Capsaicin 0.025% topical

Indications

Capsaicin 0.025% topical is used for: Rheumatoid arthritis, Osteoarthritis, Psoriasis, Post-herpetic neuralgia, Anogenital pruritus, Sprains, Stiff neck, Low back pain, Trigeminal neuralgia, Spondylitis, Peripheral neuralgias:, Diabetic neuropathy, Post-surgical pains

Adult Dose

Apply to affected area three/four times daily for 3-4 consecutive weeks and evaluate efficacy; efficacy decreased if used < 3 times daily; not to exceed 4 applications/day;

Child Dose

Safety & efficacy not established

Renal Dose

Administration

Apply a thin film of Capsaicin cream to affected area. A burning sensation may occur upon application, but generally disappears with regular use. Wash hands with soap and water after applying.

Contra Indications

Capsaicin cream is contraindicated for use on broken or irritated skin or known hypersensitivity to this medication.

Precautions

Capsaicin cream should not be applied to broken or irritated skin. Applied area should not be tightly bandaged. Do not get on mucous membranes and into eyes or on contact lenses. If this occurs, rinse the affected area thoroughly with water. Do not apply the cream on the heat treated area as this may increase the burning sensation. Lactation: Unknown whether distributed in breast milk; do not apply to nipple or areola

Pregnancy-Lactation

Pregnancy Category: B Lactation: Unknown whether distributed in breast milk; do not apply to nipple or areola

Interactions

Capsaicin, including topical use, may cause or exacerbate coughing associated with ACE inhibitor treatment and vice versa. If a severe cough develops in patients taking an ACE inhibitor and using capsaicin, 1 or both drugs may need to be discontinued.

Adverse Effects

Side effects of Capsaicin 0.025% topical : >10% Transient increased pain at application site (dissipates w/ continued use), Application site erythema (63%), Pain (42%) 1-10% Nausea (5%), Vomiting (3%), Hypertension (2%), Dryness (2%), Swelling (2%), Pruritus (6%), Papules (6%), Edema (4%), Sinusitis (3%), Bronchitis (2%) <1% Exfoliation, Dizziness, Cough, Skin odor, Headache, Dysguesia

Mechanism of Action

Transient receptor potential vanilloid-1 (TRPV1) agonist; topical application causes initial TRPV1 stimulation that may cause pain, followed by pain relief by reduction in TRPV1-expressing nociceptive nerve endings