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Capsaicin belongs to the class of topical analgesics.
Capsaicin belongs to the class of topical analgesics. Capsaicin is a neuropeptide releasing agent selective for primary sensory peripheral neurons. Capsaicin aids in controlling peripheral nerve pain.
Pharmacological class: Topical Analgesic
Capsaicin works by first stimulating and then decreasing the intensity of pain signals in the body. Although pain may at first increase, it usually decreases after the first use. Capsaicin stimulates the release of a compound believed to be involved in communicating pain between the nerves in the spinal cord and other parts of the body.
Usual Adult Dose for Postherpetic Neuralgia
Up to 4 patches can be applied and allowed to remain in place for 30 minutes for the feet and 60 minutes for other locations
Usual Adult Dose for Pain
Not to be applied more than 3 to 4 times a day
There has been no published data from low-concentration formulations, but after 60 or 90 min capsaicin 8% patch treatments for painful peripheral neuropathy, plasma concentrations are also very low (with a population Cmax of 1.86 ng ml−1) and transient (mean elimination half-life of 1.64 h). The longer elimination half-life of topical capsaicin relative to oral exposure is likely to reflect its slow release from the skin at the patch application site.
Common (affecting between 1 in 10 to 1 in 100)
Uncommon (affecting 1 in 100 to 1 in 1000)
Very rare (affecting less than 1 in 10,000)
In a randomized double-blind multi-centre study, 281 patients suffering from chronic soft tissue pain were treated either with a cream containing capsaicin 0.05% (n = 140) or placebo (n = 141). Of these, 151 were excluded from the ITT analysis, as they had in addition to their soft-tissue pain, pain of other origin. The primary outcome measure was a positive treatment response, defined as a pain sum score reduction of 30% or more. After 3 weeks of treatment, median pain sum score had decreased by 49% (capsicum group) and 23% (placebo group) (ITT analysis, p = 0.0006). The odds ratio of the responders in favor for capsaicin was 4.3 (CI 97.5% lower limit 1.9, p < 0.0001). Improvements in secondary efficacy measures confirmed the results. Likewise, all outcome measures had significantly more improved in the capsaicin compared with the placebo chronic back pain sufferers. All patients were included in the safety assessments. More adverse events occurred in the capsicum group (n = 13) than in the placebo group (n = 6). The capsaicin cream was generally well tolerated. The results indicate that capsaicin cream is useful in patients with chronic soft tissue pain and is also efficacious in patients with chronic back pain for which effectiveness has been demonstrated in earlier clinical trials.1
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