I have been unable to find topical NSAIDs. The code which seems appropriate, 21506167, “NSAID Analgesic & Topical Irritant Counter-Irritant Combinations”, brings up NSAIDs in tablet and other PO forms. Is there an error in my vocabulary files or am I looking at the wrong category?
You are right. It looks fishy. But that’s what we got from FDB:
The 21506167 links to drug products in GCN_SEQNO, their equivalent to RxNorm:
45721367 NAPROXEN/IRRITANTS COUNTER-IRRITANTS COMBINATION #2 500 mg MISCELL KIT
45727001 IBUPROFEN/IRRITANTS COUNTER-IRRITANTS COMBINATION #2 800 mg MISCELL KIT
45727163 MELOXICAM/IRRITANTS COUNTER-IRRITANTS COMBINATION NO.2 15 mg MISCELL KIT
These are mapped to the following RxNorm:
19019273 Naproxen 500 MG Oral Tablet
19019074 Ibuprofen 800 MG Oral Tablet
1150347 meloxicam 15 MG Oral Tablet
So, it seems the combination consists of an NSAID (definitely not topical, it is water soluble and wouldn’t work that way) and a anti-irritant cream or so. No idea where the latter went. But the problem seems on FDB’s side. We could talk to them, if you like.
Thank you.
I spoke with two of my colleagues, a pharmacist and a physician, for examples of the"Topical NSAIDs" for which I should be looking.
Here’s what I was told:
Voltaren (diclofenac) gel, Ketoralac gel,Salicylic acid, Ibuprofen, Piroxicam, and Indomethacin have all been described, but not sure other than salicylic acid, diclofenac and ketorolac are commercially available and perhaps not even the Ketorolac one is still made commercially. They are often compounded by pharmacies.
As Voltaren (diclofenac) gel is apparently the most common of the products which do not require compounding, I will take a look and see how it is classified. Not a critical issue now. I can omit it from my preliminary exploration.