Topical & Transdermal Therapies

Topical

Peripheral tissue activity
Systemic side effects less likely
If analgesic, applied directly over painful site
Insignificant serum levels


Transdermal
Systemic activity
Potential for adverse effects
If analgesic, may be applied away from painful site
Serum levels necessary for effect

Medications that relieve pain, reduce inflammation, and relax muscles can have side effects that are detrimental to athletic performance, such as drowsiness. However, when these medications are administered topically, the therapeutic benefit can be enhanced while significantly reducing the risk of adverse effects.

For example, research has shown that topically-applied ketoprofen provides a high local concentration of drug below the site of application but decreases systemic exposure and significantly reduces the risk of gastrointestinal upset or bleeding. When properly compounded into an appropriate base, tissue concentrations of ketoprofen were found to be 100-fold greater below the application site (knee) compared to systemic concentrations. Muscle relaxants can be similarly prepared to minimize the risk of drowsiness.
A symposium held during the 93rd Annual Congress of the Italian Society of Orthopedics and Traumatology (SIOT) in Rome, Italy in November 2008, noted that topical anti-inflammatory therapy is a promising therapeutic strategy in the treatment of muscle strains, since it provides local analgesic and anti-inflammatory effects while minimizing systemic adverse events.

Adv Ther. 2009 Dec;26(12):1072-83. Epub 2010 Feb 4.
New therapeutic approaches for management of sport-induced muscle strains.
De Carli A et al.
Click here to access the PubMed abstract of this article.