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Pain relief without pills

A topical cream containing an ibuprofen-like ingredient may avoid problems associated with oral medication.

August 04, 2003|Jane E. Allen | Times Staff Writer

Weekend warriors often need a way to combat the pain, swelling and inflammation that comes with overdoing it, but common pain relievers can cause stomach irritation and ulcers.

Now, a topical cream containing ketoprofen, a chemical cousin of ibuprofen (Advil), has been found to decrease the common muscle soreness that peaks a day or two after exercise, without stomach discomfort.

Because the medication is applied directly to the aching area, rather than released into the bloodstream, the cream might prevent potential damage to the kidneys and liver.

Oral non-steroidal anti-inflammatories such as ketoprofen (Orudis) are the most commonly used medications in the world.

Although such creams are sold in other countries, they're not commercially available in the United States -- with the exception of aspirin creams. Some Americans obtain them overseas or through U.S. doctors who prescribe topical versions of ketoprofen, ibuprofen, naproxen, indomethicin and diclofenac, which must be custom-made by compounding pharmacies.

Dr. Jeffrey Abrams, director of product development for Trans-Pharma Pharmaceutical Co., a small firm in San Diego, and researchers from UC San Diego tested the company's patented cream on 32 men, ages 18 to 35, in a small, preliminary study. (Women were excluded to avoid any pregnancy or fertility complications.)

The men were put through vigorous leg exercises designed to elicit sore thigh muscles. Then they were given either ketoprofen cream or a placebo to rub three times a day into their quadriceps muscles. Each dose was the equivalent of a 250-milligram ketoprofen pill. (A standard dose of ibuprofen is 200 milligrams).

Two days later, according to a manufacturer-sponsored study published in the July issue of the quarterly Clinical Journal of Sport Medicine, those men given the medication reported 37% to 45% less discomfort than those given the unmedicated cream. Blood testing showed that less than 1% of the medication was absorbed into their bloodstreams.

Abrams said if results hold up in larger clinical trials, the ketoprofen cream should work not just for soft-tissue inflammation but also for pain in knees, wrists and fingers, because the medication passes into joint fluid.

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