effects even though it's topical?

Yes. So all three actives can be absorbed through skin, particularly with regular use, application to large areas, or use on broken skin. Watch for drowsiness, dry mouth, dizziness, or low blood pressure — these suggest systemic absorption. Contact our prescriber if these develop.

Can I drive while using this cream?

Cautiously. So all three actives can theoretically affect alertness if absorbed systemically:

Test how the cream affects you for the first 1-2 weeks before driving
Avoid driving if you feel drowsy, dizzy, or your reaction time feels slowed
Lower amounts and infrequent use carry less risk than maximum doses
Heat packs or hot environments increase absorption — be more cautious in those conditions

Can I use it during pregnancy?

Generally not recommended. So discuss with your prescriber and GP before use during pregnancy or breastfeeding. Alternatives are usually tried first. Specifically, safety data for this combination in pregnancy is limited, and all three actives can cross the placenta to varying degrees.

How long can I use it for?

As long as it's helping and being prescribed. So your prescriber will review your use at regular intervals:

Initial 4-6 weeks: to judge whether the cream is working
Ongoing review: typically every 3-6 months while you're using it
Long-term use: possible if benefit continues and side effects are manageable
Stopping: gradual reduction is sometimes recommended after long use, particularly because of clonidine rebound effects

Can I use this with my oral pain medicines?

Usually yes, but talk to our prescriber first. So:

Oral amitriptyline + topical amitriptyline: adds to systemic effects — usually one or the other, not both
Gabapentin or pregabalin: generally fine alongside this cream
Duloxetine: generally fine but watch for additive sedation
Oral antihypertensives: watch for additive blood pressure effects
Opioids: generally fine but watch for additive sedation

What if it doesn't help my pain?

Contact our prescriber. So options may include:

Trying a different compounded combination
Adjusting concentrations or active ingredients
Adding or switching to a licensed treatment
Specialist pain clinic referral
Investigation for any treatable underlying cause

Is the cream messy or hard to use?

Not particularly. So:

It looks and feels like a standard cream
Absorbs in a few minutes with gentle massage
Can leave a slight slippery feel for a while after application
Some specials bases have a slight medicinal smell
Doesn't usually stain clothes if absorbed before dressing

How should I store it?

Storage:

As labelled — typically room temperature, away from direct sunlight
Replace the cap securely after use
Use within the period stated on the label (often shorter than licensed medicines)
Keep out of sight and reach of children and pets
Don't share with other household members
Return any unused cream to a pharmacy for safe disposal

How do I order from Courier Pharmacy?

Add the cream to your basket on courierpharmacy.co.uk and complete the online consultation. Our prescriber will review and confirm whether this compounded cream is suitable. Your prescription then goes to a UK specials pharmacy, which compounds the cream for you and dispatches it in plain, unbranded packaging.

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More than a prescription: our community

Healthcare shouldn't only happen when you're paying for it.

Every fortnight we run free drop-in talks and clinics at Insomnia, Derby, from 10am to 12pm. So we show up, even when it's free.

Bring a question, bring a friend, bring a stack of bewildering letters from another clinic. We'll sit with you.

We cover chronic pain, neuropathy, fibromyalgia, MCAS, CFS, dermatology, eczema, psoriasis, allergies, asthma, hair loss, men's and women's health, digestive health, weight management, and whatever else people bring through the door. No appointment. No cost. No pressure. Just real support and treatment that fits.

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Disclaimer: This article is for information only and isn't a substitute for personal medical advice. This compounded pain cream is an unlicensed UK Prescription-Only Medicine made under a Manufacturer's Specials Licence. Always speak to a qualified prescriber before starting or changing treatment for chronic pain.

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How this content was created

Written by the Courier Pharmacy editorial team and reviewed by a GPhC-registered pharmacist.

The content is grounded in current NICE guidance (CG173 on neuropathic pain), the BNF entries for amitriptyline, clonidine, and lidocaine, and peer-reviewed pain medicine research on compounded topical pain treatments. In addition, it draws on the real questions patients bring to our drop-in clinics in Derby.

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References

[1] National Institute for Health and Care Excellence (2020) Neuropathic pain in adults: pharmacological management in non-specialist settings — NICE guideline CG173. Available at: https://www.nice.org.uk/guidance/cg173

[2] British National Formulary (2024) Amitriptyline hydrochloride. Available at: https://bnf.nice.org.uk/drugs/amitriptyline-hydrochloride/

[3] NHS (2024) Peripheral neuropathy. Available at: https://www.nhs.uk/conditions/peripheral-neuropathy/

[4] Haderer, A., Gerner, P., Kao, G., Srinivasa, V. and Wang, G.K., 2003. Cutaneous analgesia after transdermal application of amitriptyline versus lidocaine in rats. Anesthesia & Analgesia, 96(6), pp.1707-1710.

[5] Kocot-K?pska, M., Zaj?czkowska, R., Mika, J., Kopsky, D.J., Wordliczek, J., Dobrogowski, J. and Przeklasa-Muszy?ska, A., 2021. Topical treatments and their molecular/cellular mechanisms in patients with peripheral neuropathic pain—narrative review. Pharmaceutics, 13(4), p.450.

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Amitriptyline 3% / Clonidine 0.2316% / Lidocaine 5% Compounded Pain Cream

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Product description: Amitriptyline / Clonidine / Lidocaine cream

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