Home' Australian Pharmacist : Australian Pharmacist January 2013 Contents Australian Pharmacist January 2013 I © Pharmaceutical Society of Australia Ltd.
1. Topical NSAIDs are indicated for the
treatment of osteoarthritis because
a) effective in short term pain relief for
b) more likely to cause adverse
c) useful alternatives when oral NSAIDs
are well tolerated.
d) less effective than a placebo for short-
e) useful for treating small areas such as
knees and hands.
2. Which of the following is an example
of a gelling agent, commonly used
both in commercially available and
a) Liquid paraffin.
d) Isopropyl alcohol.
e) Propylene glycol.
3. Lipogels are thought to be superior to
water-based (aqueous gels) due to:
a) increased viscosity.
b) improved penetration.
c) superior spreadability.
4. The electronic mortar and pestle
(EMP) is an important piece of
equipment in compounding lipogels
due to its ability to ensure:
a) shear mixing.
b) even distribution of the API
throughout the lipogel base.
c) reduction of particle size.
d) stability of the API.
e) removal of trapped air from the gel.
5. Carbomer, used as a gelling agent,
forms an acidic colloidal dispersion
which requires neutralisation with
__ ___ to form a viscous gel.
c) benzyl alcohol
d) cocoyl caprylocaprate
Directions for use
• Wash your hands well with soap and
water before opening any packaging.
• Apply the gel to clean, dry skin that does
not have any cuts, infections or rashes.
• Do not use sunscreens, cosmetics,
lotions, moisturisers, insect repellents,
or other topical medicines on the same
skin areas where you apply the gel.
• Apply the correct amount as described
by the pharmacist* to affected areas and
gently massage the gel over the affected
area 2–4 times daily for up to seven days
or as directed by the prescriber. Patients
should consult their doctor or pharmacist
if the condition does not improve within
seven days, or if it gets worse.
• Avoid contact with eyes, nose, mouth
and other sensitive areas. Wash your
hands after application, unless they are
the site being treated.
• Do not use heating pads or apply
bandages where you have applied the
gel, and avoid exposing the area to
sunlight and artificial light, such as in
• Store the preparation in a cool place
(below 25°C), protected from light and
away from children and pets.
*Note: The amount applied will depend on
which API is used and the strength of the
preparation. Examples include ‘a circular
mass the size of a 50 cent coin’7 or the use
of dosing cards described in Voltaren® gel
patient information sheets.2
1. Therapeutic Guidelines. eTG Complete. North Melbourne:
Therapeutic Guidelines; 2012.
2. Voltaren® Gel. Patient Instructions for use. At: www.voltarengel.
3. Altman RD, Barthel HR. Topical therapies for osteoarthritis.
4. Rubefacients, topical analgesics/NSAIDs. MIMS Online. MIMS
5. Winfield AJ, Rees JA, Smith I. Pharmaceutical practice. 4th edn.
New York: Churchill Livingstone; 2009.
6. Ruiz Martinez MA, Lopez-Viota Gallardo J, de Benavides MM,
et al. Rheological behavior of gels and meloxicam release. Int J
7. Orudis® Gel CMI. At: www.racgp.org.au/cmi/swcorudg.pdf
8. Feldene® Gel CMI. At: www.nps.org.au/__data/assets/pdf_
9. Voltaren Emulgel®. MIMS Online. MIMS Australia; 2012.
10. Rowe RC, Sheskey PJ, Quinn ME. Handbook of pharmaceutical
excipients. 6th edn. London: Pharmaceutical Press; 2009.
11. Martindale: The complete drug reference. London:
Pharmaceutical Press; 2012.
12. Haywood A, Glass B. Nifedipine for the treatment of chilblains.
Aust Pharmacist 2011;30(8):664–68 .
13. Mixon W, Helms SR. Transdermal amlodipine besylate in
lipoderm for the treatment of feline hypertension. IJPC
14. PCCA Lipoderm® Base. Professional Compounding Centers of
America. At: www.pccarx.com/pcca-products/pcca-exclusives/
15. Marshall R, Vidaurri VA, Boomsma D, et al. Case Reports:
Compounding to relieve arthritis pain. IJPC 2008;12(6):498–
16. PSA. Professional Practice Standards. Version 4. Compounding.
17. Australian Pharmaceutical Formulary and Handbook. 22nd
edn. Canberra: PSA; 2012.
SOLUTIONS THROUGH COMPOUNDING
Key learning points
• Pharmacists are able to advise on
the appropriate choice of a base
for incorporating a NSAID for
• Pharmacists are can counsel
patients to ensure the appropriate
dose, storage and disposal of the
• Knowledge of the capability
of various Lipoderm bases to
– due to their resilience to
incorporation of high salt loads and
presenting a smooth, creamy touch,
resulting in an elegant appearance.
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