Capsaicin

Aka: Capsaicin, Zostrix

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II. Indications

  1. Peripheral Neuropathy (e.g. Postherpetic Neuralgia, Diabetic Neuropathy)
  2. Muscle pain or Joint Pain
  3. Cannabinoid Hyperemesis Syndrome (off label)

III. Mechanism

  1. Capsaicin is derived from chili peppers (genus Capsicum) such as jalapeno peppers
  2. Capsaicin is a Transient Receptor Potential Vanilloid 1 (TRPV1) Agonist
    1. TRPV1 activates cation channels on pain nerve fibers (nociceptive fibers)
    2. Nociceptive nerves depolarize, transmitting pain signal to the spinal cord
  3. Capsaicin depletes Substance P from pain fibers, desensitizing nerves and preventing pain transmission
    1. Requires frequent and repeat applications for effect
    2. Inconsistent use is not effective

IV. Dose: Capsaicin Cream (OTC)

  1. Neuropathic pain
    1. Apply Capsaicin cream as a thin film (0.025% to 0.075%) to affected area 3-4 times daily
  2. Cannabinoid Hyperemesis Syndrome (off label)
    1. Apply Capsaicin cream as a thin film (0.075%) to 15 x 25 cm periumbilical area every 4 hours until symptoms resolve

V. Dose: Capsaicin Patch (high dose - 8%)

  1. Applied in office
  2. Pre-treat area by applying 4% Lidocaine cream for 60 minutes
  3. Check area for Anesthesia following application
  4. Apply Capsaicin 8% cream with gloves and leave on for 60 minutes
  5. Wash off after 1 hour

VI. Adverse effects

  1. Local Irritation
    1. Erythema (63%)
    2. Burning Sensation (42%)
      1. Most significant on initial application
    3. Less commonly, Pruritus, edema and local swelling
  2. Increased pain for up to first week of application

VII. Precautions

  1. Wash hands thoroughly after Capsaicin application

VIII. Resources

  1. Capsaicin (PubChem)
    1. https://pubchem.ncbi.nlm.nih.gov/compound/Capsaicin

IX. References

  1. Chang and Quick (2019) Stat Pearls
    1. https://www.ncbi.nlm.nih.gov/books/NBK459168/
  2. Fattori (2016) Molecules 21(7): 844 +PMID:27367653 [PubMed]
    1. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6273101/

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Related Studies

Cost: Medications

capsaicin (on 12/21/2022 at Medicaid.Gov Survey of pharmacy drug pricing)
CAPSAICIN 0.025% CREAM Generic OTC $0.08 per gram
CAPSAICIN 0.075% CREAM Generic OTC $0.08 per gram
CAPSAICIN 0.1% CREAM Generic OTC $0.18 per gram
FPNotebook does not benefit financially from showing this medication data or their pharmacy links. This information is provided only to help medical providers and their patients see relative costs. Insurance plans negotiate lower medication prices with suppliers. Prices shown here are out of pocket, non-negotiated rates. See Needy Meds for financial assistance information. GoodRx is another tool for finding lower drug prices.

Ontology: Capsaicin (C0006931)

Definition (NCI_NCI-GLOSS) A component of certain plants, including cayenne and red pepper, used topically for peripheral nerve pain. Also being studied for controlling mucositis pain after chemotherapy and radiation therapy.
Definition (NCI) A chili pepper extract with analgesic properties. Capsaicin is a neuropeptide releasing agent selective for primary sensory peripheral neurons. Used topically, capsaicin aids in controlling peripheral nerve pain. This agent has been used experimentally to manipulate substance P and other tachykinins. In addition, capsaicin may be useful in controlling chemotherapy- and radiotherapy-induced mucositis.
Definition (NCI_CRCH) Capsaicinoid compound with side chain CO(CH2)4(CH)2CH(CH3)2. The chemical structure is CC(C)C=CCCCCC(=O)NCC1=CC(=C(C=C1)O)OC.
Definition (CSP) N-(4-hydroxy-3-methoxyphenylmethyl) -8-methyl-6-nonenamide; chili pepper extract and neuropeptide releasing agent selective for primary sensory peripheral neurons, used to experimentally manipulate substance P and other tachykinins, and as an analgesic for Herpes zoster infection.
Definition (MSH) An alkylamide found in CAPSICUM that acts at TRPV CATION CHANNELS.
Concepts Pharmacologic Substance (T121) , Lipid (T119)
MSH D002211
SnomedCT 400416009, 95995002
English 8-Methyl-N-Vanillyl-6-Nonenamide, Capsaicin, Capsaicine, 6-Nonenamide, N-((4-hydroxy-3-methoxyphenyl)methyl)-8-methyl-, (E)-, (E)-N-[(4-Hydroxy-3-methoxyphenyl)methyl]-8-methyl-6-nonenamide, N-(4-hydroxy-3-methoxyphenylmethyl) -8-Methyl-6-Nonenamide, 8 Methyl N Vanillyl 6 Nonenamide, CAPSAICIN, capsaicin, Capsaicin [Chemical/Ingredient], capsaicine, (E)-N-[(4-hydroxy-3-methoxy-phenyl)methyl]-8-methyl-non-6-enamide, Capsaicin (product), Capsaicin (substance)
Swedish Kapsaicin
Czech kapsaicin
Finnish Kapsaisiini
German Trans-8-Methyl-N-vanillyl- 6-nonensäureamid, Capsaicin
Russian KAPSAITSIN, КАПСАИЦИН
Japanese カプサイシン
French N-(4-Hydroxy-3-méthoxybenzyl)-8-méthylnon-6-énamide, 8-Méthyl-N-vanillyl-non-6-énamide, N-(4-Hydroxy-3-méthoxybenzyl)-8-méthyl-non-6-énamide, Capsaïcine
Croatian KAPSAICIN
Polish Kapsaicyna
Spanish capsaicina (producto), capsaicina (sustancia), capsaicina, Capsaicina
Italian Capsaicina
Portuguese Capsaicina
Derived from the NIH UMLS (Unified Medical Language System)

Ontology: Zostrix (C0308191)

Concepts Pharmacologic Substance (T121) , Organic Chemical (T109)
MSH D002211
English Zostrix Neuropathy, zostrix, Link Brand of Capsaicin, Medicis Brand of Capsaicin, Zostrix
Derived from the NIH UMLS (Unified Medical Language System)

Related Topics in Analgesic Medications

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