Topical or Systemic? The Road Ahead for Pain Management

(DGIwire) – There are several routes for delivering pain medication to patients. Two of the most important are the topical or transdermal route (in which a drug is placed directly on the skin and absorbed into the bloodstream) and the systemic route (in which a drug is taken orally). Which of these two options might be favored by doctors and patients in the future, and why?

One type of problem with systemic treatments such as opioids is the potential for side effects that their use can entail. These side effects can include opioid-induced constipation, sedation and physical dependence, as well as nausea, dizziness and respiratory depression, according to a recent article in the American Journal of Managed Care.

In contrast, topical and transdermal treatments for local pain typically can have a much better safety profile. Specifically, local administration of a drug comes with a significantly reduced risk of addiction compared to the oral route, as noted in a recent article in the journal Molecules. Topical and transdermal pain medications also hold advantages for those patients who are unable to take drugs orally.

“During an era of heightened awareness regarding the risks of opioid addiction, there has been a burgeoning interest in the benefits of topical and transdermal drug delivery in the pain space,” says Tony Mack, CEO of Virpax Pharmaceuticals. “Given their comparative benefits over systemic treatments, it is likely that this work will continue.”

Virpax is seeking to become a pioneer in this endeavor. Through Tony’s leadership, the company is studying the use of new transdermal and topical drug delivery systems to advance how patients and physicians are able to manage pain without opioids. For example, the company has licensed a patented aerosol-based system—which it has dubbed a “Patch-in-a-Can®”—that is designed to deliver non-opioids such as NSAIDs for the topical treatment of acute pain in a metered-dose spray.

Thinner than a standard liquid bandage, the aerosol spray is invisible and dries on the skin. It can be configured for an immediate-release or extended formulation, so a drug can be delivered either at once or over a span of time that can range from 12 to 48 hours. As a spray, this formulation manages to avoid the mess of creams or gels that can be rubbed off by clothing or physical contact.

“Among all the fascinating innovations in pain management, the steady transition from systemic to topical and transdermal approaches could prove among the most significant for pain patients and the doctors charged with overseeing their care,” Mack adds.

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