ABSTRACT
Cyclobenzaprine, a chemical closely related to the antidepressant amitriptyline, is a centrally acting skeletal muscle relaxant with antidepressant activity. It is indicated for use as an adjunct to rest and physical therapy for relief of muscle spasm associated with acute, painful musculoskeletal conditions. A 39-year-old man with degenerative disc disease complicated by cervical radiculopathy was treated topically with a compounded pain medication containing ketamine 10%, diclofenac 5%, baclofen 2%, bupivacaine 1%, cyclobenzaprine 2%, gabapentin 6%, ibuprofen 3%, and pentoxifylline 3% in a cream base. The patient benefitted from substantial pain relief, but after several weeks of use, he developed an itchy rash at the site of application. The topical compounded formulation without cyclobenzaprine was subsequently well tolerated by the patient.
