Topical analgesics including creams, lotions, gels, or patches, are one avenue for pain relief that are available both over-the-counter (OTC) for mild to moderate pain and can be prescribed for more severe pain conditions. Topical analgesics are particularly attractive due to low side effect profiles with reduced risk for abuse and addiction properties as compared to oral opioids. Amitriptyline (1–5%) is a tricyclic antidepressant commonly used in compounded topical analgesics. Amitriptyline is used both topically and orally off-label for neuropathic pain conditions, PHN, PDN, postsurgical neuropathic pain, CRPS, chemotherapy-induced neuropathy, migraine prophylaxis, and musculoskeletal pain.